5 Feb 2010 --- A low-carbohydrate diet appears to be associated with substantial weight loss similar to that produced by a combination of the weight-loss drug orlistat and a low-fat diet, but may be more effective in reducing blood pressure. William S. Yancy Jr., M.D., M.H.S., and colleagues at the Department of Veterans Affairs Medical Center and Duke University Medical Center, Durham, N.C., examined body weight, metabolic and adverse effects in obese or overweight outpatients ages 18 to 70 who were randomly assigned to one therapy or the other for 48 weeks.

Of the participants, 57 in the low-carb diet group and 65 in the orlistat and low-fat diet group completed the study. Weight loss was similar for both groups (an average of 8.5 percent to 9.5 percent of body weight), but the low-carb diet resulted in greater reductions to systolic (top number) and diastolic (bottom number) blood pressures. High-density lipoprotein cholesterol and triglyceride levels improved similarly in both groups.

"In conclusion, the low-carbohydrate ketogenic diet and the orlistat plus low-fat diet were equally effective for weight loss and several cardiovascular disease risk factors, although the low-carbohydrate diet was more effective for lowering blood pressure," the authors conclude. "Efforts should be made to incorporate similarly intensive weight loss programs into medical practice."