Comparative Efficacy and Safety of Apple Cider Vinegar Versus Orlistat in reducing Weight and improving aspects of Metabolic Parameters in Overweight and Obese Individuals: A Pilot Trial in Sulaimani City

Volume 15 , Issue 2 , December 2025 , Pages 173-182

Authors

Sima Soran Hama Ali 1 ; Taha Othman Asaad Mahwi 2

1 Clinical science branch, college of medicine, university of Sulaimani

2 Clinical Science Branch university of Suleimani college of medicine

DOI logo 10.17656/jsmc.10501

Keywords

Abstract

Background and Objectives: Obesity is a major public health concern, and effective, safe interventions are needed. This study aimed to compare the efficacy and safety of apple cider vinegar (ACV) and orlistat, alone and in combination, for weight loss and metabolic improvement in overweight and obese adults in Sulaymaniyah, Kurdistan region.

Methods: In this randomized controlled trial, 183 adults (BMI ≥25 kg/m²) were allocated to orlistat, ACV, or combined therapy all alongside a standardized balanced diet from September 2024 to April 2025. Baseline and post-intervention assessments included anthropometric measurements (weight, BMI, percent body fat, visceral fat, waist-hip ratio), metabolic markers (lipid profile), and adverse events.

Results: All groups showed significant reductions in weight, BMI, PBF, VF, CHOL, TGS, LDL, and WHR post-intervention (p ≤ 0.001). Orlistat uniquely increased HDL (44.4 ± 10.5 to 92.6 ± 24.5, p ≤ 0.001) and reduced LDL (109.4 ± 32.8 to 48.0 ± 9.4, p ≤ 0.001). Post-intervention, HDL and LDL levels varied markedly across groups (p ≤ 0.001). Adverse events included constipation (Vinegar: 15 cases; Combine: 14 cases) and decreased appetite (Orlistat: 20 cases).

Conclusion & Recommendation: ACV is an effective, low-cost intervention for weight loss and metabolic health, with superior safety compared to orlistat. While combination therapy enhanced BMI reduction, it increased gastrointestinal adverse effects. ACV represents a viable adjunct for obesity management in similar populations; larger long-term studies are needed to confirm these findings.

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  • First online21 December 2025
  • Published at21 December 2025

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