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Fat Drug No Easy Weight-Loss Cure

Posted on: Friday, 3 February 2006, 12:00 CST

By Lisa Ryckman

A fat-blocking drug called orlistat, currently sold as the prescription drug Xenical, is poised to become the first such substance approved by the U.S. Food and Drug Administration for over- the-counter sales. It's not magic, experts say, but it might help improve the health of a country that appears to be getting fatter every day.

"I think because obesity is such a complex problem, the more effective tools you have in the shed, the more likely you are to have a solution," says Roberta Anding, a registered dietitian and spokeswoman for the American Dietetic Association. "At least with Xenical, the medication has gone through FDA approval. We know the pros and cons."

The drug works by blocking digestion of about 30 percent of the fat in your food. Over six months, people who used the drug lost four to six pounds.

That doesn't sound like much of a difference, but some experts say every little bit helps.

"It has a fairly modest effect, but at the end of the day, we need more tools like this one to help people achieve and maintain weight loss," says Dr. Jim Hill, director of the Center for Human Nutrition at the University of Colorado Health Sciences Center.

The drug is supposed to be used for only six months in conjunction with a reduced-fat diet and exercise.

According to orlistat's maker, Hoffman-LaRoche, common side effects include "gas with oily discharge, an increased number of bowel movements, an urgent need to have them and an inability to control them, particularly after meals containing higher amounts of fat than are recommended."

Efficacy notwithstanding, orlistat has a good track record in terms of safety, Hill says.

"The bottom line is, look at what's out there for weight loss. There are some really, really scary products," he says. "This one is not very scary."

Hill says he thinks orlistat is unlikely to be abused, but FDA adviser Dr. Ruth Parker, a professor at Emory University's School of Medicine, expressed concern that the drug would be misused by teenagers.

There are reasons to worry. In a University of Michigan survey, 58 percent of 737 girls ages 11 to 19 thought they should lose weight, and only 14 percent were happy with their bodies. More than 60 percent said they dieted with varying frequency. And most disturbing of all, nearly 25 percent had purchased diet pills.

Anding, who works with kids at Texas Children's Hospital in Houston, said most adolescents would be put off by the drug's side effects.

"If you don't follow the diet and reduce fat intake, you can have oil leakage," she says. "You're not a fun date."

Text of fax box follows:

Comparison

The three prescription drugs approved for obesity are designed to be used with a reduced-calorie diet, exercise and behavior modification.

Xenical (orlistat)

Blocks about 30 percent of dietary fat from being absorbed.

Pros: Effects limited to the digestive tract. In studies, weight loss was four to six pounds more than with a placebo.

Cons: Side effects include gas with oily discharge, more bowel movements, bowel urgency and loss of control. Study participants who stopped using the drug regained all lost weight.

Phentermine

A nervous-system stimulant similar to amphetamine, it increases heart rate and blood pressure and suppresses appetite. It was half of the "fen-phen" combination.

Pros: Modestly increases weight loss when combined with reduced- calorie diets.

Cons: Can cause nervousness, anxiety, dry mouth, dizziness, diarrhea, changes in sex drive. Habit-forming; requires gradual weaning to avoid withdrawal symptoms.

Meridia (sibutramine)

Controls eating by sending a signal of fullness to the brain.

Pros: Studies have shown that Meridia, along with a reduced- calorie diet and exercise, helped patients lose weight and maintain weight loss for up to two years.

Cons: Can increase blood pressure and heart rate; possible link to cardiovascular deaths.

Source: Cincinnati Post

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