Word: orlistat
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...good news is that orlistat is flushed out of the body too: less than 1% of the drug remains in the system. Perhaps as a consequence, the only documented side effects--caused by excess fat coursing through the colon--are flatulence, greasy stools and, in a few cases, oily anal leakage...
That's one reason orlistat users are supposed to change their eating habits. If someone takes it without also switching to a low-fat diet, says Dr. Michael Hamilton, director of Duke University's Diet and Fitness Center, "that person is going to have a rude awakening...
Beyond that, orlistat isn't dramatically effective by itself. All the patients in the double-blind study went on strict eating regimens and exercise programs. Half of them were given orlistat, and half got an inert placebo. While those in the orlistat group lost an average of 10% of their initial weight after six months, the folks on the sugar pills lost nearly as much--a not inconsiderable...
That's not enough of a difference to justify putting orlistat on the market, says Dr. Jules Hirsch, an obesity expert at Rockefeller University and a member of the FDA advisory panel that evaluated the drug. Hirsch voted against approval. "We're talking about something that will take a little bit of weight off--a little more than a placebo--for a few years," he says, "but that will not make obesity vanish. The question is, How valuable is that...
...itself, not all that valuable. Ideally, says St. Luke's Heymsfield, doctors should first urge obese patients to change their diet and start exercising regularly. If they still can't lose weight, he would add orlistat to the mix. Another possibility, suggests Duke's Hamilton, is to use orlistat with an appetite suppressant. The value of this new drug, says Heymsfield, is that it adds to the available anti-obesity therapies and lets doctors tailor the treatment to a patient's needs. "I don't see Xenical as something to displace one or another of the currently available drugs...