Word: orlistat
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Dates: during 1993-1993
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...most interesting thing about orlistat is the way it works. It targets a pair of key enzymes in the digestive tract and by blocking their action neatly thwarts one of the body's most basic functions: the breakdown and utilization of dietary fat. Most of the fat we eat is too . . . well, fat to be absorbed by the body. Before it can pass through the walls of the intestine into the bloodstream, each fat molecule must be split into its constituent parts: three fatty acids and the glycerol backbone to which they are attached. That...
...Orlistat, taken three times a day, inhibits fatty buildup but does not completely prevent the enzymes from doing their job. According to Dr. Jonathan Hauptman, director of therapeutic research at Hoffmann-La Roche, the body produces lipase in such quantities that the drug is only about 30% effective, no matter how much of it you ingest. If you took a dose of orlistat and then ate 100 grams of fat (roughly four Big Macs), 70 of those grams would be absorbed as usual and 30 grams would pass, undigested, through the intestine...
That was enough, in a recent test, for 100 Americans on a light diet to lose an average of 11 lbs. in three months -- nearly twice as much as control subjects, who were on the same moderate eating regime but were given a placebo. The group taking the orlistat did experience minor but unpleasant side effects, including greasier stools and some diarrhea. It is not known how many of those people gained back the weight they had lost as soon as the trial was over. An ambitious two-year study, involving 4,000 subjects from Europe...
Even if all goes well, it could be years before orlistat gets FDA approval and goes on sale -- by prescription. Researchers warn that it has proved effective only when accompanied by significant changes in diet and exercise and just for a few months. It remains to be seen whether patients will have to stay on the drug indefinitely to maintain their weight loss, and whether some will undo the drug's modest benefits by eating more...
Given the uncertainties -- and the hefty premium Hoffmann-La Roche can be expected to charge for any new diet pill -- medical experts say that use of orlistat should generally be limited to those who need it most. Candidates would include the tens of millions of people who suffer from chronic, intractable obesity and the millions more who are only a few binges away from that plight...