Fed: fear of flatulence forces fat loss with new pill

AAP General News (Australia)
04-26-2000
Fed: fear of flatulence forces fat loss with new pill

By Rada Rouse, National Medical Correspondent

BRISBANE, April 26 AAP - An anti-obesity drug which gives patients wind and diarrhoea
if they eat too much fat went on the market today.

The prescription drug orlistat, marketed as Xenical, is the first to work by stopping
the absorption of fat rather than suppressing appetite like most "slimming" pills, Dr
Sharon Marks said.

Dr Marks, consultant physician in clinical nutrition at Melbourne's Monash medical
Centre, said orlistat was only for seriously overweight individuals and offered a fresh
option for people who had no success with amphetamine-based slimming drugs.

These included patients diagnosed as obese, with a body mass index (BMI) over 30, and
those who were overweight (BMI over 27) and who also had another risk factor such as diabetes,
high cholesterol or hypertension.

"It's important to see this drug as a medical intervention," Dr Marks said.

"But just as in any weight loss program if you don't make lifestyle changes you will
put the weight back on when you stop the drug."

Orlistat "encourages" patients to reduce their dietary fat intake by repaying over-indulgence
with temporary gastrointestinal side-effects including diarrhoea, stomach cramps and flatulence.

In Australia around 800 patients have trialled the drug with fewer than three per cent
dropping out.

Dr Marks said no more than 60g of fat could be consumed in a day, and this had to be
spread over three meals which were accompanied by the orlistat tablets.

One-third of the fat eaten was excreted by the body without being absorbed but with
no ill-effects unless the limit was exceeded.

Orlistat works by inhibiting an enzyme in the stomach which digests fat.

Patients prescribed orlistat would be assisted to make permanent lifestyle and diet
changes by enrolling in a program offering counselling by a dietician.

Dr Marks said education was an important part of a weight reduction plan.

"Many of my patients believe that `lite' olive oil is good for you or think that nuts
are a good alternative without realising that they have to decrease their total consumption
of fats," she said.

A clinical trial of orlistat showed that 39 per cent of people taking the drug and
dieting were able to reduce their weight by more than ten per cent. This compared with
18 per cent of people who made dietary changes only.

Trials have shown that taking the drug and changing the diet not only drops weight
but reduces cholesterol levels and high blood pressure.

It will sell for $140 for a month's supply.

Information provided by the manufacturer, Roche, showed that in New Zealand, 65 per
cent of patients enrolled in the Xenical weight management program were still taking the
drug and adhering to lifestyle changes at four to six months.

AAP rr/jhm/rsm

KEYWORD: OBESITY

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