The Skinny on Orlistat
What is it?
The FDA approved Orlistat (brand name Xenical) in May 1997 as
a prescription medication to help people lose weight and, as a
result of this weight loss, to decrease other health risks.
Hoffmann-La Roche Inc. has recently released it onto the market.
Orlistat is the first member of a new group of weight loss pills
called lipase inhibitors. Lipase inhibitors act in the gastrointestinal
tract to block the absorption of fat by inhibiting pancreatic
enzymes, and not by interfering in any way with brain chemistry.
Orlistat blocks fat absorption by about 30%.
What's the evidence? Is it effective?
Prior to its release of Orlistat onto the market, Hoffmann-La Roche
conducted a yearlong study to collect data on the weight loss
effectiveness and safety of the drug. This study consisted of two
groups of people, one a control/placebo group, the other a
treatment group. The placebo group took a pill that did not contain
any Orlistat, but they were not told whether or not their pill
contained the drug. The treatment group received a pill that did
contain Orlistat, but they also were not told which pill they were
taking. Both the placebo and treatment groups were put on a diet
of slightly lower calories. 4,000 patients were involved in this study
and each took 120mg capsules of Xenical three times a day while
at the same time dieting.
The placebo group showed weight loss of approximately 5% of
their body weight, while the treatment group (i.e. those who
received Xenical) exhibited weight loss of approximately 10% of
their body weight. Typically, patients in this study weighed an
average of 220 pounds initially and lost about 20 pounds over the
course of the treatment. According to the company, many, but not
all, of the patients who remained with the study into a second year
were able to keep off the weight they lost in the first year.
Another study performed recently was designed to determine the
usefulness of Orlistat in weight reduction in an effort to decrease
the risk of cardiovascular disease in obese patients. The
parameters for this study were much like those in the Hoffmann-La
Roche study. After one year, patients who took Orlistat (120mg
capsules) three times a day lost an average of 9.2% of their body
weight, while placebo patients lost 5.8%. It is apparent that Orlistat
did cause increased weight loss in the treatment group, but not by
a very large margin. This study did, however, indicate that patients
who took Orlistat regularly exhibited improvements in total
cholesterol, LDL, triglycerides, glucose tolerance, and blood
pressure, all of which are known risk factors for cardiovascular
Side effects of Orlistat mostly included gastrointestinal problems
such as oily, loose stools, much like the side effects experienced
by patients taking Olean (brand name Olestra). Hoffmann-La
Roche says that the less fat one ingests while taking Orlistat, the
less gastrointestinal problems one should experience. Orlistat may
in effect function to "train" patients to eat less fatty foods due to the
unpleasant side effects they experience when they eat fatty foods.
The FDA has recommended that patients who take Orlistat should
also take supplementary vitamins, especially Vitamin D. The
non-absorptive properties of Orlistat can effect not only fat, but also
Is it worth it?
We've all heard the old adage, "No pain, no gain." Usually, this
refers to exercise; if you don't feel the pain, you aren't working hard
enough. Here, it could take on a different meaning. You won't be
able to lose any weight without some pain. Is it worth it to go
through the misery of the unpleasant (to say the least) side effects
of Orlistat just to lose a few pounds? All the studies showed that
Orlistat helps most when in conjunction with dieting and that the
side effects were less pronounced when fat intake was lowered.
Wouldn't it just be easier to lower the amount of fat in your diet and
avoid any Orlistat-induced side effects? You can check out what
others have had to say about it at the Olestra/Olean Haiku page.