Is it worth it?

doi:10.1136/bmj.39434.694421.3A

BMJ 2008;336:7 (5 January), doi:10.1136/bmj.39434.694421.3A

Letters

Orlistat over the counter

Is it worth it?

The first 150 words of the full text of this article appear below.

Stung by recent criticism that general practitioners were failing,among other things, to contribute to the thinning of the nationby not prescribing enough orlistat,¹ I carried out a brief auditof the patients for whom we had, in our practice, prescribedthis drug over the previous three and a half years.

Fifty two patients lost 172 kg between them. Totalling up thecost of their prescriptions this worked out at a price of £74.34per kilogram lost. Some of them actually put on weight whilethey were taking orlistat, and at least 12 put on substantialamounts of weight when they came off it. It is acknowledgedthat this audit was small and had many limitations, but it confirmedour gut feeling that merely prescribing medication is not theanswer to the obesity epidemic, as Gareth Williams says in hiseditorial.¹ Most of these patients needed to lose at . . . [Full text of this article]