BMJ, doi: 10.1136/bmj.39385.347049.80, (Published 15 November 2007)

Editorials

Orlistat over the counter

Has a minimal effect on obesity and is no substitute for a healthy lifestyle

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

Orlistat (Xenical, Roche) is one of a handful of antiobesity drugs that, when used appropriately, can cause significant weight loss with acceptable safety.¹ It inhibits the gut lipases that hydrolyse ingested triglyceride (which constitutes almost all dietary fat) and decreases the absorption of lipid, which is the most energy dense nutrient. In clinical trials, such as those included in a systematic review by Rucker and colleagues (see bmj.com), up to a third of obese people taking the standard therapeutic dosage (120 mg three times daily) lost at least 10% of their initial weight.¹ This is the threshold value that is generally assumed to confer clinically important reductions in the metabolic and cardiovascular risks associated with obesity.²

The drug acts only in the gut lumen and—apart from potential deficiencies of fat soluble vitamins with chronic use—it seems to be safe. The main side effect is steatorrhoea (excess fat in the faeces), . . . [Full text of this article]

Faculty of Medicine and Dentistry, University of Bristol, Bristol BS2 8DZ

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This article has been cited by other articles:

• Mozley, C. (2008). People should be free to spend their money as they wish. BMJ 336: 7-7 [Full text]  
• Connery, T. P (2008). Is it worth it?. BMJ 336: 7-7 [Full text]  

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