(Flushing away the fat) BMJ Volume 317, 26 September 1998, p.830-1
Thirteen per cent of men and sixteen per cent of women in the UK are obese. Obesity is a serious disease which predisposes people to problems such as heart disease, hypertension, stroke, diabetes and osteoarthritis. It accounts for two to seven per cent of total health care costs and a substantial proportion of disability pensions.
In this week's BMJ John Garrow, a former Professor of Human Nutrition, notes that there have been misplaced claims that the new obesity drug orlistat, will enable fat people to eat what they like and still lose weight. He stresses that this is highly misleading and that anyone taking orlistat who eats a high fat diet will receive a powerful incentive to reduce their fat intake (owing to foul smelling, fatty stools).
Garrow explains that orlistat works by causing 30 per cent of dietary fat to be excreted in faeces rather than being digested. But he claims that over half of the weight loss achieved in patients taking the drug is down to changes in diet and he believes that similar rates of weight loss could be achieved with well supervised outpatient dieting whereby energy intake is reduced.
The author highlights the potential irony if orlistat succeeds in its aims by exactly the action which it was said not to have - by inducing obese people to keep to a low fat reducing diet, because the side-effects of having a high-fat intake are so unpleasant!
Contact:
Professor John Garrow
Carolyn Summerbell, Principal Lecturer in Human Nutrition, School of Health, University of Teeside, Newcastle