May experience adverse side effects
This is sort of oldish news, but the FDA approved an over the counter form of Xenical/Orlistat last week. Called Alli (I'm assuming this should be pronounced like "ally" and not like "Muhammed Ali"), it will be available this summer.
I've taken Orlistat. The upside? I lost about 35 pounds over the course of six months. The downside? There are definitely some crazy side effects, such as almost shitting oneself after a particularly rich meal (and by "almost" I mean "yes"), not to mention the fact that the drug also discourages the absorption fat-soluable vitamins and my hair started falling out at an alarming rate.
The real reason that I quit, though, is that once I calculated the cost of each pill (my insurance didn't cover it) I was always mentally bargaining: did an Egg McMuffin, which only has 7 WW points, have enough fat in it to justify a pill or should I save the $2 capsule so I can have a Whopper for lunch? I decided that I was treating it like a "get out of jail free" card when it came to calories and it wasn't a healthy balance, so I stopped taking it.
Is this method a wise choice for reasonable weight reduction? Do the side effects mean nothing if you can indulge and still lose weight? Will we start seeing models shopping in the Depends aisle?
I've taken Orlistat. The upside? I lost about 35 pounds over the course of six months. The downside? There are definitely some crazy side effects, such as almost shitting oneself after a particularly rich meal (and by "almost" I mean "yes"), not to mention the fact that the drug also discourages the absorption fat-soluable vitamins and my hair started falling out at an alarming rate.
The real reason that I quit, though, is that once I calculated the cost of each pill (my insurance didn't cover it) I was always mentally bargaining: did an Egg McMuffin, which only has 7 WW points, have enough fat in it to justify a pill or should I save the $2 capsule so I can have a Whopper for lunch? I decided that I was treating it like a "get out of jail free" card when it came to calories and it wasn't a healthy balance, so I stopped taking it.
Is this method a wise choice for reasonable weight reduction? Do the side effects mean nothing if you can indulge and still lose weight? Will we start seeing models shopping in the Depends aisle?
14 Comments:
This really bothers me, especially in light of the fight it took to get emergency contraception approved for OTC use (which, in fact, is still a struggle in many parts of the country). I think there is far more potential risk of girls getting a hold of Alli and abusing it—and with far graver consequences.
I have tried various meds (OTC) and have always stopped taking them b/c of the side effects. As much as I hate being fat (and knowing the increased medical risks that being fat brings), there was always that thought in the back of my mind, "is getting skinny really worth dying for?". Look at the FenPhen debacle.
This also makes me think of the AnnaNicole situation. I have no doubt that her death will be linked to some drug. Illegal or legal....most likely a combination. I can't help but think that, if she was still taking TrimSpa, the combination of that with other drugs could very easily have played a role in her death.
I know that having a poor diet, sedentary lifestyle, and being fat can cause death. But I really don't think that taking some weight loss drug is the answer. If anything, it will probably put us more at risk (overtaxing our hearts, which may already be under strain due to lifestyle choices).
How on earth can losing hair or defecating on yourself be considered an acceptable solution????
I think we had a discussion about this here a few months ago when the FDA first considered Orlistat's application to be available OTC.
Anyway, as OTC drugs go, Orlistat seems to be one of the more benign ones. It does not affect your heart, it simply prevents your body from absorbing some of the fat you eat. The most "dangerous" side effect of this drug is vitamin deficiency, but that is something that takes a long time to develop, presents with obvious symptoms, and is totally reversible (and part of the labelling requirement for the drug will say that it has to be taken with a multivitamin). As for the GI side effects, those are embarrassing, but not dangerous. They can also be avoided by not eating very fatty foods, which is what the drug's manufacturers advise.
The drug is also not an abuse risk for anorexics, because if you're eating virtually no fat to start with (as anorexics do) the drug isn't going to do anything for you.
I know defecating yourself is not dangerous but what about life quality?
Being fat also affects your life quality, be it by medical issues or by societal ones, but the poop issue is just too high a price to pay in my opinion.
I heard an NPR story about Orlistat recently, and it said that the side effects are minimized if you eat a low-fat diet anyway. So one of the drug's effects is to make you feel crappy (Ha) if you eat rich food. From my totally un-scientific perspective, it seems like a lot of medical weight-loss "treatments" work that way- even with surgeries, the primary effect is less food absorption, but the secondary effect is that it makes you feel bad if you eat too much. Is that really progress? Is it really a long-term solution? It sounds like a physical form of guilt to me.
Attn blog owner. Thank you for providing a safe place to be big. I want to get to know you guys/girls better and will try to post again soon. My name is Tammie I am 5' tall and shaped like a pepsi bottle (the old glass ones). I have a hard time loosing weight and an even harder time finding jeans that are short enough and not petite. I am not comfortable in my size but current physical limitations are keeping me overweight, a car accident. I really see no other option but GBS for weight loss. I don't want to do a RNY but thats all my ins. will pay for. I would prefer the Lapband. Anyway... it's late and I have to sleep.
thanks for listening and sharing.
Thanks, Tammie, and welcome!
I lost 90 pounds by taking Xenical, sticking to a low-fat diet and working out. As Jen said, the side effects are not dangerous. You can counter the loss of the fat-soluble vitamins A, D, E and K with a good multivitamin.
As for the side effects, they usually last only for the first 4-6 weeks (4 weeks for me). You will only poop yourself if you eat fatty food.
Xenical is only a crutch, not a magic bullet. But looking back, it helped me to keep steadily losing weight until I developed better eating habits and a love of exercise. If I hadn't been taking Xenical, I'm sure I would have given up at the first sign of a stall.
I can't understand why people pooh-pooh Xenical (pun intended!) yet think WLS is a better alternative.
Susan, sounds like it really worked for you. I don't see anyone here suggesting WLS instead of Xenical, so I assume you mean generally? In that case you make a good point, and I was actually thinking about this yesterday. I was reading about the side-effects of WLS and a lot of it seems to be the same kind of negative reinforcement--if you eat unhealthily, it will have bad/painful/uncomfortable physical consequences. I can definitely imagine Xenical being Plan A before WLS is tried. But as galnoir said, the problem with OTC Xenical is that it can be abused and now does not require any sort of medical supervision. Whereas of course WLS is very carefully controlled.
I don't see anyone here suggesting WLS instead of Xenical, so I assume you mean generally?
Yes, I meant generally speaking. It seems to me that some people tend to recoil in horror at the thought of dealing with poop, but will gladly sign up for major, life-altering surgery. (And from my reading, WLS patients can also have problems with "dumping".) I've suggested to quite a few people that they should at least give Xenical an honest trial before opting for WLS, but they won't hear of it.
Here in Australia, full-strength Xenical has been available OTC for several years. Pharmacists are so reluctant to sell it, I can't imagine that anyone would be abusing it. I had trouble buying it even when I was still overweight, so I can't imagine they'd sell it to a sknny person.
I would imagine (but I am not sure) that surgeons would only perform WLS if the patient had exhausted other possibilities--medication maybe being one of them? I'm just making this up though, and maybe someone who is more experienced can speak to this.
I do want to say though that the pharmacy system may be different in Australia than it is here. If something is available OTC, for the most part, pharmacists have to sell it. (Unless they belong to some evil corporation that hates the morning-after pill, for instance.) I can't imagine a pharmacist asking you to step on the scale before selling you an OTC medication.
But there, again, my knowledge may be lacking.
I do want to say though that the pharmacy system may be different in Australia than it is here. If something is available OTC, for the most part, pharmacists have to sell it.
Not here! Australian pharmacists are part of "Pseudowatch" which means if you want to buy anything with pseudoephedrine it, they treat you as though you're a criminal manufacturing illegal drugs in your basement. I've seen my husband standing in a pharmacy with a streaming nose and eyes from hayfever, barely able to speak, and still be put throught the 3rd degree before they would sell him OTC medication. I just had a vision of people staging armed robberies on pharmacies and making off with Xenical and hayfever and cold medications!
As for the Xenical, they don't ask you to step on a scale, just look you up and down and tell you that you don't need it. At which point I'd have to produce an expired prescription from my doctor (I started taking it when it was prescription-only) and throw a hissy fit. Somehow I don't think Roche is making much money down here. [Rant over]
I would be interested to hear from someone who has had WLS and the criteria for their surgery. I have the impression - and, granted, it's only an impression - that doctors are only too keen to refer patients to a surgeon without thoroughly exploring the alternatives.
Yes, I meant generally speaking. It seems to me that some people tend to recoil in horror at the thought of dealing with poop, but will gladly sign up for major, life-altering surgery. (And from my reading, WLS patients can also have problems with "dumping".)
From what I understand, the WLS complication of "dumping" refers to violent fluctuations in blood sugar, which causes severe cramping. It's not as, uh, poopy as it sounds. (Though it doesn't sound fun, either.)
Wendy is right, the dumping that you hear about with WLS is a constellation of symptoms brought about in about 50% of patients when they eat too much sugar or fat at a given time. Too much is often relative, where one person may be able to tolerate a candy bar and another may not be able to tolerate the amount of sugar in a low-sugar yogurt. It is caused by the stomach "dumping" the sugar into the intestine and the body reacting by dousing it with insulin, causing a blood sugar reaction that can include sweating, chills, shaking and cramps. Some people have vomiting and diarrhea, but not always.
I know many people who are considering weight loss surgery have used diet medications as Plan A and consider WLS as a final attempt, although there are also those out there that think it is magic and will solve all of their problems.
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