Here is an interesting topic that I came recently and about weight loss pills. This shows you that only thing that's losing is your money in your wallet! Check it out:
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Are Alli Weight Loss Pills Safe?
This drug is sold over the counter, but I’ve heard they cause liver damage.
By Martica Heaner, Ph.D., M.A., M.Ed., for MSN Health & Fitness
Q. I was thinking about trying the Alli weight loss drug. But I heard it causes liver damage. Is this drug safe?
A. Alli is the over-the-counter version of the weight-loss drug orlistat. Orlistat works in your stomach by inhibiting the gastric and pancreatic enzymes that help break down fat. This results in undigested fat from the food you eat passing through your body rather than being absorbed by it. This process limits your caloric intake and can lead to weight loss.
Sounds too good to be true, doesn’t it? Eat all the fat you want and it passes right through you. The only problem is—as with any drug—there are side effects. For example, some fat-soluble vitamins in fats are lost, so vitamin supplementation is encouraged to prevent nutrient deficiencies while taking the drug. A few of the other potential side effects aren’t so pretty. Some people taking the drug have oily stools, fecal frequency and even uncontrolled fecal release.
Still, these effects are considered to be fairly mild, and Alli was found to be safe in drug-company-sponsored clinical trials. Coupled with the fact that the drug does limit calorie intake and produces some weight loss, orlistat, in its original higher dose and marketed as Xenical, was approved by the FDA in 1999. Alli is a lower-dose formulation of the prescription drug and was released in 2007.
“Why take these drugs if the effects are so insignificant and weight loss is not even guaranteed?”
For a drug to become FDA approved it must go through rigorous testing, first on animals, then later in a series of human clinical trials (You can read more about each phase of the process in drug development.
But an initial FDA approval does not guarantee that a drug won’t later be found unsafe as more people take it and use it over a longer periods of time. This has happened to a host of obesity drugs that have been approved and sold, only to be taken off the market later; well known examples of this are amphetamines and Fen-phen.
In the case of orlistat, a red flag has been raised by the FDA. In late August 2009, a notice was issued to healthcare professionals and those taking the drug communicating that a safety review was being conducted. Thirty-two liver-related injuries had been reported in patients using the drug since 1999, indicating the potential for a serious health risk. While the most common complaints were jaundice, weakness and abdominal pain, there were six cases of liver failure.
Upon further investigation by the FDA, it may be discovered that those people with liver problems had a pre-existing condition that may or may not have been exacerbated by the drug. Or it might be revealed that the liver is seriously stressed from this drug. In any case, until the review is completed, the drug is still considered FDA-approved and has not been taken off the market.
Should you take a weight loss drug?
Weight loss drugs are seductive because they seem to promise all the glory of a slimmer body, but with less effort than the proven regimen of dieting and exercise. The problem is weight loss drugs are not as powerful as some believe. In fact, most of these drugs produce relatively small weight loss over time.
At the recent annual research meeting of the Obesity Society, several prominent researchers reviewed the results of studies and meta-analyses (results from a number of studies grouped together) of current weight-loss drugs on the market as well as those being developed. Among the various drugs, the average weight loss in patients being treated with FDA-approved weight-loss drugs over a period of almost one year was only around 6 to 10 pounds more than weight lost by those on a placebo.
An analysis of 22 randomized clinical trials of mostly middle-aged women taking orlistate found that after taking it for a year the average weight loss was only 6 pounds greater than those on a placebo—or one-half pound more per month. Is this worth putting up with potential pooping problems?
However, these small amounts of weight loss are considered successful based on the criteria used in 2007 for a weight-loss drug to be approved by the FDA. The guidelines call for at least 35 percent of those taking a drug to lose at least 5 percent of their starting weight over the course of a year or that the difference between the amount of weight loss by those not taking the drug and those taking the drug be at least 5 percent and statistically significant.
In other words, if a 250-pound person lost around 13 pounds, or 1 pound per month, after taking the drug for a year, that drug would be considered effective. Take note that almost two-thirds of those taking the drug are not required to show this level of weight loss for the drug to still be considered effective. (Often people taking the drug may not lose weight or may even gain.)
The reason for the 5 percent difference in weight loss between the drug group and the placebo group is because often those in the placebo group may also lose weight. This may be because the act of participating in a trial makes the placebo group change their behaviors or perhaps that the diet and physical activity changes that are also part of the study, and that both sets of subjects follow, also lead to weight loss.
In any case, weight loss from drugs is surprisingly small. It may seem as if the emperor is wearing no clothes, but no one’s talking. Why take these drugs if the effects are so insignificant and weight loss is not even guaranteed? Why take the drug for such modest weight loss when there are side effects?
Diet and exercise changes are always recommended as part of drug treatment and these methods have been proven—on their own—to produce similar amounts of weight loss. There are no side effects, provided that the exercise and diets are not extreme, so why take a drug?
Before taking a weight-loss drug, consult with your doctor. Pharmacotherapy is only indicated for certain people: either those who are classified as obese with a BMI of 30 or above or those with a BMI of 27 and above who also have co-morbidities (risk factors such as hypertension, abnormal cholesterol levels, etc.). Even then, lifestyle behavioral changes are recommended as the first step before resorting to drugs. If drugs are prescribed, guidelines emphasize that lifestyle changes—such as improved diet and increased physical activity—should be a part of the drug treatment. Research has proved that after managing to lose weight, few people can successfully maintain weight loss long term if they do not continue with a healthful diet and regular physical activity.
So should you just skip the drug? It’s worth evaluating these questions seriously. No matter what, drug or not, you will need to commit to long-term lifestyle changes to manage your weight.
Do you have a fitness or weight-loss question for Martica? Send e-mail toexperts@microsoft.com. Please include Ask Martica in the subject line. Each of our experts responds to one question each week and the responses are posted on Mondays on MSN Health. We regret that we cannot provide a personalized response to every submission.
Martica Heaner, Ph.D., M.A., M.Ed., is a Manhattan-based exercise physiologist and nutritionist, and an award-winning fitness instructor and health writer. She has a Ph.D. in behavioral nutrition and physical activity from Columbia University, and is also a NASM-certified personal trainer. She has written hundreds of articles for publications such as Self , Health ,Prevention , The New York Times and others. Martica is the author of eight books, including her latest, Cross-Training for Dummies. (Read her full bio.)
