Weight loss drugs - Xenical & Reductil
Dr Andrew Binns,

Xenical


A weight loss drug called Xenical can help with weight loss and also reduce some of the complications of being overweight or obese, including reducing risk factors involved with heart diease and diabetes. It is only available on a doctor's prescription.

How does it work?
It is a new class of drug that works in the gut and stops the absorption of 30% of the fat eaten. It does this by inhibiting the enzyme that breaks down fat. As a result the fat not absorbed passes through the intestines and is excreted. The drug itself does not get absorbed into the body but only works in the gut.

What are the side effects?
If too much fat is eaten whilst taking this medication it may produce loose stools, fatty stools, urgency and even faecal incontinence. However this only happens when the fat intake is high, at more than 60 grams a day.

The daily recommendation of fat for weight control is about 30-40 grams per day. A breakfast of bacon (two pieces) and egg, sausage and toast with a generous amount of butter will contain most of the daily allowance (about 50 grams of fat.) On the other hand, just as filling are two pieces of toast without butter, but with baked beans plus a tomato and this meal only contains about 10 grams of fat.

It is therefore easy to take the drug and still have plentiful low fat, higher carbohydrate food and not get any of the side effects. These actually act as a deterrent to eating too much fat.

How effective is it?
For people who are significantly overweight or obese many studies show that a loss of just 5-10% of their weight will result in major health benefits, particularly with lowering of cholesterol and blood pressure and better control of blood sugars, particularly those with diabetes.

Studies show that 68% of people will lose more than 5% of their weight on Xenical and 39% will lose more than 10%. These losses will result in significant health benefits.

Who should take this medication?
This drug is suitable for people who are significantly overweight or obese particularly if they have complications such as high cholesterol, high blood sugars and high blood pressure.

It is advisable to try lifestyle modification first, particularly use of a low fat, high carbohydrate diet and to increase the level of activity. For those who need it, Xenical will produce a significantly greater weight loss than lifestyle modification alone.There is an associated support program from health professionals through a 1800 phone number.

Who should not take this medication?
Xenical is a safe and effective drug but is not a quick fix or a wonder drug. It should only be used for health risk factor reduction and should not be taken for appearance or for slimming.

Reductil


A weight loss drug called Reductil works by giving a feeling of satiety or fullness after eating, which reduces the urge to overeat. The medication also raises the metabolic rate slightly.

On average it will result in weight loss of about 5-10% in a six month period. This is a similar to the amount of weight loss produced by another drug called Xenical. However, Xenical works entirely differently by reducing the absorption of ingested fat by 30%.

Reductil can have some side effects such as raising blood pressure slightly, dry mouth, constipation, nausea, anxiety, headache, and insomnia to name a few. However, it is generally well tolerated. It is similar to some of the antidepressants and works by acting on natural chemicals in the brain.

Is this a new quick fix wonder drug? Quite frankly no. The problem with these drugs is what happens after you stop taking them. The hope is that with Xenical, the patient will be permanently conditioned to eat less fat, because eating too much fat while taking Xenical causes embarrassing bowel problems. For Reductil it is hoped the patient will get permanently used to eating less. In reality after stopping the medication, reverting to previous habits with consequent weight regain is likely.

So, for sustainable weight loss, it is back to making appropriate lifestyle changes first and many will succeed in doing this with knowledge and determination. Some may benefit from a program like Weight Watchers or GutBusters.

Medication may have a role for some, if they can afford about $120 a month for six months or more. Reductil and Xenical are available on prescription from GPs.