Our old friend Xenical was never intended for teenagers; it has always a dangerous and nasty “weight-loss” drug even for adults. Now it’s in trouble with doctors. Prescriptions are down by something approaching 2/3. That should be good news, but in the brave new FDA, it’s a reason to make the drug available over the counter, now calling it “Orlistat.”
Why is this a bad idea? Let us count (some of) the ways.
1) The drug doesn’t work. When used in “mildly to moderately overweight adults” with normal blood pressure and no other reasons to avoid the drug (in one study, that reduced the possible participants to 42% of the original pool), in combination with a low-calorie diet, patients lose an average of one additional pound per month. Wow! Twelve whole pounds per year.
2) No one recommends using it for more than six months, and when patients stop using it and go back to a regular diet, surprise, surprise! They gain back the weight they’ve lost plus a little more.
3) More than half (!) of the people who take Orlistat experience “fecal incontinence, gas, and oily discharge.” The FDA commissioner was joking about putting a warning on the box not to wear expensive underwear when you take it.
4) The drug blocks absorption of vitamins A, D, and K. This is why it can’t be taken with blood-clotting drugs. Patients are supposed to take a multivitamin at the same time. 54% of adults under a doctor’s care do. Vitamin loss is much worse for teenagers than it is for adults, and everyone is denying how teenagers will latch onto this as a cure for their body image woes.
5) So now they want to make it available inexpensively to everyone without medical supervision? Do they think people who buy it over the counter will read the warnings about hypertension, blood clot drugs, and vitamins? Do they think they’ll only take it for six months? Do they think they’ll diet rigorously while they take it? Would they rather see teenagers suffer long-term health effects from vitamin loss than carry one extra pound a month?
Or is it just that the drug companies want to get richer and the FDA wants to help?
The approval isn’t definite yet, and it’s time for a letter-writing campaign. A big one.
Here’s the address and phone number:
Food and Drug Administration
5600 Fishers Lane
Rockville, Maryland 20857