Obesity is a harmful for your health

by Britney M. Pharmacist

Orlistat blocks some of the fat that you eat, keeping it from being absorbed by your body.

Orlistat is used to aid in weight loss, or to help reduce the risk of regaining weight already lost. This medicine must be used together with a reduced-calorie diet and increased physical activity. Orlistat is for use only in adults that are overweight or obese.

Orlistat works by blocking enzymes in the gut that normally digest fat, thus preventing its absorption. (During our review of the latest information one of our medical consultants commented that “fat malabsorption,” as the condition is known, is actually a disease.) But that lack of absorption can lead to a number of adverse effects. In clinical trials of Xenical, during the first year of use, 27 percent of people experienced oily underwear staining, 24 percent had gas with involuntary discharge of stool, 22 percent experienced fecal urgency, 11 percent had an increased number of bowel movements, and 8 percent suffered fecal incontinence. Virtually everyone who takes orlistat experiences diarrhea, at least, occasionally.

Most people can reduce the frequency and severity of those unpleasant side effects by cutting the amount of fat in their diets to 30 percent or less. But even then they must make other nutritional adjustments, since orlistat also hinders the absorption of fat-soluble vitamins, notably beta-carotene (vitamin A), vitamin D, vitamin E, and vitamin K.

In addition, the prescription version (Orlistat) includes warnings on its label about the possibility of pancreatitis (inflammation of the pancreas).

The benefits. Even when orlistat is combined with exercise and nutritional changes, it produces only a modest 5 percent to 10 percent decline in body weight. Three studies done before the approval of orlistat measured weight loss over a one-year period in obese patients with and without type 2 diabetes. They had a BMI (body mass index) over 28 and were on a reduced-calorie diet. At the beginning of the trials, the patients weighed an average of 220 pounds. Pooled data show that the average weight loss with orlistat was about 19 pounds vs. 12 pounds with a placebo. Other trials found similar evidence of limited effectiveness.

The bottom line. The risks of orlistat vastly outweigh the benefits. The millions of Americans who legitimately need to lose weight are far better off avoiding orlistat and weight-loss gimmicks. They should focus instead on what has been shown to work, without the risks: engaging in regular exercise, eating fewer calories, and sticking with both.

How should I take orlistat?

Use orlistat exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Never share orlistat with another person, especially someone with a history of eating disorders.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Orlistat is usually taken 3 times per day with each main meal that contains some fat (no more than 30% of the calories for that meal). You may take the medicine either with your meal or up to 1 hour after eating.

If you skip a meal or you eat a meal that does not contain any fat, skip your dose for that meal.

The fat content of your daily diet should not be greater than 30% of your total daily caloric intake. For example, if you eat 1200 calories per day, no more than 360 of those calories should be in the form of fat.

Read the label of all food items you consume, paying special attention to the number of servings per container. Your doctor, nutrition counselor, or dietitian can help you develop a healthy eating plan.

Orlistat is only part of a complete program of treatment that also includes diet and exercise. Your daily intake of fat, protein, and carbohydrates should be evenly divided over all of your daily meals. Follow your diet, medication, and exercise routines very closely.

Orlistat can make it harder for your body to absorb certain vitamins, and you may need to take a vitamin and mineral supplement while you are taking this medicine. Follow your doctor’s instructions about the type of supplement to use. Take the supplement at bedtime, or at least 2 hours before or after you take orlistat.

What happens if I miss a dose?
Take the missed dose as soon as you remember, but no more than 1 hour after eating a meal. If it has been more than an hour since your last meal, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1–800–222–1222.

What should I avoid while taking orlistat?
Avoid eating high-fat meals or you could have unpleasant side effects on your stomach or intestines.

If you also take cyclosporine, do not take it within 3 hours before or 3 hours after you take orlistat.

If you also take levothyroxine (such as Synthroid), do not take it within 4 hours before or 4 hours after you take orlistat.

Orlistat side effects
Get emergency medical help if you have signs of an allergic reaction to orlistat: hives; difficult breathing; swelling of your face, lips, tongue, or throat.