Viagra, Propecia, Xenical - Product information

The Daily Mail

NEWSPAPER OF THE YEAR

Tuesday September 22nd 1998


Anti-fat Drugs: A cure or a curse ?

Yesterday saw the launch of Xenical, what is claimed to be a new anti-fat wonder drug designed to transform the lives of Britain's 7.5 million obese adults. But will it merely become the latest in a long line of lifestyle pills used by people looking for a quick fix? Here, Melanie McDonagh argues using chemicals to control our greed will simply cause us to care even less about our bodies.

AGAINST

You might call it Virtual Eating. The new drug Xenical, launched yesterday at the Royal Society of Medicine, sounds like the archetypal female fantasy: how to eat fat and not get fat.

This wonder-pill promises to be one of the defining drugs of the Nineties along with Prozac and Viagra. If you take it three times a day, it conditions the body not to absorb all the fats you consume. It allows you to eat and stay thin, or at least get less large.

It sounds too brilliant to be true. But it is true. In tests of Xenical users, it was found that about a third of fats simply passed through their bodies. Research for The Lancet showed that Xenical helps obese patients lose between 10 and 16 percent of their body weight. Users in the U.S. lost about 600 calories a day.

It sounds like a fattists' charter. And this is just the drug in its infancy. Taken to its logical limits, Xenical may mean the end of the Hip and Thigh Diet and - hurrah - a new career for Rosemary Conley.

Swiss pharmaceutical manufacturer Hoffman-La Roche is not, of course, being triumphalistic about its new discovery. It urges caution and reminds us that Xenical should be used only as part of a low-fat diet: which seems, somehow, to miss the point.

The Royal Society of Physicians says that anti-obesity drugs should be prescribed only for people whose lives are at risk from being overweight.

The British Dietetic Association tells would-be users that they should not imagine Xenical will work witout changes in their eating habits.

The Association might as well save its breath. It is as likely that Xenical will be used only to combat life-threatening obesity as it is that Viagra will be used only to treat clinical, diagnosed impotence.

We're talking about a lifestyle drug here, one that enables us to have it all: the pleasures of food with few of the calories. It's like the advent of the Pill. That separated sex from reproduction; well, this separates food from nourishment.

Most of the objections to the drug are based on its expense. Xenical could easily cost £1,000 a year per user. If it is used for most of the clinically diagnosed obese people in Britain, the bill for the NHS could run to $750 million for a year.

No wonder Health Secretary Frank Dobson is taking the same dusty approach to Xenical on the state as he took to Viagra on the state: that it should be prescribed only for those with a grave clinical need.

It remains to be seen in both cases how family doctors will manage to fend off their patients' demands for what they will undoubtedly see as keys to a happy life - namely, more sex for men, less fat for women. It won't just be attractive for the overtly upholstered: anorexic girls will want it too.

There are also medical reservations about Xenical. The drug can help patients shed about a stone-and-a-half in a year, which means fewer heart attacks, strokes and high blood pressure for real fatties.

But it could also have problematic side-effects: some vitamins, A, D, E and K are fat soluble, and it might be that a drug which suppresses fat-absorption might, if misused, also inhibit the absorption of vitamins important for health.

It is also true that our bodies need a certain amount of fat: we just don't know what the long-term consequences of a drug like Xenical will be.

As U.S food writer Jeffrey Steingarten pointed out in an article about a similar slimming drug called Olestra, there are any number of unidentified nutrients in our diet which are fat soluble. How do we replace these nutrients if we don't even know what they are?

But the real objections to Xenical are more profound. What kind of society is it that devises ways of eating without digesting, of obtaining the pleasures of food with none of the natural consequences?

The Romans used to retire from their banquets to vomit, to allow room for more food. When adolescent girls do the same, we call it bulimia. But we're doing something similar by thwarting the workings of our digestive system, which was designed for the days when people ate for survival, not merely for pleasure.

I have nothing against eating for pleasure; it is not for nothing that my friends call me the Human Hoover. Eating for fun, eating socially, is part of the human condition. But when I eat too much, I pay the price: my abdomen balloons and the Lycra leggings go to the back of the wardrobe.

Trying to avoid the consequences of our greed with chemicals can only make us less disciplined, less responsible, less in touch with our bodies. There's also something obscene about us trying to avoid the body-fat consequences of fatty foods when hundreds of thousands of people in the Third World are desperate for any fatty foods they can lay their hands on.

On the bright side, as I mentioned earlier, Xenical is bad news for diet writers such as Rosemary Conley, whose depressing eating plans are based on identifying all the fats in our diets and zapping them.

Her New Inch Loss Plan has a grisly Foods To Avoid section which strictly forbids the following: butter, margarine, low-fat spreads, mayonnaise, cakes, biscuits, pastries, quiches, egg custard, cheese, cream, fats and oils, olive oil, lard, dripping, suet. All the things, really, that make food nice to eat.

Xenical might well mean that we can throw out the New Inch Loss Plan, but is it not possible to eat rationally and pleasurably without using either drugs or drastic diet plans?

How about just cutting back on the fats, and eating butter and olive oil in moderation? Or is self-control no longer an option in this, the age of no consequences? Xenical is testimony to the society we have become. It is one that can't say no to itself.

By Melanie McDonagh

FOR

Lynn Roger, 45, had been trying to lose weight through dieting for most of her life. At her heaviest Lynn, who is 5ft 2in, was 14st 12lb. But when she took part in the clinical trial for Xenical she lost two-and-a-half stones in a year. She was taken off the drug nearly a year ago so any after-effects could be assessed and she has since gained a stone. Lynn, from Aberdeenshire, who shows competition dogs, says;
Food is my addiction - I have no willpower to resist it, especially chocolate, cakes and biscuits. I'm a scavenger, while I'm cooking I constantly help myself to what I'm making and I often have tea and biscuits while I'm doing it.

But, unlike other addictions where temptation can be removed, there is no getting away from food. We are surrounded by it.

I've joined countless slimming clubs. But I found the whole experience of being told each week in front of everyone how much weight you've lost or gained humiliating.

At one point my weight zoomed up two stones in just over a year. My GP referred me for food counselling to try to help me lose weight. But it still did not work.

I'd almost given up when I saw a newspaper ad asking for volunteers to join clinical trials for Xenical. After medical tests to check my blood for cholsterol levels and blood pressure, I was accepted.

I took three tablets a day before each meal. Because orlistat, the drug's active ingredient, works by discarding excess fat from the body I had to cut down on eating fatty foods to avoid suffering from diarrhoea immediately afterwards.

The only side-effect of the drug is that excess fat goes straight through the body. The more fat you eat, the worse the immediate after-effects. It doesn't wipe out fat completely, just what the body doesn't need. The drug makes the body act like a strainer - it lets the body retain only half the fat it needs.

After taking the drug for a while I found I couldn't eat as much fatty foods because of the unpleasant after-effects.

When I did eat fatty foods, I'd regret it. But on the whole I started eating more vegetables and fruit and if I wanted something sweet I'd have a low-fat yoghurt.

In the year that I was on the drug I lost two-and-a-half stones and felt great. I regained my confidence and zest for life. It provided the helping hand I never had. And I looked so much better.

Usually I just wear jeans and a sweatshirt to walk the dogs but now I could buy off the peg for the first time in years.

Initially, even with the drug, it was hard for me to lose weight. I didn't shed much in the first month, which was very disappointing. But after a few weeks I started experiencing a steady loss of 2 to 4 lb a week. I'd kill to go back on it. Since I was taken off it my weight has been creeping up. If I have to rely on willpower alone I can't manage. The drug put me back in control of my weight, which felt fantastic.

By Lynn Roger

This story is reproduced from the Daily Mail Newspaper of September 22nd 1998. All copyrights acknowledged.

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