J. Douglas Bremner
See book keywords and concepts |
 ORLISTAT
Orlistat (Xenical), another drug approved for the treatment of obesity, prevents the digestion and absorption of some fats by inhibiting the lipase enzyme. orlistat treatment results in a six-pound weight loss that persists for as long as treatment continues.3 Gastrointestinal side effects are experienced by 91% of patients vs. 65% on placebo. Diarrhea is very common; flatulence, bloating, and dyspepsia are less so. orlistat inhibits absorption of fat-soluble vitamins (A, D, E, K) and can lead to vitamin deficiency, so you should take a vitamin if you are on this drug. |
Thomson Healthcare, Inc.
See book keywords and concepts |
 MINOR RISKS
Orlistat: Concurrent use of orlistat and beta carotene may result in decreased beta carotene efficacy. Clinical Management: Patients should be instructed to space the administration of orlistat and beta carotene by at least two hours.
POTENTIAL INTERACTIONS
Cholestyramine, Colestipol, Mineral Oil, and Neomycin: Concurrent use, may interfere with the absorption of beta-carotene or vitamin A (USP DI 2004). Clinical Management: Vitamin A requirements may be increased; monitor for deficiency. |
Ann M. Coulston and Carol J. Boushey
See book keywords and concepts |
 Orlistat in the long-term treatment of obesity in the primary care setting.. Arch. Fam. Med. 9, 160-167.
108. Anderson, J., Schwartz, S., Hauptman, J., Boldrin, M., Rossi, M., Bansal, V., and Hale, C. (2006). Low-dose orlistat effects on body weight on mildly to moderately overweight individuals: a 16-week, double-blind, placebo-controlled trial. Ann Pharmaco. 40, 1717-1723.
109. Van Gaal, L. F., Rissanen, A. M., Scheen, A. J., Ziegler, O., and Rossner, S. (2005). |
Joe Graedon, M.S. and Teresa Graedon, Ph.D.
See book keywords and concepts |
 Orlistat is intended to be used in conjunction with a reduced-calorie, reduced-fat diet. The drug prevents the absorption of fat from the gastrointestinal tract. Nearly twice as many people on orlistat manage to lose 15 percent of their body weight in a year as people on diet restrictions alone.
Side effects: Most of the side effects are gastrointestinal. Because orlistat prevents the absorption of fat, fat is retained in the intestines. This may result in stomachache, diarrhea, nausea, flatulence, rectal discharge, and fecal incontinence. Headache is also a possible side effect. |
J. Douglas Bremner
See book keywords and concepts |
| Diarrhea is very common; flatulence, bloating, and dyspepsia are less so. orlistat inhibits absorption of fat-soluble vitamins (A, D, E, K) and can lead to vitamin deficiency, so you should take a vitamin if you are on this drug. Recently a low-dose version of orlistat called Alii (pronounced ally) has been approved for over-the-counter use in conjunction with a diet and exercise program, and is being heavily advertised. |
Hyla Cass, M.D.
See book keywords and concepts |
 The latest weight-loss wonder, over-the-counter (OTC) orlistat (Alii), promises that "if you could lose 10 pounds through dieting, you could lose 15 pounds with hard work and Alii." orlistat is also available by prescription as the brand-name product Xenical. Since the drug's actions rely on binding 25 percent of the fats you consume in your gut and passing them through your body unabsorbed, there's no focus on the real reason that most people get fat: too much refined carbohydrate. No wonder the drugs don't have much effect. |
Ann M. Coulston and Carol J. Boushey
See book keywords and concepts |
| Similar to the 120-mg orlistat studies, significantly greater weight loss was observed with an orlistat dosage of 60 mg plus diet compared to placebo plus diet in overweight and obese patients [106-108]. Weight losses in the range of 4.8 to 9.7% were reported with the 60-mg OTC dose at 1 year.
E. Medications in Phase III Clinical Trials with No Approval
1. |
Hyla Cass, M.D.
See book keywords and concepts |
| The latest weight-loss wonder, over-the-counter (OTC) orlistat (Alii), promises that "if you could lose 10 pounds through dieting, you could lose 15 pounds with hard work and Alii." orlistat is also available by prescription as the brand-name product Xenical. Since the drug's actions rely on binding 25 percent of the fats you consume in your gut and passing them through your body unabsorbed, there's no focus on the real reason that most people get fat: too much refined carbohydrate. No wonder the drugs don't have much effect. |
Ann M. Coulston and Carol J. Boushey
See book keywords and concepts |
| Higher doses do not have any additional efficacy in weight loss and may result in more adverse events [105]. orlistat is minimally absorbed; therefore, any systemic adverse events would be expected to be negligible. orlistat should be used with a diet that is less than 30% energy from fat to prevent adverse side effects that include oily stools, oily spotting, flatus with discharge, fecal urgency, and fecal incontinence [105]. These events are due to the drug inhibiting fat absorption rather than a direct effect of the drug itself. |
Hyla Cass
See book keywords and concepts |
| The latest weight-loss wonder, over-the-counter (OTC) orlistat (Alii), promises that "if you could lose 10 pounds through dieting, you could lose 15 pounds with hard work and Alii." orlistat is also available by prescription as the brand-name product Xenical. Since the drug's actions rely on binding 25 percent of the fats you consume in your gut and passing them through your body unabsorbed, there's no focus on the real reason that most people get fat: too much refined carbohydrate. No wonder the drugs don't have much effect. |
Thomson Healthcare, Inc.
See book keywords and concepts |
| Clinical Management: Patients should be instructed to space the administration of orlistat and beta carotene by at least two hours.
POTENTIAL INTERACTIONS
Cholestyramine, Colestipol, Mineral Oil, and Neomycin: Concurrent use, may interfere with the absorption of beta-carotene or vitamin A (USP DI 2004). Clinical Management: Vitamin A requirements may be increased; monitor for deficiency. overdosage
Vitamin A toxicity has been reported in a 20-year-old Japanese woman whose diet included an excessive amount of beta-carotene-rich foods. |
H. Winter Griffith, M.D.
See book keywords and concepts |
 Orlistat may interfere with your body's absorption of certain vitamins; therefore, you should take a multivitamin supplement daily, two hours before or after taking orlistat.
• orlistat may affect the results of some medical tests.
• During treatment, you should be on a nutritionally balanced reduced-calorie diet that contains no more than 30 percent of calories from fat.
• Patients with diabetes may require a reduced dosage of oral hypoglycemic medicine or insulin due to weight loss.
• Advise any doctor or dentist whom you consult that you take this medicine. |
| Others:
• Expect to start with small doses and increase gradually to lessen frequency and severity of adverse reactions.
• orlistat may interfere with your body's absorption of certain vitamins; therefore, you should take a multivitamin supplement daily, two hours before or after taking orlistat.
• orlistat may affect the results of some medical tests.
• During treatment, you should be on a nutritionally balanced reduced-calorie diet that contains no more than 30 percent of calories from fat. |
Jonny Bowden, M.A., C.N.S.
See book keywords and concepts |
 Orlistat (Xenical)
Marketed under the trade name Xenical, orlistat is the only member of the second category of weight loss drugs, a category that could be called "digestive inhibitors." And it's the only drug other than sibutramine (Meridia) currently approved for long-term use. Xenical works by blocking some of the fat that you eat from being digested and assimilated. It does this by blocking up to 75 percent of the digestive enzyme lipase—which breaks down fat—resulting in as much as 30 percent of the fat you eat not going to your hips. |
Hyla Cass, M.D.
See book keywords and concepts |
| Action: orlistat prevents the digestion and absorption of fat in the intestine by blocking the action of lipase, an enzyme that helps break down fat.
Side effects: The drug's side effects are more likely if you go off the wagon and eat a meal with a bit more fat in it. In this situation, you're at substantial risk for gas, "oily spotting," loose stools, and possible partial loss of bowel control. In other words, you may poop in your pants. Who needs it? |
| Omega-3 fish oils: It may be beneficial to take fish oil supplements between doses of orlistat to replenish your body's levels of omega-3 fats; use a supplement that delivers 1,000-3,000 mg of combined DHA/EPA.
ANTIPSYCHOTICS
Drugs in this class are mostly prescribed to people who have schizophrenia, bipolar disorder, or other mental illnesses that involve breaks from reality. |
The Life Extension Editorial Staff
See book keywords and concepts |
 Orlistat (Xenical) is unique among current obesity drugs in that it does not act directly on the central nervous system. orlistat inhibits an enzyme (pancreatic lipase) essential to fat digestion. In 2 years of clinical trials, orlistat has produced sustained weight loss similar to that of other single agents.
The most common side effects are intestinal symptoms, including cramping, gas, and diarrhea, particularly in patients who eat high-fat foods against the advice of their physician. |
Thomson Healthcare, Inc.
See book keywords and concepts |
| Clinical Management: Patients should be instructed to space the administration of orlistat and vitamin E by at least two hours.
Phenprocoumon: Vitamin E has been shown to enhance the response to oral anticoagulants, perhaps due to an interference with the effect of vitamin K in clotting factor synthesis (Anon, 1982; Corrigan & Marcus, 1974). Clinical Management: Concomitant use of oral anticoagulants and vitamin E should be avoided if possible. If these drugs are used together, careful monitoring is called for. overdosage
Vitamin E plasma concentrations greater than 3. |
Marshall Editions
See book keywords and concepts |
 Orlistat decreases fat absorption and is appropriate for those who have high-fat diets. Sibutramine (Meridia®) is more appropriate when the appetite needs to be suppressed. Fluoxetine (Prozac®) is also used as a weight loss agent.
460
Supplements: 5-hydroxytryptophan (5-HTP) is a tryptophan derivative that increases serotonin and decreases cravings for carbohydrates. Take 50 mg three times a day before meals. Green tea and hydroxycitrate have had some success in suppressing the appetite
>cc
< and carbohydrate metabolism. |
Earl L. Mindell, RPh, PhD with Virginia Hopkins, MA
See book keywords and concepts |
| In patients with normal baseline vitamin levels before using orlistat, after using orlistat vitamin A levels were low in 2.2 percent; vitamin D levels were low in 12 percent; vitamin E levels were low in 5.8 percent; and beta-carotene levels were low in 6.1 percent. When fats are flushed through the system without being broken down, fat soluble vitamins go along with them.
What Else to Take If You Take This Drug A high-potency multivitamin containing vitamins A, D, and E, and beta-carotene, along with an essential fatty acid supplement. Take them between doses of orlistat. |
Bottom Line Health
See book keywords and concepts |
| The other is orlistat (Xenical), and a third medication, rimonabant (Acomplia), showed promising results in a trial, and is currently undergoing FDA review.
The international study on rimonabant was led by Jean-Pierre Despres of Laval University in Sainte-Foy, Quebec, Canada, and involved more than 1,000 overweight or obese patients who had untreated high cholesterol The participants were placed on a low-calorie diet and given either daily rimonabant (at doses of 5 or 20 mg) or a placebo.
Don't look for a quick fix from the drug store. |
Bill Sardi
See book keywords and concepts |
 American Journal Gastroenterology 100:2724-9, 2005]
The weight-loss drug orlistat (Xenical) causes deleterious changes in the lining of the intestines that can lead to polyp formation. Public Citizen has petitioned the FDA to recall this drug.
Preventive measures for colon cancer
Diet and health habits
SUMMARY ^^^^ risk for colon cancer.
Summary and recommendations
It is obvious that the state of colon cancer care today is deplorable. Much that can be done to prevent colon cancer either from occurring in the first place, or from re-occurring is not being put into practice. |
Earl L. Mindell, RPh, PhD with Virginia Hopkins, MA
See book keywords and concepts |
| In patients with normal baseline vitamin levels before using orlistat, after using orlistat vitamin A levels were low in 2.2 percent; vitamin D levels were low in 12 percent; vitamin E levels were low in 5.8 percent; and beta-carotene levels were low in 6.1 percent. When fats are flushed through the system without being broken down, fat soluble vitamins go along with them.
What Else to Take If You Take This Drug A high-potency multivitamin containing vitamins A, D, and E, and beta-carotene, along with an essential fatty acid supplement. Take them between doses of orlistat. |
| While taking orlistat, it is important to adhere to a low-fat diet (less than 30 percent fat) to avoid fecal incontinence and diarrhea.
• This and other weight loss drugs should not be used by anyone with a history of eating disorders such as anorexia nervosa or bulimia.
What Are the Interactions with Other Drugs?
Orlistat can have varying effects on levels and duration of action of cyclosporine and warfarin. It can increase or prolong the effects of the cholesterol drug pravastatin.
What Are the Interactions with Food?
Orlistat should be taken with meals. |
Frederic Vagnini, M.D. and Barry Fox, Ph.D.
See book keywords and concepts |
 One of the strategies for reducing weight is to prevent the body from absorbing much of the fat in the diet. orlistat accomplishes this by interfering with the action of enzymes that break down dietary fat and make it available for absorption in the digestive tract. As a result, less fat can be absorbed, and much of it is carried out along with the stool. orlistat is typically used in conjunction with a weight-control diet to treat obese patients who also have diabetes, elevated blood pressure, or other serious conditions. |
J. Douglas Bremner
See book keywords and concepts |
| Although I don't recommend orlistat and Alii, if you take a multivitamin with either one, the worst thing that will probably happen to you is embarrassing and uncontrollable gas (and other related and more embarrassing events). Do not under any circumstance take Meridia, ephedra, ma huang, phenter-mine, or any of the other amphetaminelike drugs.
Drug
Common, . |
Joe Graedon, M.S. and Teresa Graedon, Ph.D.
See book keywords and concepts |
| Nearly twice as many people on orlistat manage to lose 15 percent of their body weight in a year as people on diet restrictions alone.
Side effects: Most of the side effects are gastrointestinal. Because orlistat prevents the absorption of fat, fat is retained in the intestines. This may result in stomachache, diarrhea, nausea, flatulence, rectal discharge, and fecal incontinence. Headache is also a possible side effect. Downside: The drug may interfere with the absorption of fat-soluble vitamins. Take a multivitamin either 2 hours prior to or 2 hours after taking Alii. |
| With the approval of orlistat (available by prescription as Xenical) to go over the counter under the name Alii, people finally have a tested do-it-yourself option. The company has chosen the name Alii to imply that it will work best if allied with a full program of dietary and behavior modification approaches. The FDA appears confident that this drug does not pose significant safety issues.
Orlistat is a compound that prevents the absorption of fat. It can help people lose weight, but there are some drawbacks. For one thing, there's the underwear risk: spotting with oily stool. |
Hyla Cass
See book keywords and concepts |
| Action: orlistat prevents the digestion and absorption of fat in the intestine by blocking the action of lipase, an enzyme that helps break down fat.
Side effects: The drug's side effects are more likely if you go off the wagon and eat a meal with a bit more fat in it. In this situation, you're at substantial risk for gas, "oily spotting," loose stools, and possible partial loss of bowel control. In other words, you may poop in your pants. Who needs it? |
Email this page to a friend
