The usual dose is 5, 10 or 15 milligrams per day taken around lunchtime. Orilstat, with the trade name of Xenical, received FDA approval in 1999. The over-the- counter lower dose of orlistat, with the trade name Alli, became available in June.
Orlistat doesn't work in the brain. It works in the digestive system. Alli is a gastric and pancreatic lipase inhibitor that works by blocking the absorption of about one-third of the fat contained in a meal.
In other words, some of the fat from the foods you have eaten is not absorbed and is passed out of your body through your stool. The usual dose for orlistat is 120 mg three times a day at meals for prescription-strength Xenical or 60 mg three times a day for over-the counter Alli. Both of these medications have two years of data showing that they are safe and effective and help with weight loss and weight maintenance.
People who take these medications have been shown to lose more weight, up to 50 percent more, than by diet and exercise alone. If you have been trying to lose those last 10 pounds and think a weight-loss pill might be what you have been looking for, think again. The National Intitutes of Health has specific guidelines regarding who should use weight-loss medications.
It is recommended that if you need to lose weight, but have a body mass index (BMI) of less than 27, you should try doing it through diet, exercise and behavioral counseling without weight-loss medications. If your BMI is greater or equal to 30, or greater or equal to 27 and you have at least two or more health problems, such as diabetes, high blood pressure, heart disease or sleep apnea, weight-loss medications may be helpful when used along with diet, exercise and counseling. To calculate your BMI, which is a way of relating your body weight to your height, multiply your weight by 703, divide that number by your height in inches, and that number by your height inches again.
Just like almost any medication, weight-loss drugs can have side effects. Sibutramine can cause an increase in heart rate and blood pressure, so regular monitoring of heart rate and blood pressure is required. Sibutramine is not recommended if you have a history of heart disease, stroke, arrhythmia, congestive heart failure, seizure disorders or uncontrolled high blood pressure.
It should also not be used with certain antidepressants or if you are pregnant or lactating. The side effects (or "treatment effects" as the Alli brochure calls them) of orlistat include fecal incontinence, oily stools, flatulence and a decrease in absorption of fat-soluble vitamins. Eating a low-fat diet of less than 70 grams a day and less than 20 grams a meal can help decrease these side effects.
Orlistat is not recommended if you have a history of malabsorption, reduced gall bladder function, have had an organ transplant, take certain medications or are pregnant or breastfeeding. It is recommended that when taking orlistat, you also take a daily multivitamin two hours before or after a meal. The NIH recommends that weight loss medications should be discontinued if you lose less than 4 pounds in the first four weeks or if serious side effects occur.
Both of these medications are approved for long-term use and seem to be quite beneficial in helping people keep the weight off. Studies show that people who take sibutramine and orlistat for two years keep off almost twice as much weight as those not on these medications. Unfortunately, these are not magic pills in and of themselves.
You can not just pop one of these pills and go about your life and lose weight while you sleep. You still have to do the work by eating less and exercising more. The NIH recommend that these weight loss drugs should always be used in combination with diet, physical activity and behavior counseling and should be used only when a person's weight goals have been difficult to achieve by diet and exercise alone.
The cost of weight loss medications can be high, well over $100 a month, usually out of pocket. However, the benefits of weight loss, including reducing your risk for heart disease, diabetes, stroke and some cancers and being able to play out in the yard with your kids can be priceless.
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