The National Institute for Clinical excellence (NICE) and the National Obesity Forum (NOF) both recommend pharmacotherapy (medications) as appropriate for patients who either haven’t been successful with a weight management program based around lifestyle, exercise or nutrition advice or are considered at that much risk for the co-morbidities of obesity that they need to lose weight more rapidly.

Orlistat

Orlistat is a type of medication called a lipase inhibitor. It works by reducing the amount of fat that’s absorbed into your body. About 1/3 or any fat that’s put into your mouth in the form of food is not absorbed or turned calories. If a patient is, previous to taking the medication, weight stable, then they cannot help but lose weight while taking the medication. If they’re eating a diet that’s high in fat then they will have side effects. These are not side effects of the medication it’s a side effect of their diet and they should be counseled that whilst taking this medication, they should be eating a low fat diet to reduce the risks. If a patient eats a low fat diet, they won’t really get many side effects at all. If they’re a little bit naughty and they do eat a high fat diet they can expect some side effects that include potentially yellow diarrhea, bad painful flatulence, oily stools or in extreme cases, a little bit of fecal incontinence. 

Recently, another pharmaceutical company has gained European license to sell a version of Orlistat in a slightly lower dose of 60 mg over the counter through the pharmacy setting. Although it’s over the counter, its not going to be a medication that can just be picked up, taken to a till and purchased. It’s going to be purchased through a structured weight management program which is supervised by the pharmacist. But the advantage to the individual patient is that they don’t necessarily have to see a GP to get a weight reducing drug and this will be the first time that its available over the counter in this way in the UK.

Sibrutramine

Sibrutramine or Reductil, is an alternative weight reducing drug, now the way that this works is that it acts centrally on parts of the brain to make you feel more full. During the first few weeks, there is a concern that your blood pressure will go up and so your GP may want to see you fortnightly to check your blood pressure and make sure that this remains under good control whilst on the medication.

Warning: The European Medicines Agency has recommended that sales of sibutramine be suspended due to links to an increased risk of cardiovascular events. Read more

Date posted: 22/01/2010