The currently available drug Xenical (generic name: orlistat) can be prescribed for chronic obese patients who are in danger of developing associated diseases like diabetes or cardiovascular complications.
Xenical blocks the enzymes that break down fats in your food. Dietary fats must be broken down before they can be absorbed. With Xenical, fewer fats are broken down, and any undigested fats will not be taken up and will pass out of your body in normal bowel movements.
Orlistat only blocks the uptake of fats, and doesn’t interfere with the absorption of sugars and other non-fat foods. In this sense, it does not have a big effect on total calorie intake, so it must be taken along with a controlled diet and is usually prescribed along with an exercise regime.
Coming soon – engineered sand
Research at the University of South Australia published last week has shown that it may be possible to treat obese patients even more effectively than orlistat. The new research shows that a similar effect to Xenical can be achieved by engineering silica particles that are produced from purified sand to give them a high surface area. This enables them to soak up large amounts of digestive enzymes, fats, and sugars within the gastrointestinal tract.
This new silica-based therapy will be gentler on digestion, with fewer side effects than Xenical.
It will be a few years before we are likely to see this new product reach our shelves. In the meantime, if you are struggling to lose weight, or are seeing your weight start to creep up after achieving good loss, you could discuss with your healthcare physician whether going onto Xenical could be a way of holding off until the new drug can be prescribed.
Can you get the right treatment for obesity?
As we reported in July, there are significant problems for people with chronic obesity to find doctors who have the right specialization in this area. Obesity may be the biggest chronic medical problem in the US, where nearly one in three adults are overweight and two out of every five adults (42.4%) are obese. About 1 in 11 adults (9.2%) are severely obese. Despite this, fewer than one in one hundred doctors in the U.S. are trained as obesity specialists. It also affects general practice, because many doctors are not used to recognizing and treating the causes and symptoms. There is still a general feeling that obesity is not a disease, but instead is a sign of weakness of character and that the way to correct it is for the person suffering is to “pull themselves up by their bootstraps and try harder.” Many doctors think that drugs for weight loss are unsafe, and that patients will eventually regain whatever weight they have lost anyway.
Now there are two alternatives to Xenical, which use the wonder-drug semaglutide. For the past four years, Ozempic has been prescribed for treatment of Type 2 adult diabetics, and over this time period, it was found that patients were losing weight as a side effect. Doctors then started prescribing it for obese patients even when they did not have diabetes. Recently, the same company that produces Ozempic has come out with a daily-dose oral version called Rybelsus.
These three drugs, when taken along with a controlled diet and proper exercise, can produce weight loss and allow you to reach and maintain a healthy weight. We can now look forward to adding a fourth treatment when the remarkable findings of the South Australian research reaches the market.
What are the health risks from being overweight?
Obesity is a risk factor that may promote chronic conditions and diseases including cardiovascular disease, cancer and Type 2 diabetes. People who are overweight have higher death rates and shorter life expectancy.