Experts Speak Out: FDA Approval of Orlistat
Feb. 8, 2007 — -- This summer, with the Food and Drug Administration's permission, pharmacies will begin selling alli, an over-the-counter version of the weight loss drug orlistat.
The decision marks the first time such a drug has been available without a prescription. And with the nation's obesity problem ballooning, some diet experts say the pill could be a boon for those looking to give their weight loss efforts a boost.
But some also say the side effects -- which include severe diarrhea -- may limit public acceptance of the drug. And one consumer group has already come forward to argue that the FDA overlooked the drug's potential to have even more serious health effects.
Here is more of what the experts had to say:
David L. Katz, M.D., MPH, FACPM, FACP
Director, Prevention Research Center
Yale University School of Medicine
New Haven, Conn.
"Obesity really is a desperate problem in this country, so it's hard to justify not doing everything possible to combat it. orlistat works -- a little -- so the FDA is obligated to weight the pros and cons of disapproval versus those of approval.
"While this drug is of limited utility for weight loss, it has clear potential for abuse by teens striving for thinness. I worry about use by those with eating disorders. Fortunately, the side effects will limit the extent of this hazard, as anal leakage is not likely to be too socially acceptable among image-conscious teens -- or anyone else, for that matter."
Keith-Thomas Ayoob, EdD, RD, FADA
Associate Professor
Department of Pediatrics
Albert Einstein College of Medicine
Bronx, N.Y.
"It's safe to use, but it blocks the absorption of about 30 percent of fat. That's both the good and the bad news. It's good, because it could represent a significant reduction in calories absorbed. It's bad because, face it, if those fats don't get absorbed, they also don't just go away. They go into your colon. Think mineral oil and do the math.
"It's also going to block the absorption of fat-soluble vitamins, hence the warning to take it in conjunction with a multivitamin, which should compensate for the lowered absorption of fat-soluble vitamins.
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