Xenical is not the magic bullet solution to obesity. CHOICE is concerned that advertising Xenical direct to consumers is sending an inappropriate message to the Australian public. See Drug advertising: TAKE ACTION, below for details.
What is it, and how does it work?
Xenical (also known as orlistat) is a drug that's promoted as a treatment for overweight and obesity. It works in your stomach and intestine by preventing your body from absorbing as much as 30% of the fat you eat. As a result it can help you lose weight. But it's only suitable for some people. See Who can use it?
You need to take Xenical when you're eating the fat in your diet, so you will usually take a capsule with each of the three main meals a day. Your daily intake of fat, carbohydrate and protein should be distributed over these meals.
- Xenical only works in the presence of dietary fat in your body, so if you miss a main meal or if you know the meal contains no fat, then you don't need to take it.
- But you also need to limit the fat that you do eat to less than 12g in each meal and no more than 40g of fat per day. A really fatty meal could result in some unpleasant side effects.
Is it effective?
A clinical trial has found that participants who took Xenical three times a day lost an average of 4.8kg in the first month, increasing up to 7.2kg at 3 months. After a year, the average loss was 10% of original body weight.
Xenical has also been studied for long-term weight loss (up to 4 years).
IMPORTANT: weight loss occurs with Xenical when used in conjunction with a reduced fat diet and exercise program.
What are possible risks and side effects?
Because you don't absorb all the fat you eat when taking Xenical, the most common side effects are gastro-intestinal problems, including:
- oily bowel movements
- frequent bowel motions and flatulence
- abdominal pain
Xenicalalso affects the amount of fat-soluble vitamins and beta-carotene you absorb, so a vitamin supplement taken at least two hours before or after taking Xenical may be recommended.
Who can use it?
You're only eligible to receive Xenical If you have:
- a BMI (Body Mass Index) of 30 and over; OR
- a BMI of 27 and over with other risk factors like diabetes or high blood pressure
Studies haven't been done in children or teenagers under 18 years or adults over 74 years of age, so it's not recommended for these groups.
How do you get it?
Xenical is available from pharmacies. You don't need a prescription, but before it can be sold pharmacists are supposed to assess you for suitability. They're expected to check:
- weight, height and BMI
- health status (existence of conditions such as diabetes, high blood pressure, ostesoporosis, for example)
- factors contributing to excess weight (including genetic influences, life states and events, and medical conditions or treatments).
If Xenical is dispensed, pharmacists should then give counselling on points including dosage, side effects and lifestyle modifications required (including diet and exercise).
Cost: Approximately $128 for one month's supply.
IMPORTANT: it’s always sensible to be fully checked out by your doctor before trying any medication – they’re the best person to advise you on your situation and help you decide on the best and safest way to tackle your problem.
Drug advertising: TAKE ACTION
Since September 2006, Roche (the manufacturer or Xenical) has been allowed to advertise directly to consumers – you may have seen the ads on TV.
CHOICE is concerned because:
- The ad suggests that Xenical could be appropriate for anyone who thinks they have a weight problem. But only certain people are eligible.
- It doesn't make it clear that changes to diet and exercise are essential to weight loss.
CHOICE has complained about the advertisements to the regulator. We've also written to the National Drugs and Poisons Schedule Committee asking that advertising approval for Xenical be removed and for this drug's schedule to be changed back to S4 (requiring a prescription).
If you'd like to support our actions, or for more information, go to Drug Advertising.