SubscribeWeight Loss Drugs: Rates of Persistence Are Terrible
Weight loss from diet pills come with one fundamental requirement. To lose weight (and most likely maintain weight) you have to keep using them.
A drug such Orlistat (or it's cutdown OTC version Alli) will decrease absorption of fat by the intestines. Less fat means less calories. Less calories means weight loss.
So what happens when you stop taking the drug?
Unless you've made major changes to your eating habits - there's every chance the weight will come back.
So maybe you take the drug for a long time and lose a fair bit of weight. Maybe after a long period of time you have made permanent lifestyle changes.
What are the rates of attrition with such a drug? Clinical trials report that around 60%. That is, after a period of time, 6 out of every 10 users have stopped taking the drug.
This isn't the real truth. Research conducted outside of the tightly controlled clinical trials shows a completely different picture.
Nearly 17 000 users of orlistat and 3500 users of sibutramine were identified. For both orlistat and sibutramine, 1-year persistence rates were <10% and 2-year persistence rates were 2%.
So after two years just 2 out of every 100 users were still taking the drug.
Where are the other 98 drug users? Did they reach their maintenance weight? Have they ended up regaining the weight? Were the side effects too much to handle?
I sadly suspect that the favorable long-term results from pharmaceutical interventions are few and far between. Recent research published in Diabetes Care showed that the end results of 3 years of Orlistat only succeeded in slightly reducing weight gain compared with placebo.
To rephrase that: After losing weight on a very low-calorie diet - those taking Orlistat still re-gained weight (but not quite as much those who took a placebo).
Rephrase again: People gained weight while taking Orlistat.
Sure you have to make lifestyle changes to "help" the drug work. In that case, what's the point in taking the drug?
The anti-obesity drug has some side effects. People who takes it will grow tired after some time. The drug blocks even the fat soluble vitamins like A, D, E and K and therefore a vitamin supplement is necessary. Once they are off the drug, they start eating the usual stuff it is no wonder they gain back the weight. A lifestyle change is necessary to lose weight not any drugs.
ReplyNewsflash: Fats are still essential to human health. Block them at your own risk.
ReplyHas anyone actually had major results with Alli? I heard so much about it when it first came out, but haven't heard a word since then.
ReplyI've been on xenical since 1999. While it did help lower my cholesterol levels from low 200's to 175, I still weigh what I did in 1999. (which is 75lbs higher than I would like) I also recently developed
Replycolitis and am off the drug for good. I do not know if there is a relation there either
Not only do you have to keep taking them but they help they give is so minimum. Try the basics as nothing is better than exercising and eating healthy. So many people want the easy way out when the same solution has been true for the past 15 years. Exercise and eating healthy.
ReplyAlli is like Antabuse for fat people...if you make the consequences bad enough, the people eating the fat should theoretically stop doing that. But the big test is taking the Antabuse away from the alcoholic, taking the Alli away from the "reformed" eater. I'm guessing that if you continue to eat a sensible diet after quitting Alli, you'd probably keep the weight off. But if you just go right back to pizza and onion rings, you'll gain it back. Just like any other diet, I suppose.
ReplyI, personally am leary of any weight loss pill... Course I have lost 200lbs (yep--200lbs) on my own. When I went to my new dr, I showed him a picture of what I used to look like (at 350) and he wanted to know what surgeries I had had besides Gastric Bypass. I told him, none. I have lost my weight with watching what I eat (whole foods, eating real fats and no frankinfoods) and excercise. And a lot of time. I would loose 20-40 pounds (course my first big drop was 70lbs in 6 months) and I would maintain that for a few months, then start again. Personally, I think that is a better way to loose the weight--slow adn steady wins the race--and loosing as slowly as I did, less chance of it coming back. Just my 2 cents worth...
ReplyBTW--Never had gastric bypass--I have lost all that weight thru healthy living/eating.
ReplyIt means that diet pills are only useful to people who wants to lose weight for a certain period of time, and then go back to their old shape.
ReplyWhy would anyone take alli anyway? All it really does is gives u "leaks" Anyway, alli does not even control your appetite! Besides, people with eating disorders could possibly abuse this pill by thinking that they can eat all they want & "run" the food & calories out of their bodies. Just like abusing laxatives. I really think that this alli is just bad news.
ReplyI find it interesting that we celebrate drugs like the nicotine patch, and *never* discuss possible side effects (nausea, vomiting, dizziness, weakness, rapid heartbeat) or the possiblity of relapse (a whopping 93%, according to studies published in March of 2003), but we decry weight-loss drugs because of their side-effects and their low success rate. Double Standard, anyone?
I'm one of those people who struggles every single day with eating. I am an addict, and am working to overcome the destructive behaviors that are associated with addiction. I am eternally frustrated by the lack of support by the general population (in which I include "Big Food", and the restaurant and drug industries) for those of us who are in this boat. Tell someone that you are a recovering alcoholic, drug addict, or smoker, and you get piles of sympathy. People don't drink or smoke around you, and go out of their way to offer support and encouragement. Tell someone that you are on a diet and they offer you a cookie. God forbid you tell someone that you are a compulsive eater or addicted to food, and they tell you just how delusional you are, and what a moron you are to believe "that crap".
So, while I won't be jumping on the Alli bandwagon anytime soon - the side effects are a bit unsavory - I am constantly watching the markets to see if there is anything, ANYTHING, out there that can help me in this fight. Because it seems like there aren't many others in my corner.
ReplyI can understand what you are saying about lack of support for people who have eating weakness. In my office we get cakes, chocolate, candy,all sorts of things from other law firms. People will offer me things and when I say thank you but I'm on a diet they scoff. Just one couldn't hurt. So I stopped saying no I take whatever they give me wrap it in a napkin and throw it in the trash when they walk away. When my boyfriend says oh lets go to (insert fast food place) for dinner. I do not go with him and I do not sit in the room if he's eating. I've tried dieting for a long time and what has finally got me losing weightis this. I do not eat unless its to serve a need. I think about what I am eating while I eat it, what will I get out of this, what will it do to me. Rather than this tastes good, or I'm in a hurry so this will do. I have 10 cokes a day for over 15 years and I have completely cut them out. I started to think about the sugar and syrup and acidic junk that makes up coke, I read labels, I study healthy alternatives when I crave useless food. Be aware, look for foods you like that aren't worthless that will sustain you take 5 bites and stop for 15 min. on a timer (put the food away so you will have to go get it)... most of the time after 15 min you are all set... if not then the next 5 bites taste even better.
Tell everyone you see on a regular basis what you are doing in a way that gets their sympathy and gets them to relate. "I am miserable about my weight, not fitting in my clothing, I need people to work out with and for people around me to not tempt me."
Good luck
ReplyIt's quite a bit different to give someone more nicotine, weaning them off of it, than to give them some novel substance they have never before had.
Yes, the side effects you mentioned for the nicotine patch are all the same side effects that someone gets when having imbibed a cigarette too quickly (speaking from personal experience).
But to give someone a new chemical, not even found in nature, something never before encountered by their body or intended by natural selection to grow within a plant... There is a difference.
ReplyKailash, that wasn't really my point.
My point was that our society is very quick to jump on the bandwagon when it comes to stopping smoking, drinking and drugs, society is quick to praise any and all cures, including drugs. And in some cases, like methadone - a synthetic drug, by the way - drugs are a celebrated salvation. But ask for the same support for those who have a weight problem, and in general, the response is a snort, a chuckle, and the phrase, "duhhh, just eat less. Put your fork down and go for a run."
For some of us, more assistance is needed. We've tried putting down our forks. We exercise. We may have tried therapy or self-help groups. We would like our problem to be considered in the same serious light shed on other addictions.
And for the record, Orlistat is not a synthetic drug. It is a derivative lipstatin, which is an inhibitor of a pancreatic enzyme. I agree, I don't think that nature necessarily intended for us to be ingesting something like this. But nicotine is ok? Alcohol is ok? Meth is ok? No. None of those are, and there are drugs on the market to help the addict kick the habit. Why are those ok, but not something to help the obese?
ReplyLaura, the difference between drugs that help people kick alcohol, heroin, etc., and weight loss pills is that you don't need cigarettes, alcohol, heroin, etc., to live. But you DO need food to live and most weight loss pills out there either a) increase your heart rate to increase your metabolism (dangerous if your heart isn't used to beating that fast) or b) block macronutrients that your body needs for energy and sometimes vitamin absorption. Orlistat blocks fat and fat-soluble vitamins. There are other pills out there that claim to block carbs, etc. In truth, the only way to safely lose weight is to eat fewer calories and increase your activity. There are tools out there to help people that just can't do that on their own...lap band surgery, gastric bypass, etc. I personally think those surgeries should be a last resort for people that have literally tried absolutely everything and are still obese.
ReplyI think using diet pills is pointless. Instead of helping people lose weight, it will only add another concern to their health and their wallets.
ReplyI guess what I'm looking for is twofold.
First, accept that for some people, losing weight is more of a battle than just "eating less" or "exercising more". It's a full-on war that happens all day, every day, and any help from the medical community (other than the usual snort that most of us receive from our physicians) is more than welcome.
Second, when we choose to go the pharmaceutical route, be it orlistat or another (as yet not discovered) drug, understand that we know the side effects. Just like the smoker who is willing to introduce MORE of the drug to wean himself off of the drug, we are willing to introduce a substance (or procedure, like gastric bypass) that will make eating too much a very unpleasant experience. For some, it's the only answer.
ReplyI'm sure that the drugs which we will take will reduces the weight. But it will be for a very short time. with that it causes many other problems like gas trouble, diabetes and so on.....
ReplyIf we are taking pills then we must take food, or else some other problem will arises.
weight loss pills is that you don't need cigarettes, alcohol, heroin, etc., to live...
Now there is a better and more stable solution to loose or gain weight. But there is a website on herbal medicines that can balance out those up and down moments and lower your blood pressure, weight, diabetes to natural safe levels, quickly, yet gently. And without the risky side effects!
You're right...it's not just "eat less and exercise more"...if it were that simple, everyone would be skinny. There are other biological factors involved. I just finished reading Gary Taubes' new book "good calories, bad calories" and I have to say it's extremely eye opening. All of the modern day conventional wisdom on weight loss is built on a house of cards. We've repeated the same things over and over so many times that these myths are ingrained in our society as absolute truth. I suggest EVERYONE read this book. It's infuriating to me how the government and so-called "experts" have made recommendations over the years based on very little, if no evidence whatsoever to back up their claims.
Sorry...I didn't mean to go off on a rant there. Back to the topic at hand. I'm on phen/pro (phentermine/prozac combo). I know I'm going to get jumped on for this, but I'm in perfect health and know what I'm doing. I've been on and off phentermine for years, and yes you DO gain all of your weight lost back if you don't change your habits, and wean yourself off of them correctly.
People have a knee-jerk reaction when you say you're taking diet pills "oh those are so unhealthy", "they raise your blood pressure", "you have to stay on them forever", etc...
These comments are just another example of statements that are repeated so often they become "truth" in our society.
While people did develop heart valve issues while on phen-fen, it was the fenflurimine, NOT the phentermine that was the issue.
Being overweight is not healthy, so I consider resorting to medicinal aid to help me alleviate that issue to be the lesser of two evils.
Diet and exercise can alleviate, if not cure, diabetes, high-cholesteral, high blood pressure, depression, etc., but nobody thinks twice if you're taking meds for these ailments.
ReplyI think those weight loss pills were meant for one thing and one thing only. To be able to help you burn off the fat and weight faster with your diet and daily exercise(cardio mainly). Calorie deficit and eating much less carbohydrates than what you weigh is a plus :-)
ReplyI don't use diet pills. Only pill I take is Glucophage for diabetes. However, I have lost almost 45 pounds in the last two months. Purely diet and exercise. My site shows how and provides my diet diary. (And no, this isn't an ad... all the info is free. Just click on ym name in the comment.)
ReplyThat would be MY name, not YM name. Too bad glucophage doesn't treat dyslexic typing.
ReplyNO drug for me definitly :)
ReplyBy simply maintaining a balance diet and having targeted execise will only truely benefit both health and weight lossing in months.
Please do not consume drugs as a way of slimming or lossing of fat.
can alli do something to your blood
ReplyKnowledge is the best tool with dieting. Most people, not all, jump on a diet pill that sounds like it will solve their problem for just the cost of money and not the sacrifice of habits.
Some diet pills can assist you in your goal but the majority are useless.
Alli can punish you into eating right and some people believe that if you do something the same for 30 days it becomes habit. If that is the case it can help you to stop eating fatty foods and by experience let you know whats bad for you. It will not magically make food not fattening! It can block vitamins that you need and you should take a supplement with it.
Hydroxycut will give you a jolt of energy if your problem is being tired and drinking fattening drinks like coke or coffee with creamer. It can help with lack of energy to exercise. It can not fix lazy, it will not make you go outside and walk or drive to the gym or watch your exercise video.
The best thing for you is to stop viewing food as what you want and start seeing it as a need.
Food for people is like gasoline to a car. Different cars "need" different gas. You "need" healthy useful food and to stop overfilling the tank! Read the labels that's why they are there.
America is full of spoiled lazy people who complain when they can't have everything they want, that's why we have so many obese people. If you want to be thin you have to give up other things you want. If you're still big then maybe you want rest and junk food more... that's your choice live with it.
ReplyKathryne, I think you hit the nail on the head when you say that Americans want everything...they want to be thin AND still live the lifestyle of an obese person. To be really honest, if you are obese and want to be thin, you will probably have to give something up in your life that is contributing to your obesity. For me, that was my daily habit of drinking a giant 20 ounce juice drink and eating a whole bag of candy while I was studying and NEVER working out. Once I gave up most of my junk food and started exercising, I lost weight. Sometimes, a little sacrifice is definitely necessary. Diet pills definitely don't fix lazy, that's for sure.
ReplyI think diet drugs are different from diet supplements for the reason that the side affects can be more disturbing than the unwanted weight itself. I think there are plenty of healthier alternatives out there that with proper diet and exercise they can help to encourage weight-loss and keep it off for good. Eating healthy and exercising is a way of life not a trend so anyone that thinks that they are going to just take a pill to make their fat magically disappear is sadly mistaken. If you try a natural fat burner or natural appetite suppressant for a period of time to help assist your weight-loss there is no reason why you should gain all the weight back if you have truly made changes to your eating and your lifestyle. Also, I agree that if you are using any kind of fat blocker or fat binder you should definitely make sure you are supplementing or eating proper fats so you don't do damage to the body. Healthy fats are essential for brain function, energy production, and hormone regulation not to mention your hair, skin, and nails will definitely take a beating without incorporating healthy fat in the diet. My suggestion is to try coconut oil because it contains fewer calories than most fats and actually increases weight-loss significantly.
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