In January 2006, a federal advisory panel recommended that the FDA make the weight-loss medication orlistat (Xenical) available without a prescription. Although the FDA usually takes the panel's advice, orlistat's approval is uncertain in the face of rising opposition.
A report by Harvard Women's Health Watch questions the drug's effectiveness in the broader population and has expressed concern about its side effects.
A new weight-loss solution is likely to be popular; two-thirds of adults in the United States are overweight or obese and at risk for major health problems and early death. But Harvard Women's Health Watch says the reasons for weight problems are complex. It says that while no pill can melt away fat or keep the pounds off, for people whose health is at risk, drug therapy may increase the odds of success.
Even though weight-loss drugs have a role to play in medical treatment, their long-term safety is unknown, the group adds. And like all medications, they can pose problems. Orlistat, which inhibits the body's ability to take in fats, can also reportedly interfere with the absorption of certain vitamins.
The National Institutes of Health advises that diet drugs be taken only by severely overweight people who need them for health reasons, and only in combination with lifestyle modifications. For example, one study found that people taking the weight-loss drug Meridia (sibutramine) who also received counseling on diet and exercise lost twice as much weight as those who received either Meridia or counseling alone.
The bottom line: The Harvard Women's Health Watch says that weight-loss drugs can help, but they're not the ultimate solution. The key to long-term weight loss is a lot of effort and isn't easy.
