Drug shows promise for obese teens
6 July,2004
Orlistat, until now marketed only to adults, absorbs up to one-third of fat ingested
A weight-loss drug that blocks fat absorption helps obese adolescents lose more weight than traditional ways to trim unwanted pounds, a one-year study suggests.
Dr. Jean-Pierre Chanoine of the B.C. Children's Hospital in Vancouver says the drug orlistat (brand name Xenical), until now marketed exclusively to adults, absorbed up to one-third of the fat ingested by teens in the study.
"You decrease the absorption of calories and there is a very, very minimal amount -- less than one per cent -- of fat that is absorbed into the circulation. So it's certainly very safe, too."
During the trial, 539 obese adolescents were split into two groups and were required to eat a calorie-reduced diet, exercise and undergo behavioural therapy. The first group was given orlistat three times a day, while the second group was given inactive (placebo) pills.
Those on the placebo maintained their weight, while those on orlistat lost an average of 2.5 kilograms over the year. That might not seem like much of a weight loss, Chanoine says, but young people, unlike adults, are still gaining height and increasing body mass. So to actually lose weight, not just maintain it, is significant.
Chanoine says he would prefer not to prescribe medication to children, but excess weight puts them at risk of becoming obese adults and contracting obesity-related illnesses. He points out orlistat is not a magic bullet, but must be used with a good diet, exercise and, where necessary, behavioural therapy.
"It's not a blanket treatment. It's not going to replace lifestyle and physical education. That's an extremely important message, because these people are usually so desperate they would take anything if they felt it might help them."
Orlistat might have the additional benefit of encouraging young people to reduce their fat intake, Chanoine says. This is because lower absorption of fat means more fat ends up in the stool, resulting in "greasy diarrhea and cramps."
The one remaining challenge, says Chanoine, is identifying which children will benefit most from the drug. The U.S. Food and Drug Administration has approved orlistat for children ages 12 to 16 with extreme obesity, but so far no other country has followed suit. Chanoine is hopeful the drug will soon be approved for use by young people in Canada.
The study was funded by U.S.-based Roche Pharmaceuticals, which markets orlistat.
Source:www.medicalposting.ca
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