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Too Fat? Pop a Pill
 Your dietician is lying if she tells you that there is no magic pill to
knock off a few kilos. There is. In fact, there are a variety of them. Walk into
any chemist shop and ask for allopathic anti-obesity pills. Chances are, you
will be dazed by the assortment and the accompanying guarantees.
Roughly, these pills can be categorized into two groups-ones that suppress
hunger, and other that reduce fat absorption. The first-chemical fat absorption.
The first-chemical name sibutramine, sold under brand names Obestat, sibutrex,
Sibutrim and Slenfig-work by interfering with chemical messages in the central
nervous system so as to produce a feeling of fullness. The other pills,
available under the brand name Xenical (chemical name orlisatat), decrease
absorption of fat by about 30 per cent. While sibutramine pills are freely
available in India, Xenical can be bought on the Internet or at select chemist
shops, under the counter.
Though technically, sibutramine and orlistat pills are meant for obese people,
in reality, teenagers and others who are slightly overweight are popping these
pills to avoid getting on to the stepper for a few minutes.
Manufacturers admit that though these are prescription drugs, their unregulated,
self-referring market is expanding rapidly. Already, India's monthly consumption
of anti-obesity pills is worth Rs. 1.1 crore.
But can a pill really make you lose your appetite and turn your body into a
calorie-burning machine? Well, opinion is divided.
Dr. R.K.Suri, A Delhi-based diabetologist says, "Though these drugs are made for
people with obesity-related diseases, most can't take them because their side
effects far outweigh the risk of being mildly overweight." About 40 to 50 per
cent of his patients who were prescribed sibutramine, complained of high blood
pressure. "And in the rest negligible weight loss was recorded."
Dr. Suri, however, is all praise for Xenical, a "beautiful drug that reduces fat
absorption by 30 per cent." But warns that Xenical may result in loose stools.
Dr. Rakesh Gupta, a senior consultant with Apollo Hospital, who has been
prescribing sibutramine pills for over a year-and-a-half , however, finds them
very effective. "When taken along with a controlled diet and regular exercise,
they help in reducing 8 to 10 per cent body weight in six months. And frankly, I
have not seen any side effects, " he said.
"Sibutramine acts on the brain's satiety centres and kills hunger. As, for some,
feeling satisfied with less food is a major barrier to weight loss, medication
is necessary to control their appetite." Dr. Gupta said.
But if you are tempted to knock off a few kilos by popping these pills, be
warned. Sibutramine pills have a long list of side effects, the most common
being insomnia. "People who take sibutramine often return to buy sleeping
pills," a chemist said. More serious, though, are depression, visual disorders
and impotence. Slimming pills have also been known to lead to addiction, blood
disorders, psychosis and even death.
The Duchess of York is one of the most famous victims of slimming pills. The
pills fogged Fergie`s brain and she became "hysterical" and had to be weaned off
the pills.
Dr. Manish Chawla, who works at Cipla and is happy that their Obestat is doing
"great business" said, "These medicines have been tested internationally. All
drugs have side effects and so do these. But compared to the benefits, the side
effects are negligible." Obestat, he says, can be taken once daily for up to two
years, and helps in shedding 5-10 per cent body weight.
Dr. Sanghi, who runs Delhi's Pulse Impulse health clinic, however, rejects the
sales pitch. "If these pills are so wonderful, why do drug companies restrict
their use to two years?" Because, she explains, long term use of these pills
will result in complications similar to those of starving and anemia: Vitamin
deficiency that may affect eyes, hair, skin, and other body parts.
 Dr. Makhija, a well-known Delhi dietician says," These drugs help initially-by
motivation you and reducing your food intake. But you have to get off them soon.
You have to learn to manage your food and not fool your brain into thinking that
your have eaten.
The bottom line is, these pills are handy in curing obesity-caused by a
sedentary lifestyle, abundance of high-calorie foods and ever-expanding portion
sizes-when taken under supervision, along with controlled diet and exercise,
they get the initial push and motivation with these pills, " Dr. Sangh said. But
remember, these will only suppress your appetite. Not greed.
DO THEY WORK?
Sibutramine: If we have chocolate or milk at night, serotonin is released in our
body, giving us a sense of satisfaction. Sibutramine (brand names, Obestat,
Sibutrex, Sibutrim, Slenfig) releases serotonin without our eating anything.
Side effects: Can cause headache, dry mouth, anorexia, insomnia, constipation,
convulsions, increased blood pressure, dizziness, anxiety, depression.
Orlistat: This pill (brand name Xenical) is a lipase inhibitor. It interferes
with lipase function (lipase is the enzyme that breaks down fat for use by the
body), decreasing fat absorption by 30 per cent.
Side effects: Can lead to fecal urgency, fatty/oily stool, abdominal pain,
nausea, tooth disorder, vomiting.
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