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Diet & Optimum Nutrition

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.




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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