Diet Pills and Appetite Suppressants

By Bonnie Jenkins, Advanced Natural Medicine

Its official: America needs to loosen the belt buckle another notch. A new study has found that obesity rates continue to climb across the nation – and there’s no relief in sight.

While the obesity epidemic has hit every state in the union, Mississippi became the first state to crack the 30 percent barrier for adults considered to be obese. And West Virginia and Alabama are just slightly behind.

Playing by the Numbers

The report, which was compiled by the Trust for America's Health, is based on phone interviews with people about their height and weight in each state from 2003 to 2006. But, because the information comes from a personal estimate, some believe it’s actually a conservative estimate. Indeed, the Centers for Disease Control and Prevention released a study last year noting a 32 percent national obesity rate – a higher rate than the new estimate. The difference? The CDC's numbers came from weighing people rather than relying on telephone interviews.

How important is that two percent? Not very since anyone with a body mass index (BMI) greater than 30 is considered obese. The index is a ratio that takes into account height and weight. The overweight range is 25 to 29.9. Normal is 18.5 to 24.9. The only exception – people with a large amount of lean muscle mass, such as athletes, who can have a high BMI without having an unhealthy level of fat.

Lack of exercise is a huge factor in obesity rates. The CDC found that more than 22 percent of Americans don’t engage in any physical activity on a regular basis. Not surprisingly, the percentage was greater than 30 percent in Mississippi, Louisiana, Kentucky and Tennessee – four states where fried foods are considered a food group.

Meanwhile, Minnesotans led the way when it came to exercise. Just 15 percent of the state's residents were sedentary – still too high but the best rate in the nation. Despite that, Minnesota still ranked 28th overall when it came to the percentage of obese adults.

A Symptom of Bigger Problems

The problem with all this collective weight isn’t just confined to its social and psychological impact. The biggest threat is the effect excess weight has on health.

The risk of heart disease increases because being overweight elevates blood pressure, cholesterol, triglycerides and increases the odds of insulin resistance. The location of excess body fat can further increase risk. Central obesity, for example, is directly associated with an increased risk of heart disease. A 20 percent reduction in body weight can reduce the risk of heart disease by an impressive 40 percent.

The incidence of diabetes also increases with increasing weight. In fact, diabetes is three times more likely in obese individuals with a BMI of 28 or greater.

Cancer risk increases too due to elevated hormones that can influence cancer development. For example, excess estrogen is linked with reproductive system cancers like breast or ovarian cancer. Other diseases associated with obesity include osteoarthritis, sleep apnea, abdominal hernias, varicose veins, gout, gall bladder disease, respiratory problems and liver malfunction.

The Battle of the Bulge

If you’re one of the statistics – or even if you fit in the overweight category – you might be thinking about losing a few pounds. But how? Diet books are literally causing bookstore shelves to groan. Gym memberships are so expensive. And then there are all of those appetite suppressants and fat-burning diet pills hyped with a flurry of retouched before and after pictures.

Well, in case you’ve missed the barrage of television commercials, print ads and direct mailings, there’s a new nonprescription drug for weight loss called Alli. But is it really the weight-loss option everyone has been waiting for?

It turns out that Alli isn’t so new after all. The active ingredient is orlistat, the same ingredient in the prescription weight-loss drug Xenical. The only difference is the strength; each Xenical tablet contains 120 milligrams, while each Alli tab contains 60.

So how much weight can you lose? While Xenicalpromises to help you lose twice as much weight as you would just following a weight-loss and exercise program, Alli says you’ll lose 50 percent more than with diet and exercise alone. So if you would normally lose 10 pounds with diet alone, Alli can nudge it up to 15 pounds.

Unlike most diet pills, Alli isn’t an appetite suppressant. It works by preventing the body from absorbing 25 percent of the fat in the foods you eat. Fewer fat calories means fewer calories ingested, which leads to weight loss. The catch is, you have to use Alli in conjunction with a low fat diet and consume less than 15 grams of fat per meal.

What happens if you don't meet the 15 gram requirement?The fat that’s not absorbed has to go somewhere and that somewhere is into your stool. Not surprisingly, then, the most common side effects of orlistat are bowel changes, such as loose stools, an urgent need to use the bathroom or gas with oily spotting. All unpleasant prospects. The more fat you eat, the more likely you are to experience intestinal problems with Alli.

One Last Thing ...

So is Alli safe? As far as pharmaceutical drugs go, a number of clinical studies suggest that orlistat is safe to use for up to two years. But this new weight loss miracle has some definite drawbacks.

Aside from the gastrointestinal mishaps that can occur if you don’t play by the rules, Alli can interfere with the absorption of fat soluble vitamins like vitamins A, D and E. To combat this, the plan suggests taking a multivitamin before bedtime. While that might help if all you take is a multi, women who take calcium to prevent bone loss or people taking certain nutrients for a specific problem may have trouble fitting them in. And you might want to check with your doctor if you’re taking medication since Alli can interact with certain prescription drugs.

People who suffer from any type of intestinal problem, like Chron’s or Celiac disease, that prevents you from absorbing nutrients should avoid Alli. And forget about it if you’ve had an organ transplant.

And then there’s the cost. Alliwill cost you close to $2 per day. Plus you need to consider more than cost. You have to commit to changing your diet and to exercising. In fact, the product’s tag line is “if you have the will, we have the power.” Ultimately, it’s up to you. So save your money and start counting calories instead. It may take a little longer but you’ll save money and won’t have to make any of those emergency trips to the bathroom.

This Just In ...

We’ve known for years that folic acid was good for your heart, but there’s new evidence that it boost vascular health throughout the body. After reviewing eight clinical trials involving almost 17,000 people, researchers found that folic acid reduced the risk of a first stroke by 18 percent. And the longer this B vitamin was taken, the more risk was lowered.

While eating egg yolks, nuts, whole grains, spinach and cruciferous veggies are all wonderful ways to boost your folic acid intake, take a supplement to get the most from this nutrient. The typical dose is 500 mcg. per day. Just make sure you don’t take your supplement right after eating beans since there is some evidence that beans can interfere with absorption.

* * *

References:

Anderson JM. "Orlistat for the management of overweight individuals and obesity: a review of potential for the 60-mg, over-the-counter dosage.” Expert Opinions in Pharmacotherapy. 2007;8:1733-1742.

Bigham S, McGuigan C, MacDonald BK. “Reduced absorption of lipophilic anti-epileptic medications when used concomitantly with the anti-obesity drug orlistat.” Epilepsia. 2006;47:2207.

Carlsson CM. “Lowering homocysteine for stroke prevention.”The Lancet. 2007;369: 1841-1842. Keagy PM, Shane B, Oace SM. “Folate bioavailability in humans: effects of wheat bran and beans.” American Journal of Clinical Nutrition. 1988;47:80–88.