Ahmad Risk <[log in to unmask]> writes
>Now that I polished off all the maron glace and the port
That's alcohol - thought you didn't
>could someone
>please give me the chapter and verse on Orlistat in a couple of useful
>paragraphs?
Orlistat and the Fat Blobs - Chapter 1:
Asssumptions: high fat diets cause obesity
reducing fat in diet reduces obesity
decreasing fat absorption enhances weight loss
Orlistat Inhibits Lipases - Chapter 2:
Precisely: Orlistat is a potent, specific, long-acting inhibitor
of gastrointestinal lipases. It acts in lumen of stomach and small
intestine by covalently binding to serine residues at the active site on
both gastric and pancreatic lipases, so preventing hydrolysis and
subsequent absorption of up to one third of all ingested dietary fats.
(got that?)
More science: Minimally absorbed so negligible plasma
concentrations. No accumulation, metabolised in gut wall, t1/2 14-19
hrs, 97% excreted in faeces (gross) - 83% as unchanged orlistat (money
down the pan?)
Orlistat and the Trials - Chapter 3:
All trials involved sticking to a low fat diet (there's a hint
here)
It takes time to see results (apart from side effects)
A 2 year study showed that although the Orlistat group lost more
weight in the first year, all gained it in the second when reverting to
a eucaloric diet. i.e. results don't last
Orlistat in the patient - Chapter 4:
BMI 30-43
4 wks weight loss before start
Diet - balanced, fruit and veg, 30% max fat
1 capsule (120mg) before, during or after meal (or anywhen you
like it seems)
Discontinue if they don't lose weight
It may cause: GI disturbance (surprise)
headache
period irregularity (why?)
anxiety
fatigue
UTI (pardon?)
influenza (come on - really?)
It interacts with: fibrates, acarbose, biguanides, anorectics,
anticoagulants, pravastatin, fat-sol vitamins
Apparently it: improves LDL:HDL ratio
doesn't work so well in diabetics(type2)
BUT (and this is a big but) - up to 27% patients experience oily
spotting from the rectum, flatus with discharge, faecal urgency,
increased defaecation and faecal incontinence!
Oh, the cost?
84 (1 month) = £43.10
(Prozac is cheaper with fewer side effects)
--
Katie
(all because the lady loves Milk Tray)
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