New Nonprescription Weight Loss Product

W. Steven Pray, PhD, DPh

Disclosures

US Pharmacist. 2007;32(10):10-15. 

In This Article

Introduction

Obesity is a medical condition that is highly resistant to therapeutic interventions.[1] The simple explanation is an imbalance between energy intake and energy expenditure, but patients often resist reducing intake and increasing exercise in a manner sufficient to induce sustainable weight loss.[2] As a result, overweight patients undergo numerous approaches with varying degrees of success, including expensive gadgets, portion control, meal plans, support groups, surgery, and pharmacotherapy. This year marked the debut of a new nonprescription product, orlistat (alli). Presently, no other nonprescription product is proven safe and effective for weight loss.

The World Health Organization estimated that 1.6 billion adults (over age 15 years) were overweight in 2005.[3] In the U.S., the overall incidence of obesity has doubled since 1980.[4] Certain groups have fared even worse; the incidence tripled in children and teens. An estimated one-third of adults are considered overweight and another third are obese.[5]

Obesity exhibits distinct epidemiological trends. In women, 82% of non-Hispanic blacks are obese, compared to 75% of Mexican Americans and 58% of non-Hispanic white women.[4] Seventy-six percent of Mexican American men are obese, compared to 71% of non-Hispanic white men and 69% of non-Hispanic black men.

Family income influences obesity. Women with lower income have a 50% higher risk of developing obesity than those with higher income.[4] The reason is thought to be the preferential purchasing of high-fat, high-calories foods, which may be less expensive than healthy foods such as fruits and vegetables.[4]

The list of health problems related to obesity is compelling. It includes heart disease, hypertension, stroke, type 2 diabetes, abnormal blood cholesterol/triglyceride levels, the metabolic syndrome, cancer, osteoarthritis, sleep apnea, reproductive problems, and gallstones.[1,6]

Companies have marketed numerous weight loss prescription medications; perhaps the most notorious are the amphetamines (e.g, Dexamyl, Eskatrol, Dexedrine, Didrex). For a variety of reasons, many weight loss medications have long been discarded. However, phentermine and sibutramine (Meridia) are still available.[7] In addition, patients who meet certain criteria may opt to undergo Lap-Band or gastric bypass surgery. These surgeries can yield consistent, large-scale weight loss.[8]

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