EDP column by Professor Ketan Dhatariya
There are currently three drugs available in the UK for the treatment of obesity. They work best when used in conjunction with a healthy diet involving eating fewer calories overall, as well as a regular amount of exercise.
The first of these drugs – orlistat – works by stopping you absorbing some of the fat in your diet. It therefore lowers the actual amount of calories getting into the body. The drug has to be taken with a very low fat diet, otherwise the fat that stays in the gut can create problems with oily stools and incontinence. In some respects this is a good thing, because if you get the diarrhoea whilst taking the drug, it means that your diet has room for improvement.
The second drug is called sibutramine. This works by mimicking the signals that the brain receives to let it know that you are full. It is not addictive, but can raise the blood pressure, so it is not given to those people who have high blood pressure already, and if prescribed it, then the pulse and blood pressure have to be measured every two weeks of the first three months.
The final drug is called rimonabant. This works by blocking the signals produced by the body when it is hungry. This makes people less hungry, and when they do eat, they feel full faster. The side effects from this drug are that it can cause nausea and vomiting.
Each of these drugs on average allows weight loss of about 1Kg (2.2 pounds) per month. Weight often goes on if they are not taken, or are stopped. GP’s in Norfolk are currently severely restricted in their ability to prescribe rimonabant because it remains very expensive. However, in the USA orlistat is available over the counter.
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