Xenical (Orlistat) and Chitosan - Fat Blocking Agents

Eat Whatever You Want, And Don't Worry About the Fat?!?!  That's What The Ads Say!

The pharmaceutical companies have released their big selling fat blocker, Xenical.  The supplement companies have been cashing in with their over-the-counter fat blocking agents containing chitosan.  Although with Xenical the drug, and chitosan, the supplement, the end result, blocking the absorption of fat, is the same, the two substances are quite different in the mechanisms by which they attempt to achieve that end.

Where previous obesity drugs had stimulant or brain altering effects, Orlistat (Xenical) operates strictly in the digestive tract. Rather than acting directly to stop fat from leaving the intestine, it acts as a lipase inhibitor. It prevents enzymes (lipase) in the gastrointestinal tract from breaking dietary fats down into a molecular size small enough to pass through the tiny holes in the intestinal lining. Even the most optimistic studies have predicted Orlistat can act to prevent only about 30% of dietary fat from being absorbed. The claims made by Roche Laboratories, the pharmaceutical giants who are capitalizing on Orlistat sales often refer to a study published in the Journal of the American Medical Association which supposedly demonstrated that the Orlistat-fed group achieved greater weight loss than the control group. A close look at that study shows that after one year . . .yes an entire year . . . the Orlistat group lost an average of 19 pounds . . .but the control group . . the group being fed a placebo lost 13 pounds on average! That amounts to a greater weight loss by the Orlistat group of 1/2 pound per month! Worst of all, the study did not measure fat loss or body composition, so it is possible and even likely that the Orlistat induced dieters sacrificed lean body mass and slowed metabolism. Keep in mind that this is the study most quoted, but it is far from the only study that took place. Another study at Baylor Medical Center in Dallas took place over 57 weeks. 120 mg. Orlistat (or placebo for the control group) was administered three times daily with meals. The Orlistat group lost 6.2 pounds of body weight vs. 4.3 in the control group. In 57 weeks! Here is an example of how drug companies use the words, "research has proven" when in reality the miniscule difference between the two groups can simply be random coincidence. An interesting side line . . nine of the women taking part in a Hoffman-La Roche funded research study using Orlistat developed breast cancer as compared with only one such incident in the control group. A spokesperson for Hoffman-La Roche referred to animal studies that failed to find an Orlistat-cancer link when he stated that "this cancer incident could be due to chance." Interesting how a nine-to-one ratio they are willing to dismiss as "chance" where a ridiculously negligible weight loss differential in the same study is considered substantial "proof" of product efficacy.

The recommended dose of Orlistat is one 120 mg. capsule with each main meal that includes fat. The first challenge here lies in the fact that such a recommendation will encourage users to consume high fat foods believing the fat will not be absorbed. Looking at the recommendations further, Orlistat is indicated for obese patients with a Body Mass Index (BMI - I covered this in a previous Member's section month so I won't get into the flaws of BMI measurement here) of 30 or more. That means Orlistat would be recommended, not for people who simply want to lose a few pounds and minimize the damage caused by the cheese on their pizza, but for chronically obese. Many chronically obese individuals have over 100 excess pounds of bodyfat to lose. The Orlistat group in the best case controlled study lost only 1/2 pound per month greater than the control group. In order, therefore, to knock off even 60 pounds of excess body fat, the study would suggest it would take 10 years! I've helped people lose excessive bodyfat in a year or less . . . without any drugs at all!

Chitosan is a substance extracted from shellfish and has a "balling up" effect on oils it comes in contact with. When you put chitosan in the digestive tract, it doesn't affect enzymes as Orlistat, but rather attracts fat molecules and blobs them up into such large "fat balls" they can't be absorbed. Different mechanism, same effect.

Whenever you block absorption of fat, there are some likely discomforts and risks. First of all, the essential vitamins, A, D, E, and K are "fat soluble" vitamins. That means that they are carried, along with fat, into the bloodstream. If you are limiting fat absorption, you can not help but restrict absorption of this essential micronutrients. They play a major role in metabolism, immune function, and overall health.

As many supplements, Chitosan can "play a role," albeit a minor role, as a fat loss aid.  If you follow my program recommendations, and make one day per week the cheat day, one Chitosan capsule prior to a high fat meal can limit the likelihood that the dietary fat in that particular meal will wind up as fat on your body.  I take a Chitosan capsule before my Sunday pizza.

If you view any of these fat blocking agents as a license to consume grand amounts of high fat foods, that's where it goes beyond "playing a role" and can lead to some health issues.  Aside from blocking absorption of essential vitamins, the side effects of keeping large amounts of dietary fat in the digestive tract include (I'm using the words in the Xenical disclaimers although most if not all of these can be listed as risks with chitosan as well) . . . prepare to get grossed out . . .

Oily spotting, anal leakage, intestinal cramping, gas with discharge, nausea, diarrhea, oily discharge, fecal urgency, loose and oily stools, fecal incontinence, frequent bowel movements, and inability to control bowels. Does it sound like a wonder drug to you? Or . . . an opportunistic release by a pharmaceutical company that recognizes this as potentially the largest selling drug of all time.

Note: I have not heard of any side effects from using one (1) 500 mg chitosan capsule prior to infrequent "cheat" meals


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