Weighed down by a pill

With anti-obesity medicines multiplying in the market, it8217;s time to pause and think: are these formulations safe?

Need to knock off the extra kilos in a hurry? Don8217;t starve yourself to the ground or go overboard on the treadmill. Just pop an anti-obesity pill. It8217;s now available over the counter and most major pharmaceutical firms have their respective variants of the magic pill in the market.

Says Dr Anoop Misra, head, diabetes and metabolic diseases, Fortis Hospital: 8220;Eating healthy and regular physical workouts are a must, but one can counter occasional overeating by popping an Orlistat, a salt that fights obesity. It is a mild formulation. It reduces the body8217;s ability to absorb dietary fat by about one third.8221;

But hang on, how safe really are these pills? 8220;Most weight-loss medicines available in the market today are appetite-suppressants. They have many side-effects,8221; says Dr S.K. Wangnoo, senior consultant, endocrinology, Indraprastha Apollo Hospital. He points out that one needs oral supplements to make up for the loss of vitamin A, D and E that Orlistat causes.

The only other anti-obesity salt that was hitherto available in India, in different variants, was Sibutramine. Its regular intake could lead to dryness and rise in blood pressure.

Dr Wangnoo issues a warning: 8220;One shouldn8217;t be on an anti-obesity drug for more than two years at a stretch.8221; He adds: 8220;It is usually prescribed to patients with a BMI body mass index of 27 to 30 and certain typical conditions that include high blood pressure, type 2 diabetes, high cholesterol, coronary artery disease, joint problems, and sleep apnea. Medication may lead to a loss of only 7 to 8 kg in one year, subject to individual body response.8221;

The Indian anti-obesity market recently saw the launch of a new salt called Rimonabant. A multi-impact formulation, it increases the sensitivity of hormone insulin, lowers blood glucose, decreases unsaturated fat, boosts good cholesterol level HDL, reduces body inflammation and causes aversion to smoking.

However, the US drug regulator, FDA8217;s objection to the drug owing to its probable psychiatric side-effects has made the Indian medical fraternity sceptical about using it.

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8220;Though current statistical data does not prove it to be harmful, one cannot say anything about its future ramifications. Patients must undergo a prior and periodic psychiatric examination when consuming Rimonabant. Those who are under severe stress, suffer from anxiety attacks or depression, or have an alcohol or drug problem, must treat these conditions before using any anti-obesity medicines,8221; says Dr Misra.

Adds Ruchir Modi, VP, marketing Torrent Pharma, 8220;Psychiatric problems are an associated side-effect. But then, all drugs have side-effects. That8217;s why such medications are to be taken strictly under medical supervision.8221;

A number of herbal drugs doing the rounds also claim to treat obesity. But Dr Jamuna Kurup, a senior Ayurvedic practioner, dismisses their efficacy. 8220;To say that Ayurvedic medicines can treat obesity would be incorrect. There are some herbs which act as fat-burners but there is no direct formulation for obesity. Certain combinations may lead to weight-loss but obesity is a chronic disease and has to be dealt with accordingly.8221;

Temporary benefits of anti-obesity medicines notwithstanding, endocrinologists assert: 8220;Long-term weight loss is about lifestyle changes, not quick-fix solutions.8221; So, heed the writing on the wall: dependence on weight-loss drugs isn8217;t such a great idea. It can lead to addiction to medicines. Worse, it makes you vulnerable to rapid weight gain once you are off medication.
Indeed, it8217;s a pill that could kill if taken at will.