A magic pill for weight loss?

Anyone who has ever tried to lose weight knows from experience how dishearteningly difficult this can be.  What if there were an easier way of doing it?  You know, a magic pill that takes away all effort and, even better, allows you to eat whatever you want and as often as you want.  How cool that would be.  

...Hmmm, if only this were true

Disappointingly there is no such pill, and it is very unlikely that there ever will be.  If one does pop up on the market, I’m sure that the associated risk to health it carried would be a deal-breaker when it came to licensing for use in the NHS.
 
The reality is that the effort it takes to “eat less and move more” is about as ‘magical’ as it gets. Follow that simple formula and the pounds do disappear – the magic happens when we stick to that tried and tested approach, especially controlling portion size.  This is not sexy, although some of the weight loss diets out there do try to seduce us into buying the latest way of losing weight.  It’s smoke and mirrors.

... Weight loss diets do actually work!

Regardless of a diet’s 'exotic' name (think South Beach Diet, Noom, Keto diet, WW, Intermittent Fasting), they are all variations on how to eat less food.  By the way, diets do work … if you stick to them. Finding a way of eating that you enjoy is the key to weight loss. Go simple, go slow and get to your goal surely ... and steadily - there are no quick fixes waiting to be discovered.
 
A weight loss pill that now seems to have been around forever (since 1998) is orlistat (Xenical). Orlistat on its own doesn’t make magic happen, but what it can do is to give you a bit more from your efforts to eat less and to move more.  It’s important that the diet is low in fat when taking orlistat, otherwise results will be disappointing.  

... A pill that helps your magic

Orlistat reduces the amount of fat that gets digested at mealtimes – the undigested fat can’t be absorbed and is expelled via stool.  It can be an effective add-on to the lifestyle changes that are essential for weight loss, but it’s important to know by how much orlistat can help you on your journey, so you can be realistic about your expectations when taking it. 
 
A study back in 2011 looked at effectiveness of orlistat for weight loss. Eighty patients were given either orlistat or placebo.  In those taking orlistat, the average weight loss at 24 weeks, was 4.7kg and the average weight loss in those taking placebo was 2.5kg.  

Something I think is important to note about this study, is that the researchers did not tell us whether those on orlistat were better at sticking to a low-fat diet than were those on placebo. 

​A side-effect of orlistat when there’s too much fat in the diet is anal leakage and oily stool.  Get caught out once by this and people are either going to stop taking orlistat or double-down on reducing their fat intake, which would reduce their overall calorie intake, resulting in more weight loss. Did it happen in this study, I wonder?
 
Orlistat can be helpful and free of side-effects for those who stick strictly to a low-fat diet and control their portion sizes – that’s right, portion control is still a key part of the magic for weight loss.  You can expect to lose a little more weight (around 2kg) at 6 months into your journey than you would if you did only lifestyle changes promoted on the Aplos Health & Wellbeing Programme.

If your diet is low in fat at the halfway point of the programme, your GP can be asked to prescribe orlistat if you would like to give it a try.
 
In the meantime, control your portions, control your weight!

Tony Hirving
Dietitian