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Weight loss drug decision concerns health care professionals

The World Today - Tuesday, 28 February , 2006 12:41:00

Reporter: Jean Kennedy

ELEANOR HALL: Doctors and health professionals in Australia have expressed concern about a decision that allows the drug company Roche to directly advertise a weight loss drug that can cause side effects such as diarrhoea and incontinence.

The drug Xenical is available over the counter, but has never been advertised by name to consumers.

Now, though, the Federal Government's Drug and Poisons Committee has given the all clear for that to happen from September this year, as Jean Kennedy reports.

JEAN KENNEDY: The weight loss drug Xenical was approved as an over-the-counter medication around two years ago, after previously only being available with a prescription.

Until now, the drug company Roche has been banned from using the actual name of the drug in its advertising, with vague TV and radio ads telling people to go ask their pharmacist for more details.

And that's the way it should have stayed, according to the head of the Australian Medical Association Dr Mukesh Haikerwal, who believes direct marketing of the drug to consumers is fraught with potential problems.

MUKESH HAIKERWAL: We have significant problems with the whole process that this particular committee goes through, including putting it over-the-counter at the pharmacy in the first place.

Direct-to advertising, with a government tick of approval, will make people that this really is their salvation when they're overweight or obese.

It's simply not true. This may help in some respect for some people to reduce the absorption of fat from their body, but the downsides of it are really pretty dramatic.

If you happen to have a fatty meal, or something with fat, after you've taken this, you can have significant problems with your bowel action and you can even get leakage from the back end.

JEAN KENNEDY: He says without a low-fat diet and exercise the drug is pretty ineffective.

MUKESH HAIKERWAL: Use of Xenical alongside diet is imperative, and the results of diet alone versus diet and Xenical shows very little difference most of the time.

JEAN KENNEDY: What concerns do you have about the targeting of particular groups of people with this drug?

MUKESH HAIKERWAL: We would be concerned about young women, for instance, who may have eating disorders, or young people who really have no significant body problem but have a body image problem, who will take this stuff, which of course is freely available at the pharmacist anyway.

It may give some people a false sense of hope, a false sense of security that they're doing something about their obesity. It doesn't if it's used on its own.

JEAN KENNEDY: The drug company says it's now in the process of designing a strategy to promote the drug with a national campaign of TV, radio and print ads targeting women, primarily, aged between 25 and 55.

But Professor of Clinical Pharmacology at Newcastle University, Professor David Henry, says in some overseas countries where it's common for drugs to be directly marketed to consumers, the benefits of the product are sometimes misrepresented and any adverse effects are missing from the message.

DAVID HENRY: It's more of a promotional than an educational exercise.

So with Xenical, I think one of my concerns would be that it's promoted almost like a cosmetic product. This is about appearance rather than health.

And I would hope that the promotion in this country is responsible and concentrates on the health aspect and not appearance.

JEAN KENNEDY: But the Director of the Diabetes Centre at Sydney's St Vincent's Hospital, Professor Lesley Campbell, says the decision to allow the drug to be named in advertising is a step forward in the fight against obesity.

LESLEY CAMPBELL: Oh, it's been scientifically shown that with a diet and exercise, with a low-fat diet, up to five to 10 per cent of bodyweight can be lost, which, for an obese person, does not correct the amount of overweight they may have but will help them with their metabolic disorder.

JEAN KENNEDY: But the lobby group Healthy Skepticism, that campaigns against pharmaceutical marketing techniques, has major concerns about promoting the over-the-counter drugs by name.

The head of the group is Dr Jon Jureidini.

JON JUREIDINI: Direct to consumer advertising is more about persuasion than it is about information and Australia doesn't have direct to consumer advertising in relation to prescription drugs and there are very good reasons for that and we'd argue that the same reasoning should be applied to over-the-counter drugs.

ELEANOR HALL: And that's Dr Jon Jureidini, ending Jean Kennedy's report.

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From http://www.xenical.com/safety_home.asp

Side Effects

Because XENICAL works by blocking the absorption of dietary fat, it is likely that you will experience some changes in bowel habits. These bowel changes are a natural effect of blocking the fat from being absorbed. They generally occur during the first weeks of treatment; however, for some people they may continue for 6 months or longer while on XENICAL. These changes may include gas with oily discharge, an increased number of bowel movements, an urgent need to have them, and an inability to control them, particularly after meals containing higher amounts of fat than are recommended.

When you read the part that says "These changes may include gas with oily discharge, an increased number of bowel movements, an urgent need to have them, and an inability to control them," you will notice that it means possible incontinence. The possible changes "may continue for 6 months or longer while on XENICAL."

From dictionary.com

in·con·ti·nence (n-knt-nns)

n.

The inability to control excretory functions.

Lack of restraint in sexual relations; immoderation.

The keywords are "inability to control."

Just a few fun facts that I thought some people would like to know.

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The hell with that. For those who aren't ready for a 6-month-long diarrhia experience, I suggest you just scoot on down to your local junk-food emporium and get a few bags of WOW chips. They contain the magical substance Olestra, which blocks the absorbtion of fat (with all the side-effects) in much the same way described above.

http://www.becomehealthynow.com/article/fats/156/

"One night in the fall of 1996, 49-year-old Jean Medonic of Marion, Iowa, tried some potato chips made with the fat substitute olestra as she watched the 10 o'clock news.

"'Normally I can eat anything without becoming sick,' she says.

"An hour after turning in, she suffered gas pains so sharp and of such a magnitude that I would say it was almost like the beginning of labor.

"The pain finally subsided just before the waves of diarrhea hit. She says she was severely ill for 13 or 14 hours. Medonic is one of thousands of people who appear to have had messy run-ins with olestra, a fake fat that's touted as a way to help you stay slim and cut your risk of heart disease. While there's no direct evidence that it can do either, there is a chance that it will send some people scooting for the nearest bathroom."

I haven't experienced this for myself-- I'm not into poopy diapers at all, much less the severe abdominal cramps-- but anybody who wants to volunteer in the name of pure research, please do and let us know how it came out (pun intended).

:beer:

wv

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