I have been on Xenical for about 10 days. Here’s my report, for whatever it’s
worth.
Let me start by saying that I did a substantial amount of internet research on
Xenical and was very excited about the possibiity that it would help me lose
weight. I had already lost a significant amount of weight on phendimetrazine
(a more potent version of phentermine), but my body had developed a tolerance
to the maximum dose my doctor was willing to prescribe.
Based on my research, I was really impressed with the fact that Xenical’s
mechanism of action is local, not systemic. It prevents the GI tract from
absorbing about 1/3 of fat calories, but doesn’t produce dry mouth, insomnia,
or any other non-GI effects that are caused by drugs like phentermine.
Although there were a few more breast cancers in the Xenical-treated group
than in the placebo-control group, the numbers were statistically
insignificant. Furthermore, the data clearly show that virtually none of the
drug is actually absorbed into the bloodstream, so how can it cause cancer?
Last month — when Xenical was launched in Europe and elsewhere — I initiated
an intense web search to find an online overseas pharmacy from which to order
it. When I finally found it, I ordered a 3 month supply (the maximum aqmount
that can be imported into for personal use under FDA rules) for about $300.
But my (brief) experience — combined with subsequent research — has been
disappointing. Let me summarize my findings.
(1) Unlike phen, ephedrine, caffeine, and other stimulant-type products,
Xenical does nothing to reduce food cravings or hunger, nor does it increase
your energy level or metabolic rate. So if you need the extra help
controlling your food intake that these other drugs provide, don’t expect to
get it from Xenical.
(2) If you study the clinical trial data really carefully, you will realize
that the benefits of Xenical are actually fairly marginal. Yes, it prevented
absorbtion of 1/3 of the fat consumed by the treatment group. But that group
(as well as the control group) was *already* placed on a “mildly hypocaloric
diet” of 1800 calories in which fat intake was restricted to 30% of this
amount. In other words, the total fat consumed by clinical trial subjects was
600 calories/day — and the use of Xenical prevented the absorption of 200
calories/day.
We all know the math — one pound of fat equals 3500 calories. So, at a rate
of 200 cal./day, Xenical will help you lose less than 1/2 lb./week. Not very
impressive. And the fact that many more Xenical subjects managed to lose 5%
of their body weight over the course of 6 months is much less impressive when
you know that the average patient had a starting weight of 220. In other
words, fewer than half of Xenical patients managed to lose 11 pounds in 6
months.
(3) My personal results? Admittedly, the time I’ve been using it has been
short, but I have actually *gained* 1 - 2 lbs. Not only that, but I
discovered that this oily stool/anal leakage business is a serious issue, not
to mention intestinal gas and irritable bowel syndrome (alternating diarrhea
and constipation), at least in the early weeks of using the product. Stop
reading right here if you don’t want to read a more graphic description of
the GI effects.
I never had any GI trouble with olestra, so I just assumed that the anal
leakage business was similarly overstated with respect to Xenical. And it’s
certainly true that, unlike the test subjects, I had not reduced the amount of
fat calories in my diet, so maybe my side effects were worse than someone
who is managing to stick to a slightly-calorie-restricted diet. But let me
tell you, it is very unpleasant to wake up in the morning to discover that an
orange, watery liquid has stained your underwear and thighs. Or to be sitting
in a chair and feel like you had suddenly, somehow wet your pants.
And, God forbid, you binge one night, eating a pint of Ben & Jerry’s, you will
pay and pay the next day. Cramps, gas, diarrhea, leakage, you name it. Even
the FDA panel that voted to recommend approving Xenical admitted that the data
demonstrated this adverse conditioning effect. Kind of like that drug they
give to alcoholics to make them sick if they take a drink. Not that you have
to completely cut out fat, but you can’t even eat a couple of candy bars
without your intestines lodging a major protest.
But I haven’t given up. I’ll give it a few more weeks and, hopefully, the
side effects will subside. And –if these side effects disappear soon –
maybe I’ll decide that losing 2 “free” pounds a month thereafter made it all
worthwhile.
