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- <text id=93TT0230>
- <title>
- July 26, 1993: Cake Eater's Dream?
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1993
- July 26, 1993 The Flood Of '93
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- HEALTH, Page 54
- Cake Eater's Dream?
- </hdr>
- <body>
- <p>Not quite. But a new diet drug does seem to cut the fat.
- </p>
- <p>By PHILIP ELMER-DEWITT
- </p>
- <p> Of all the bizarre stratagems men and women have cooked up
- to reduce weight without cutting back on food, this latest one
- takes the cake. It's a pill that makes you thinner not by suppressing
- appetite or speeding up metabolism but by preventing fat from
- entering the bloodstream (and the hips, the belly and the buttocks),
- one greasy molecule at a time. Liz Smith, the syndicated gossip
- columnist, calls it the new "dream drug." The Times of London,
- which should know better, pronounced it a "pain-free pill that
- allows us to stay slim for life while eating what we like."
- </p>
- <p> Too good to be true? You bet your love handles. Developed by
- New Jersey-based Hoffmann-La Roche, orlistat (chemical name:
- tetrahydrolipstatin) shows promise, but its effects are strictly
- limited and still not completely understood. Preliminary studies
- suggest that when taken in conjunction with a moderate diet,
- it can reduce fat uptake in seriously overweight patients up
- to 270 calories a day--the equivalent of about one scoop of
- Haagen-Dazs. The drug is not a panacea. Nor is it anything anybody
- should consider swallowing just to look better in a bikini.
- </p>
- <p> The most interesting thing about orli stat is the way it works.
- It targets a pair of key enzymes in the digestive tract and
- by blocking their action neatly thwarts one of the body's most
- basic functions: the breakdown and utilization of dietary fat.
- Most of the fat we eat is too...well, fat to be absorbed
- by the body. Before it can pass through the walls of the intestine
- into the bloodstream, each fat molecule must be split into its
- constituent parts: three fatty acids and the glycerol backbone
- to which they are attached. That is the job of two fat-cleaving
- enzymes, called lipases; one of them is found in the stomach
- and the other in the small intestine. Once the fat pieces make
- it through the intestine walls, they are reassembled and transported
- by the bloodstream to cells. Then they are burned for energy
- or stored for future use in the usual unsightly places.
- </p>
- <p> Orlistat, taken three times a day, inhibits fatty buildup but
- does not completely prevent the enzymes from doing their job.
- According to Dr. Jonathan Hauptman, director of therapeutic
- research at Hoffmann-La Roche, the body produces lipase in such
- quantities that the drug is only about 30% effective, no matter
- how much of it you ingest. If you took a dose of orlistat and
- then ate 100 grams of fat (roughly four Big Macs), 70 of those
- grams would be absorbed as usual and 30 grams would pass, undigested,
- through the intestine.
- </p>
- <p> That was enough, in a recent test, for 100 Americans on a light
- diet to lose an average of 11 lbs. in three months--nearly
- twice as much as control subjects, who were on the same moderate
- eating regime but were given a placebo. The group taking the
- orlistat did experience minor but unpleasant side effects, including
- greasier stools and some diarrhea. It is not known how many
- of those people gained back the weight they had lost as soon
- as the trial was over. An ambitious two-year study, involving
- 4,000 subjects from Europe and the U.S., is under way.
- </p>
- <p> Even if all goes well, it could be years before orlistat gets
- FDA approval and goes on sale--by prescription. Researchers
- warn that it has proved effective only when accompanied by significant
- changes in diet and exercise and just for a few months. It remains
- to be seen whether patients will have to stay on the drug indefinitely
- to maintain their weight loss, and whether some will undo the
- drug's modest benefits by eating more.
- </p>
- <p> Given the uncertainties--and the hefty premium Hoffmann-La
- Roche can be expected to charge for any new diet pill--medical
- experts say that use of orlistat should generally be limited
- to those who need it most. Candidates would include the tens
- of millions of people who suffer from chronic, intractable obesity
- and the millions more who are only a few binges away from that
- plight.
- </p>
-
- </body>
- </article>
- </text>
-
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