From the beginning, the weight loss drug, orlistat has been controversial. Sold under the trade name “Alli” in the U.S., the drug promotes weight loss by blocking the absorption of fat.
And that’s where most of the controversy has hovered. People taking the orlistat report “anal leakage.” A smelly, orange oil that dribbles – or even erupts – from their anus. Often without warning.
The oily, unabsorbed fat stains clothing, clings to everything it touches, and leaves its victims mortally embarrassed. A 2014 report from the University of Surrey found the problem is severe enough that many people stop taking the drug altogether.
But anal leakage may be the least of the problems this drug causes.
FDA Approved… But Riskier Than Advertised
Orlistat’s common side effects include gastric distress… a sudden, urgent need to have a bowel movement… gas… rectal pain… headaches… anxiety… and irregular menstruation.
Less commonly, you may experience rashes, hives, or itching… nausea or vomiting… fatigue… severe or chronic stomach pain… or maybe even liver problems.
In an overlooked study from 2012, a university researcher showed orlistat interferes with a critical enzyme for liver and kidney health. The enzyme acts as a detox agent in these organs – your body’s filtration system.
Professor Bingfang Yan of the University of Rhode Island reports orlistat permanently interferes with this enzyme. This can lead to organ toxicity and a breakdown of liver or kidney function. Even worse, Yan showed the damage can be done by even tiny amounts of the drug.
How could this come out a dozen years after the drug was approved? A brand-new study casts doubt on the approval process.
Selective Reporting Puts You at Risk
Danish scientists recently looked at the reporting of orlistat trials from the 1990s. And they found disturbing irregularities.
First, the trial instructions were written in a way that could potentially “dilute” reports of adverse events. Second, as few as 3% of adverse effects actually made it into the reports.
That’s right! Regulators use these trial reports to decide whether or not to approve a drug. And – in this case – reporting of adverse events ranged from 33% all the way down to only 3%.
In other words, at least one published report listed only 3 of every 100 health issues people had taking orlistat!
This study only looked at one drug. So we shouldn’t assume all trials have this problem. But it does back the experts who say to avoid new drugs for at least 5 years after approval.
Finally, a little perspective on just how well orlistat actually works.
Leaks, Risks, and Underwhelming Performance
A study published in June 2016 compared 5 weight loss drugs to a placebo. Scientists at the University of California looked at how many overweight volunteers lost at least 5% of their body weight over a year. That’s a 10-pound loss for a 200-pound person.
All of the drugs beat the placebo. 75% of the volunteers taking the top performing drug lost at least 5% of their body weight. But that drug wasn’t orlistat.
Orlistat didn’t finish 2nd, either. Or 3rd. Or 4th. Orlistat came in dead last, only beating the placebo group. But the volunteers taking the placebo didn’t do all that badly. 23% of them lost 5% or more of their body weight.
When you think about it, 5% over 52 weeks isn’t that much if you weigh 200 pounds. In fact, you’d only have to lose about 3 ounces a week to make your goal.
So maybe avoiding weight loss drugs is no big deal anyway.
About the Author: Jason Kennedy is a celebrated investigative health writer and the author of The X-Factor Revolution and Beyond the Blue Zone. With over 10 years of experience working with today’s leading alternative and anti-aging doctors, Jason shares his insider status and access to the latest breakthroughs with thousands of readers from around world.
La, P., “Obesity drug failing patients due to lack of education about side-effects,” University of Surrey. May 8, 2014.
“Pharmacy researcher finds most popular weight-loss drug strongly alters other drug therapies,”
University of Rhode Island, via Eurekalert.org. Dec 10, 2012.
“Harms reporting in trials of orlistat,” PLOS, via Eurekalert.org. Aug 16, 2016.
“Study Compares Effectiveness of Weight-Loss Drugs,” The JAMA Network. Jun 14, 2016.
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