Weight Loss Drugs: Rates of Persistence Are Terrible

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Weight Loss Drugs: Rates of Persistence Are Terrible :

Oct 02, 2007

Weight loss from diet pills come with one fundamental requirement. To lose weight (and most likely maintain weight) you have to keep using them.

A drug such Orlistat (or it's cutdown OTC version Alli) will decrease absorption of fat by the intestines. Less fat means less calories. Less calories means weight loss.

So what happens when you stop taking the drug?

Unless you've made major changes to your eating habits - there's every chance the weight will come back.

So maybe you take the drug for a long time and lose a fair bit of weight. Maybe after a long period of time you have made permanent lifestyle changes.

What are the rates of attrition with such a drug? Clinical trials report that around 60%. That is, after a period of time, 6 out of every 10 users have stopped taking the drug.

This isn't the real truth. Research conducted outside of the tightly controlled clinical trials shows a completely different picture.

Nearly 17 000 users of orlistat and 3500 users of sibutramine were identified. For both orlistat and sibutramine, 1-year persistence rates were <10% and 2-year persistence rates were 2%.

So after two years just 2 out of every 100 users were still taking the drug.

Where are the other 98 drug users? Did they reach their maintenance weight? Have they ended up regaining the weight? Were the side effects too much to handle?

I sadly suspect that the favorable long-term results from pharmaceutical interventions are few and far between. Recent research published in Diabetes Care showed that the end results of 3 years of Orlistat only succeeded in slightly reducing weight gain compared with placebo.

To rephrase that: After losing weight on a very low-calorie diet - those taking Orlistat still re-gained weight (but not quite as much those who took a placebo).

Rephrase again: People gained weight while taking Orlistat.

Sure you have to make lifestyle changes to "help" the drug work. In that case, what's the point in taking the drug?