Streets Of London: Fat-Free, Prescription Free

Britain has been getting fatter for years, statistically. The decision to prescribe the essentially safe and effective ‘fat-busting’ drug Xenical on the NHS last year, therefore, was welcome news, particularly for obese Brits. Now the UK health authorities have a new problem to deal with: the proliferation of internet sites selling Xenical (orlistat) expensively, but with very few questions asked.

This is very problematic because Xenical is for quite big people or those with correlated conditions such as hypertension or type 2 diabetes. It shouldn’t be taken casually as a slimming pill nor prescribed for children. Moreover, it’s designed to be taken in combination with a diet and exercise-based weight loss programme, not alone. You should lose 2.5 Kilos before and more in tandem with a course of Xenical. Perhaps most importantly the drug’s normally only used for a couple of years.

Compared with the plethora of appetite suppressing pills on the market here, Xenical’s something altogether different. It’s an inhibitor of the pancreatic enzyme lipases, which converts ingested fats into digestible components. With Xenical, about 30 percent of the fat a person ingests isn’t broken down. The excess is excreted. This means users spend more time in the bathroom; sometimes they’re in a real hurry to get there. However this for many people is a price worth paying for considerably better health prospects and improved self-esteem. Obesity is associated with many health problems and here, as throughout the western world, is regarded as a grave social liability. And, tackling the prevalence of potbellies conveniently attributed by their owners to middle-agish type spread rather than exercise-free lifestyles, will pay huge dividends for an already terribly overstretched National Health System. Obesity’s responsible for 30 000 deaths in the UK and costs the NHS about half a Billion pounds annually (more than $NZ1.5 Billion). Patient satisfaction, public health and finance goals are in harmony.

However, when potential customers simply fill in a form, there’s no physical examination and no follow through, the potential for Xenical misuse is immense. Although Xenical’s undoubtedly brought relief and happiness to many lives, the specificity of the government’s drug advisory body, the National Institute for Clinical Excellence’s Xenical prescription guidelines, reflects the reality that the long term effects of taking this severe treatment aren’t yet known. Users should also take vitamin supplements and be aware the effects of contraceptive pills may diminish.

The Medicine Control Agency (MCA), which is charged with doing as its name suggests, is constrained by laws predating the Internet. These must be amended if it’s to win this battle. For one, robust laws should stipulate that prescription only follows a face-to-face consultation, preventing web vendors from undertaking on-line consultations and prescriptions following the word not the spirit of the law. And, the recently restructured MCA enforcement team will hopefully become better at tracking vendors who sell Xenical now through web site sub domains that make them tricky to pin down.

Xenical might be expensive, but if an obese or just overweight person doesn’t want to return to their old ‘self’ after a period of relative health and normality the temptation to buy Xenical without a doctor peering over their shoulder must be a big temptation. While this very helpful drug’s long-term effects are gauged Internet charlatans must be reined in.

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