In Part 1 of this series we mentioned orlistat, the generic name of one of the six kinds of drugs that the Food and Drug Administration has approved specifically for weight loss. As all pharmaceuticals of this type must warn, it is “Only effective as an adjunct to caloric restriction, increased physical activity, and behavioral modification.”
According to the manufacturer’s description,
Orlistat is a gastrointestinal lipase inhibitor that works by blocking the absorption of 25% of the fat in a meal and is used for weight loss in overweight adults, 18 years and older…
But that statement is misleading because it’s outdated. True, the substance’s safety and efficacy have not been established for children under 12 years old, and apparently it is not authorized for them. Which means, it is able to be prescribed for young persons over 12, to be taken by mouth every eight hours. And guess what? A half-strength version of the drug is available over the counter!
Another source says that for that age group,
A 6-12 month trial of orlistat… may be appropriate after specialist assessment, particularly in morbid obesity… or when co-morbidities exist, although evidence for long-term effectiveness in this age group is lacking.
A common side effect of its use is oily leakage that stains the undergarments, which results from another side effect, flatulence (gas) with discharge. The child might defecate more frequently, and the stools produced might be fatty, oily, painful, loose, liquid, clay-colored, or uncontrollable. A child who was previously picked on for being fat might have the chance to experience something new and different, the mortification of being picked on because they pooped their pants.
Then there is the possible onset of nausea, stomach pain, vomiting, weakness, itching, skin rash, dark urine, loss of appetite, jaundice, headache, and/or back pain. There might be problems with the teeth and gums, liver failure, or the whole spectrum of cold/flu symptoms, including chills and fever. The child might come down with a fancy ailment like oxalate nephropathy or leukocytoclastic vasculitis.
Orlistat has been known to interact mildly with at least 21 other drugs, and to interact moderately with at least 65 different drugs. To top it all off, the manufacturer cautions, “This information does not contain all possible interactions or adverse effects.” Orlistat is classified as a Gastrointestinal Agent and also, as Other. Maybe Other is code for “Let’s hope this is never authorized for younger kids.”
Your responses and feedback are welcome!
Source: “Orlistat,” RxList.com, 08/27/21″
Source: “Preventing Childhood Obesity: Evidence Policy and Practice,” Wiley.com, 2010
Image by Michael Saechang/CC BY-SA 2.0
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