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The BBC's health correspondent Daniel Sandford
"The drug is useful for people, especially diabetics"
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The BBC's Richard Hannaford
"There were fears that the drug would bankrupt the NHS' drug budget"
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The BBC's Lucy Atherton
"Britain is suffering from an epidemic of obesity"
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Friday, 9 March, 2001, 12:06 GMT
Green light for slimming drug
Xenical the anti-obesity drug
Xenical can help to keep people slim
Obese patients should be prescribed the drug Xenical on the NHS, say government experts.

The National Institute for Clinical Excellence (Nice) say that extremely obese adults who have already lost at least 2.5 kg by dieting will be allowed the drug, but that it must not be used as a slimming pill by any overweight patient.

Its advice is normally accepted by government ministers.

Nice also gave the green light to a new treatment for type 2 diabetes, which is called pioglitazone.

The decision on Xenical - also known as Orlistat - which costs about 40 a month, will be particularly controversial as it will have huge funding implications for the NHS.

Some say the drug could cost the NHS as much as 12 million a year, others say the bill could be much higher.

This is not going to be prescribed for somebody who wants to get into a size 12, rather than a size 14. This is for people with serious obesity

Professor Ian Macdonald

About half of the adult population in England and Wales are either obese or overweight and there were fears that the drug could be used as an easy slimming aid.

Xenical will only be given to those who are clinically obese, or who are severely overweight but already have high blood pressure and other health problems such as diabetes or high blood pressure.

The Nice guidelines make it clear that treatment with the drug should only continue after three months if a patient has lost at least 5% of their bodyweight, and after six months if 10% of original weight has been lost.

Treatment should not continue for more than two years.

Nice estimates that their new guidelines will mean 11,000 more people in England and Wales will be prescribed the drug.

Professor Peter Littlejohns, clinical director of Nice, said: "The treatment of obesity means that patients and doctors have to work together and that there has to be a contract.

"There has to be the idea that patients will reduce their calorie intake and exercise.

"But there are some patients with severe weight problems where the added bonus of having a drug will make a difference.

"What we have provided in our guidance today is clarification for patients and doctors about who will benefit."

Health experts say the drug will only be used for the very severely obese and not as a quick slim diet.

Last resort

The drug works by blocking the absorption of fat in the gut and should only be taken as part of a low-fat diet and is the first anti-obesity treatment that does not work by suppressing appetite.

If people taking it eat a fatty diet, they experience a bloated and painful stomach and oily diarrhoea.

Patients given Xenical have been shown to lose an average of 10% in body weight over a year, compared with just a 6% loss for those who follow a low fat diet only.

Overweight man
About half the adult population is overweight or obese

Professor Ian Macdonald, Professor of Metabolic Physiology at Nottingham University, said the drug works alongside a healthier lifestyle.

He said: "It will only work to help reinforce people's attempts to stick to a low fat diet.

"People will have to have demonstrated some weight loss before they get the drug," he said.

Professor Macdonald said the drug would not be a quick fix for those wanting to lose a couple of pounds.

He said: "This is not going to be prescribed for somebody who wants to get into a size 12, rather than a size 14. This is for people with serious obesity."

Dr Wendy Doyle, spokesperson for the British Dietetic Association, said the drug will be vital for people who see no other way to get slim and have tried more traditional methods.

She said if properly prescribed the drug will benefit patients and the NHS, as cutting the weight of patients will boost health and lead to fewer people being hospitalised at even greater costs to the NHS.

"Orlistat is only used when most other routes have failed and for those people I believe that anything that will help will be welcomed.

"It will help alleviate the enormous health problems that you have with obesity."

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See also:

09 Mar 01 | Health
'How obesity drug helped me'
16 Nov 00 | Health
Nice decisions to be 'public'
21 Jun 00 | Health
MS patients 'denied drug'
24 Jun 00 | Health
MS patients denied talks
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