January 26, 2010
by Jennifer Warner
A low-carbohydrate diet may have health benefits that go beyond weight loss.
A new study shows that a low-carbohydrate diet was equally good as the weight loss drug orlistat (the active ingredient in Alli and Xenical) at helping overweight and obese people lose weight, but people who followed the low-carb diet also experienced a healthy drop in their blood pressure levels.
“I expected the weight loss to be considerable with both therapies but we were surprised to see blood pressure improve so much more with the low-carbohydrate diet than with orlistat,” researcher William S. Yancy, Jr., MD, an associate professor of medicine at Duke University Medical Center, says in a news release. “If people have high blood pressure and a weight problem, a low-carbohydrate diet might be a better option than a weight loss medication.”
Researchers say studies have already shown that the two weight loss methods are effective at promoting weight loss, but it’s the first time the health effects of each have been compared head to head.
“It’s important to know you can try a diet instead of medication and get the same weight loss results with fewer costs and potentially fewer side effects,” Yancy says.
Low-Carb Lowers Blood Pressure
In the study, published in the Archives of Internal Medicine, 146 obese or overweight adults were randomly divided into two groups. Many of the participants also had chronic health problems, such as high blood pressure or diabetes.
The first group was advised to follow a low-carbohydrate, ketogenic diet consisting of less than 20 grams of carbohydrates per day, and the second group received the weight loss drug orlistat three times a day, plus counseling in following a low-fat diet (less than 30% of daily calories from fat) at group meetings over 48 weeks.
The results showed weight loss was similar in the two groups. The low-carb diet group lost an average of 9.5% of their body weight and the orlistat group lost an average of 8.5%. Both weight loss methods were also not significantly different at improving cholesterol and glucose levels.
But when researchers looked at changes in blood pressure, they found nearly half of those who followed the low-carbohydrate group had their blood pressure medication decreased or discontinued during the study, compared to only 21% of those in the orlistat group.
Overall, systolic (the top number in a blood pressure reading) dropped an average of 5.9 points among the low-carb diet group, compared with an increase of 1.5 points in the orlistat group.
Researchers say weight loss itself typically produces a healthy reduction in blood pressure, but it appears that a low-carbohydrate diet has an additional blood pressure-lowering effect that merits further study.
August 25, 2009
U.S. News & World Report
By Deborah Kotz
When it comes to losing weight, we’d all love that quick fix: a pill, shake, heck, even surgery to ease our efforts. Unfortunately, weight-loss aids—even when approved by the Food and Drug Administration—come with risks as well as benefits. Yesterday, the FDA announced an investigation into reports of liver problems thought to be related to an over-the-counter weight loss pill, Alli, and the prescription version, Xenical. This came after the agency received information on 32 cases of serious liver injury, including six cases of liver failure, in those using either product, which contain different doses of the drug orlistat. (The reports spanned 10 years.)
The FDA hasn’t determined yet whether these liver problems are related to orlistat since overweight individuals—who are most likely to use these drugs—tend to have a higher risk of developing liver failure because of a condition called nonalcoholic fatty liver disease. The agency is not putting a warning label on these drugs and hasn’t advised doctors to change their prescribing practices. Still, the FDA is telling folks to see a doctor if they’re experiencing signs of liver problems like jaundice (yellowing of the skin or whites of the eyes), brown urine, weakness, or abdominal pain.
I think, though, that the real take-home message is that we can’t assume that any weight-loss medication is risk free. Those who are severely overweight might find that the weight-loss benefits of orlistat are greater than its risks, but those with just a few pounds to lose may want to think twice, given what may be a small possibility of liver damage. (Alli and Xenical already have some nasty side effects like diarrhea and fecal incontinence if used incorrectly.) And unapproved drugs or weight-loss supplements should definitely be avoided altogether; those herbal weight-loss concoctions sold on the Internet may have harmful prescription drugs hidden in them. As tempting as these products may seem, they’re certainly not worth the price of good health. One New York doctor whom I interviewed recently told me that he frequently gets calls from female celebrities trying to get him to prescribe thyroid hormone pills that are meant for those with a slow-functioning thyroid. In healthy users, they boost metabolism and burn calories at a faster rate, but at the price of heart palpitations and bulging eyes, mimicking an autoimmune condition called Graves’ disease. While this doctor refuses to write such prescriptions, I have no doubt these actresses and models are finding other doctors who will.
On the flip side, I recently saw a photo in the September issue of Glamour depicting a full-figured model posed in a state of artful undress with her tummy sagging prominently. She looked radiant and beautiful even with this figure flaw, and Glamour was rewarded with letters from women thanking them for depicting beauty that real women could aspire to. If you’re already at a healthy weight but are looking to shed a few pounds with the help of drugs, take a moment to check out this photo. Perhaps plain old healthful eating and exercise—plus an acceptance of those small figure flaws—are really the fix you need.