Weight loss - Little blue pill cuts Kiwis down to size

By FRANCESCA MOLD

Nikki Lamont weighed 155kg - but it was not until she heard herself described as obese that she realised the fat she despised was killing her.

Her doctor warned her that if she did not start losing weight, she might not be around to watch her three children grow up.

Those words, a year ago, shocked Nikki Lamont into action.

Today, the 30-year-old Rangiora woman has lost 58kg - more than a third of her body weight.

The secret ingredient in her dramatic weight loss was a small blue capsule, known as Xenical, which has revolutionised the weight loss industry since its arrival in New Zealand in June 1998.

More than 15,000 New Zealanders now take the fat-busting drug.

The pills work by blocking one-third of fat intake, sending it out of the body through the bowel instead of leaving it to be absorbed into the bloodstream.

At $180 for a month's prescription, it is an expensive solution to fighting fat.

But it is one that people who have experienced the nightmare of obesity seem prepared to pay.

The jury is still out on its long-term effects, but sales of the drug have soared, and doctors seem to generally accept it as a safe way to help severely overweight patients shed fat and improve their overall health.

Since Xenical was introduced, 89 per cent of doctors have prescribed it.

"There's no doubt it works for some people," said Auckland gastroenterologist Cliff Tasman-Jones.

"But we still really don't know what happens 10 or 20 years down the track and, if people keep taking it, what the effects will be.

"I would still regard it as an experimental drug."

He said that while Xenical had helped a large number of patients, it was not a panacea for everyone who was overweight.

Questions also remained over depletion of fat-soluble vitamins among users.

Dr Philip Rushmer, chairman of the Medical Association's GP council, said the pharmaceutical industry's freedom to advertise Xenical, a prescription medicine, was one factor in its popularity.

"New Zealand and the United States are the only countries that allow prescription medicine advertising.

"Because patients are aware of them, they approach their medical practitioner to discuss them."

Dr Rushmer said GPs treated Xenical as just one aspect of a weight-reduction programme, along with dietary advice, exercise and followup work.

Studies showed that the drug brought only a small weight-loss benefit unless its use was accompanied by such lifestyle changes.

"There is a huge education element associated with its prescription," Dr Rushmer said.

GPs see the drug as part of a solution to the increasing number of New Zealanders who are obese.

Ministry of Health figures show that obesity levels have risen 50 per cent in the past 10 years.

About 27 per cent of Maori and 17 per cent of non-Maori are considered obese.

Obesity is described as the country's top killer because it creates health problems such as diabetes, heart disease and high cholesterol levels.

The ministry estimates that more than 1100 lives could be saved each year if obesity was eliminated.

Before prescribing Xenical, doctors must consider a number of factors, including the patient's body mass and health problems.

Xenical differs from other diet pills because it diverts fat, rather than working on the brain to reduce appetite.

Diet pills which react on the brain often have dangerous sideeffects on the central nervous system or the heart.

Xenical has its share of sideeffects, but they are more of a potential embarrassment than a health risk.

Users may suffer flatulence with some oily spotting, more bowel movements and an unpleasant fatty, oily stool.

These side-effects are not permanent and depend on the amount of fat in the diet.

And doctors encourage patients to improve their diet by cutting out fat, thereby avoiding nasty experiences with the bowels.

For Nikki Lamont, the decision to take Xenical has proved a defining moment in her life.

She began putting on weight about 12 years ago, after her brother died.

Initially, food was a comfort, but it became her worst enemy, making her afraid to go out because of the stigma attached to being fat.

Like many overweight people, she felt pressure from a society which, despite being obsessed with political correctness, believes it has a right to persecute those who are fat.

"It made life very hard," Nikki Lamont said. "I kept to myself, I didn't even like going out. I was just trying to hide myself all the time. I saw life as a kind of circle where I was always on the outside looking in."

Nikki Lamont was determined to do something about her weight when her doctor confronted her with the stark truth.

"She told me to go home and have a good look at myself.

"She said my life was at risk, that if I managed to lose even 10 per cent of my body fat I could add 10 years to my life.

"It was then I realised what the weight was doing to me.

"I was scared I wouldn't be there to care for my children any more if I didn't do something."

Nikki Lamont said taking Xenical was a difficult decision financially for her family, which survives on one income.

"But when we added up how much we spent on fast-food and eating out, we decided to spend that money on Xenical instead."

The decision was right for Nikki Lamont, and she said she had never felt better.

Her confidence had been boosted, and she no longer focused on what people thought about her.

"I don't know if I could have done this without Xenical.

"People always ask me if I will put the weight back on when I go off the pills, but I know I won't. I haven't achieved this for nothing. I have proved something to myself - that I can do anything."

She said Xenical had enabled her to make improvements to her lifestyle, including going on to a low-fat diet and exercising for about 50 minutes a day.

"The whole family have changed the way we eat. We eat a lot more fruit and vegetables.

"Before, I wasn't eating properly. It was easy to get hooked on fast-food. I would go without breakfast or lunch, then eat all day from about 2 pm onwards."

Nikki Lamont now eats three meals a day and has small snacks for morning and afternoon tea.

She feels she is gradually recovering the life she thought was lost to her forever.

"I went swimming for the first time in 14 years the other day. I play cricket with my children.

"I bought my first pair of jeans in 16 years.

"I no longer think about food all the time. I can wipe it from my mind.

"Xenical has helped me change my life."