Tuesday, April 25, 2006

The Fatty Stools Diet

While browsing Xenical's site, I wandered across their sample menus. At right you see a 2000-calorie diet menu for a day I picked at random (honestly).

Xenical® (orlistat) is a prescription medication that assists weight loss by blocking some of the fat you eat from being absorbed. The FDA is very, very close to approving a lower-dose, non-prescription version of it, which would make it the only FDA-endorsed weight-loss drug available over-the-counter.

What this post is not - An endorsement for Xenical, for a few reasons:
  • It shows only mediocre benefit in weight loss trials.
  • Since it requires no lifestyle changes other than popping a pill, any weight lost is likely to return when the (costly) therapy is ended.1
  • Some people taking it developed hepatitis, gall stones or kidney stones - for reasons unknown.
  • It may increase cancer (breast, colon) risk.
  • It blocks absorption of fat-soluble nutrients, including vitamins A, D, E, K, the carotenoids, and the much-discussed omega-3 fatty acids.
  • As if Americans don't have enough non-solicited gastrointestinal distress, the FDA lists Xenical's most common side effects as:
    • Oily spotting
    • Gas with discharge
    • Fecal urgency
    • Fatty/oily stools
    • Frequent bowel movements
What this post is - A brief discussion of that 1-day menu I posted, because I get my jollies analyzing diets.

Ready? Go:

1. I come up with 2182 calories, not 2000. You might think that 182 extra calories/day is a drop in the bucket, but it adds up. It's a real downer to see a devoted soul struggling to lose weight and not experiencing significant displacement of the needle on the scale. Also, I held my analysis tightly to the letter of the menu, while in reality, unless measuring instruments are used, I suspect lots of people would have difficulty eyeballing 2/3 cup frozen yogurt.

2. Who eats 1/2 banana? What do you do with the other half?

3. While I'm at it ... 6 slivered almonds? Not 5? Not 7? I wanna watch Dick Cheney count his almonds.

4. Men should be eating about 40g fiber/day, women a little less. This diet supplies around 25g fiber. That a diet well-strewn with fruits and vegetables (such as this one) still might not meet the daily recommended intake speaks to a need for more intense fiber-diligence. Skins, seeds, husks, pulp, wood shavings, textile scraps - throw 'em in there! Not enough good can be said about fiber, all sorts of fiber. Maybe I'll attempt to say enough good in another post. All I'll say now is ... Fiber is good stuff. Try for the 40g.

5. Where are the beverages? No fruit juices. No Starbucks, Guinness, or Zinfandel. I see they didn't fail to add a glass of cold milk for breakfast and lunch. On Thursday's menu they include some animal crackers with the milk as a bedtime snack. I'm getting a feeling someone under the age of 10 assisted in these menus.

6. The diet supplies less than 30% of calories from fat, actually 23.8%, even with that 7 oz. steak. Not bad, not bad at all. But I can see their motivation here. The more fat you eat while taking Xenical, the greater your fecal urgency, bowel accidents notwithstanding. (This is, in fact, a criticism of the drug - that it works more by discouraging fat consumption, thereby avoiding side effects, than it does by actually blocking absorption of significant fat calories.)

7. Technically, this is a good eating plan. But as with many of these stock, idealistic menus, they require you to hit the grocery store almost daily, have the time and know-how to cook, the availability of a kitchen in the middle of the day, and enough financial resources and moral numbness to buy yet throw away that portion of the apple, banana, etc. that is not sanctioned on the menu. Still, if you're scrounging ideas for how to eat within a calorie limit, Xenical.com's menus are worth a look. If you're drawn to experiment with their fat blocker, keep in mind the above side-effect laundry list. It's sure to increase your laundry load.

Update: Click here for a status on Xenical's new over-the-counter version, Alli™.

1 This concern was kindled by 2 recent clinical trials which showed only a 2.8% difference in weight loss after four years between those taking orlistat vs. placebo.

1 comment:

AppleJack said...

Nice analysis