Fattache vs Xenical Comparison

A Comparison of a Mixed Fiber Dietary Supplement vs. a Pancreatic Lipase Inhibitor Drug on Weight Loss


​Michael J. Gonzalez, Jorge R. Miranda-Massari And Carlos M. Ricare

InBioMed Project

University of Puerto Rico, Medical Sciences Campus
Schools of Public Health and Pharmacy
PO Box 365067

San Juan PR 00936-5067

Dept. Biology Cayey
Campus Cayey PR
​00736

Abstract

​A mixed fiber supplement (Fattache®) and a pancreatic inhibitor drug (Xenical®) are compared on effectiveness and side effects. Both products proved effective for weight loss and improved lipid profile. Nevertheless, the pancreatic inhibitor has demonstrated an array of negative side effects especially of gastrointestinal fiber compared to the mixed fiber supplement. We conclude that the mixed fiber supplement’s a better alternative to attain healthy weight loss.

Introduction

Obesity is a public health concern because it is related to the increase risk of morbidity, mortality, and psychological problems, discrimination and reduces economic achievement (I). With a variable etiology and a very complex metabolic and physiologic nature, the treatment of obesity proves difficult. Obesity can be defined as an excessive adipose tissue (a body mass index 30) or the excessive accumulation of body fat (4). This accumulation of excessive fat is the primary culprit of obesity’s harmful effects. Americans and Puerto Ricans consume about two times as much fat as considered appropriate (40% vs. 20%), in addition to consuming the wrong types of fat, mainly saturated, trans fatty acids and excessive omega 6 fatty acids (5).

Many obese patients accomplish weight loss with diet, exercise and other lifestyle modifications. Others may require more aggressive therapy. Weight loss supplements and/or medications may be appropriate for the use of obese patients with comorbid conditions. Most medications for the obese are formulated to reduce energy intake, increase energy output or decrease absorption of fat. Nevertheless, they carry the burden of an array of secondary side effects. Of great interest is the use of supplements and nutritional products to help create a proper environment or provide a fine metabolic tuning that will facilitate weight/fat reduction goals with substantially less side effects. We will compare the drug Xenical® Orlistat to a mix fiber supplement, (Fattache’®) in terms of effectiveness and side effects.

Discussion

Xenical® (Orlistat) is a weight loss agent with a novel mechanism of action that was approved by FDA for the treatment of Obesity. It inhibits gastric and pancreatic passes in the lumen of the gastrointestinal tract to decrease systemic absorption of dietary fat (6). In several trials lasting up to 2 years, Orlistat® (120mg Td) was more effective than diet alone for weight reduction and maintenance of loss weight (6). Xenical® (Orlistat) treatment also resulted in modest improvements in total cholesterol, LDL and fasting glucose (6). Xenical® (Orlistat) is minimally absorbed and has no CNS effects (7,8). Because Xenical® (Orlistat) decreases the absorption of fat-soluble vitamins, a multiple vitamin/mineral supplement is recommended daily during therapy (6). The major and most problematic adverse effects are gastrointestinal (8). Such as oily fecal spotting, abdominal pain, flatus with discharge and fatty oily stool (8). The potential for severe gastrointestinal discomfort and a modest degree of weight loss in some patients may limit the agent’s clinical utility. Up to 40% of all patients experience gastrointestinal side effects (9).

Also caution should be taken when using oral anti-contraceptive pills with Xenical® (Orlistat), since it may reduce its absorption, thus its effectiveness (10). Xenical® (Orlistat) has also been associated with hypertension (11) and sub acute hepatic failure (12). In relation to Xenical® (Orlistat) effectiveness in reducing fat absorption, in three randomized controlled trails, Xenical® (Orlistat) compared to placebo resulted in significant weight loss. Patients treated with Xenical® (Orlistat) loss an average of 3.4kg more that patients taking placebo while on a hypo caloric diet. Xenical® (Orlistat) inhibits pancreatic lipase and can block 30% of the triglyceride hydrolysis in subjects eating a 30 % fat diet (13). Xenical® (Orlistat) reduces dietary fat absorption by approximately one-third (7). Xenical® (Orlistat) has been reported to reduce coronary heart disease risk by reducing body weight, waist and hip circumferences, also reductions in blood pressure, improved serum lipid profile, improved fasting glucose and glycosylated hemoglobin have been reported (14).

Fattache ® is a mixed fiber dietary supplement containing natural fibers, chitosan, apple pectin, glucomannan and psyllium. Its formula has been patented and is the only weight /fat reduction supplement with clinical studies (15, 16).

Conclusions

Both products Xenical® and Fattache® have demonstrated effectiveness attaining weight reduction (3.40 Vs. 2.57 kg, respectively) In addition to improving lipid profile, thus reducing cardiovascular disease risk. Nevertheless, the mixed fiber supplement had no adverse side effects while the drug presented a whole array of gastrointestinal problems, in addition to other potential physiological negative side effects. Given that both products have similar effectiveness, we conclude that the mixed fiber supplement is a safer way to attain healthy weigh loss.

This supplement has a short-term study (open label) to assess efficacy and safety and to identify trends in body weight, fecal fat, serum lipids and blood pressure (15). Also published is a long term study (double blind, placebo controlled) to asses its clinical effectiveness (16).

Fattache® was effective in achieving weight loss, cholesterol reduction, LDL reduction, HDL increases and increase fecal fat content (10); interestingly it had no secondary side effects in the dose given (4 capsules, twice a day). In addition, patients followed their normal dietary habits. This weight reduction was attained even in the absence of a hypo caloric diet. Because the general potential to reduce overall absorption, a multivitamin/mineral supplement is recommended during the use of this supplement and taken three hours after the supplement or one (1) hour before. In addition the intake of 8-10 ounces glasses of water is recommended for the effectiveness of this mixed fiber weight reduction supplement. Patients treated with Fattache® had a weight loss average of 2.57 kg, this weight reduction was associated with a corresponding statistically significant increase in fecal fat content and decreasing total cholesterol, LDL and increase in HDL with no adverse side effects (15).

References

1. Wadden TA and Stunkard AJ. Psychosocial consequences of obesity and dieting. In
Obesity, Theory and Therapy, 1993, 2nd ed. Raven Press, New York, NY.

2. Robison II, Hoerr, SI, Standmark J and Mavis B. Obesity, weight loss and health. JAm Dietet Assoc. 1993, 93:445-449.

3. Petersmark K., Rodriguez JR, Matos MI and GonzB.lez MJ. Regional differences in fat cell lipolytic mechanisms: A critical review. PR Health Sci J 1995, 14: 11-16.

4. Naus JL, Thompson JL and Nag Vary J. The binding of micellar Lipids to chitosan lipids 1983, 18: 714-719.

5. Ebihara K and Schneeman BO. Interaction of bile acids phospholipids cholesterol and triglyceride absorption in rats. J Nutr 1989, 119: 1383-1387.

6. Heck AM, Yanovski JA and Calisk A. Orlistat a new lipase inhibitor for the management of obesity. Pharmacotherapy 2000, 20: 270-279.

7. Hauptman J. Orlistat: selective inhibition or caloric absorption affect long-term body weight.
Endocrine 2000, 13:201-206.

8. Ballinger A. Orlistat in the treatment of obesity. Expert Opin Pharmcother 2000, 1:541-847.

9. Nordmann A. What is .the evidence in regards to the effectiveness of Orlistat. Schweiz Med Wochenschr 2000, 130:629-639.

10. Peleg R. Caution when using oral contraceptives pills with Orlistat. Isr Med Assoc J 2000,2: 712.

11. Johnston GD. Orlistat associated with hypertension. Digit preference lays conclusions about Orlistat open to doubt. BMJ 2001,322: 110-111.

12. Montero JL, Muntane J, Fraga E, Delgado M, Costan G, Serrano M, Padilla J, de la Mata M and Mino G. Orlistat associated subacute hepatic failure. J Hepatol 2001, 34:173.

13. Bray GA. Drug treatment of obesity. Bailliers Best Pract Res Clin Endocrinal Metab 1999, 13:131-148

14. Lingarde F. The effect of Orlistat on body weight and coronary heart disease risk profile in disease patients: The Swedish multi-morbidity study. J Intern Med 2000, 248:245-254.

15. Gonzalez MJ, Ricart CM, Nesbitt Land Claudio J. Short term effect of a high fiber dietary supplement on total body weight, fecal fat, lipid profile and blood pressure in human subjects. Biomedicine 1998,1:51-57.

16. Nesbitt L, Ricart CM, Miranda-Massari J and Gonzalez MJ. Long term effect of a high fiber dietary supplement on total body weight, fecal fat, lipid profile and blood pressure in female huinan subjects. Biomedicina 1999, 2:59-512.