Opinions of health experts at odds over latest diet fad

Art Nadler

Thursday, July 22, 1999 | 10:21 a.m.

In the never-ending battle of the bulge, a powerful new diet pill hit the market in April and appears to be gathering steam in Las Vegas.

The drug is called Xenical (pronounced zen-i-cal) and works by blocking fat from being digested. Its manufacturer, Hoffmann-La Roche Inc. of New Jersey, claims it stops up to 30 percent of fat in foods from getting absorbed through the digestive tract.

The downside is that you will probably have to make a few more trips to the bathroom, brought on by what the company calls "fecal urgency."

The side effects include a fatty or oily stool and the need to take vitamin supplements. That's because the fat-soluble vitamins A, D, E and K and beta carotene also are expelled from foods and not absorbed when Xenical is taken.

At 4 feet 11 inches tall, Lisa Mueller has been dieting all her life. She can't take most diet pills because they affect her kidney disease. The most she has lost is 11 pounds a year. Since taking Xenical two months ago, she said she lost 8 pounds.

"I just like the fact that something has put me in a frame of mind that I can do this. It's inspiring me," Mueller said. "I'm losing a half pound a week, and I'm down two dress sizes."

Mueller said she takes Xenical three times a day and would like to get down to 115 pounds.

She usually eats cereal for breakfast, has chicken or meat and a vegetable for lunch and only a light salad or soup for dinner. She avoids all fatty foods and takes a multiple vitamin daily.

Mueller said she doesn't think the diet pill will affect her health because it only stays in the digestive tract. It is not absorbed into the blood stream and doesn't enter the brain.

But Dr. Frank Nemec, a Las Vegas gastroenterologist, thinks there could be some long-term medical consequences.

"Xenical impairs the ability of fat dissolving enzymes from working in the stomach," Nemec said. "Clearly there is a risk that fat-soluble vitamins will be lost. How do you know you will get them back by taking vitamin supplements?"

Nemec said he has treated several patients who have had trouble dealing with having to go to the bathroom all the time. He said the fat is literally pouring out of them, and they have to wear some form of absorbent undergarment all the time.

Dr. Art Ulene, a nationally recognized medical expert who for 20 years appeared on the NBC network's "Today Show," said he doesn't see any immediate danger in taking Xenical, but he thinks in the long run people will experience vitamin deficiencies.

"You should change the way you eat and increase your activity level," Ulene said. "Everyone is looking for a magic bullet pill. I think there will be few people who will take the pill for life. And then once you stop, the weight will come back."

Ulene said the simple thing to do is reduce the amount of fat one eats.

Dr. Steven Miller, a Las Vegas internal medicine physician, said he is currently treating about 40 patients with Xenical. He said people shouldn't take the drug unless they are obese or overweight and have medical problems. He doesn't recommend it for people who just want to lose a few pounds for cosmetic reasons.

"I think it's worthwhile trying." Miller said. "It's safe, and you won't lose 20 pounds fast like with fen phen. Doing it slowly is the only way to take the weight off. But people need to increase their exercise and watch what they eat."

Unlike crash diets in which people shed lots of pounds quickly, national studies have shown that a person will lose about 13 pounds a year with Xenical. Aside from the immediate side effect of a loose stool and the possible long-term vitamin deficiency, another deterrent is the cost.

A month's supply -- 90 pills -- costs around $120.

For Franklin Curhan, 66, being overweight affects his hypertension. He's tried two diets and has found that he's always put weight back on after he stopped. He considers Xenical "a crutch" to take once he stops dieting where he would use it to curb his appetite.

Curhan said since he began using Xenical in June, he has been able to manage sudden urges to go to the bathroom, but the cramping that precedes this is painful.

Besides the loose stools, Curhan said he gets a lot of stomach gas and is frequently burping.

Miller said Xenical is not for everyone, but he says studies have shown before the Food and Drug Administration approved it in April, it was tested and found to be safe in the two-year study.

Ulene, however, thinks Xenical is just another fad taking the market by storm.

"Once again another pill has come on the market, and soon it will disappear from sight," Ulene said. "Save your money and spend it on a good exercise program."