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DR MICHAEL MOSLEY: Diet pills may sound great, but are they a magic bullet? 

The average Briton puts on 4.5 lb over the summer holidays, according to a survey by Cancer UK, and then spends the next couple of months trying to lose it.

But why go to the effort of dieting when you can just take a pill? It was claimed last week that the ‘Holy Grail’ of weight loss had been discovered: a tablet that could help us effortlessly slim down.

Some 12,000 overweight or obese Americans who had been testing a drug called lorcaserin – an appetite-suppressant which stimulates the brain chemicals that make you feel full – had shed an average of 8.8 lb and kept it off for 40 months.

Why go to the effort of dieting when you can just take a pill? It was claimed last week that the ‘Holy Grail’ of weight loss had been discovered: a tablet

Why go to the effort of dieting when you can just take a pill? It was claimed last week that the ‘Holy Grail’ of weight loss had been discovered: a tablet

So Give me those pills, now!

Well, before you get too excited, looking closely at the study, the results aren’t quite so impressive.

For starters, this was a placebo-controlled trial, which means half the patients were taking a fake drug or sugar pill.

Those taking the placebo had also lost weight: 4.6 lb on average.

So if you had swallowed 2,400 of the new pills over 40 months at a cost of around £8,000 you would have lost on average 4.1lb more than someone swallowing chalk or whatever was in the placebo.

And although the people taking lorcaserin did not develop ‘significant’ side effects, seven per cent gave up taking the drug because of dizziness, fatigue, headache, diarrhoea or nausea.

Suicidal thoughts were also twice as common in the drug group as in the placebo group, which would suggest the medication may have a negative effect on mental health.

Quite apart from the cost, I cannot see your GP prescribing lorcaserin any time soon.

There are a raft of other pills that claim to reduce weight. Some are stimulants that suppress the appetite – these work but are generally outlawed in the UK as they are dangerous. Others, available over the counter, swell in the stomach leading to a feeling of fullness or claim to ‘boost the metabolism’ but there is scant evidence that these do anything.

Although the people taking lorcaserin did not develop ‘significant’ side effects, seven per cent gave up taking the drug because of dizziness, fatigue, headache, diarrhoea or nausea

Although the people taking lorcaserin did not develop ‘significant’ side effects, seven per cent gave up taking the drug because of dizziness, fatigue, headache, diarrhoea or nausea

One medication, orlistat, is prescribed on the NHS and available in a lower dose over the counter under the brand name Alli for people with a BMI of 28 or more. It works by blocking the absorption of fats in the digestive system. Studies suggest you will lose about three per cent more than if you dieted alone – though side effects include incontinence and flatulence. So hardly a magic bullet.

At the extreme end (a BMI over 35 to 40), you might be offered bariatric or weight-loss surgery.

I have watched a couple of these ops and they are pretty extreme. The most recent involved Bob, who was hugely overweight. Aged only 34, Bob had already developed type 2 diabetes and had had a minor heart attack. He opted for a gastric bypass operation.

What does that involve?

A surgeon creates a small pouch out of your stomach, reducing it from the size of your fist to the size of your little finger, then attaches your much smaller stomach further down your small intestine, bypassing a yard or so of gut. 

Gastric bypass can be very effective. In most cases there is not only massive, sustained weight loss but reversal of type 2 diabetes

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