¹Pennington Biomedical Research Center of Louisiana State University, Baton Rouge, Louisiana, USA

Correspondence: George A. Bray (brayga@pbrc.edu)

Received 11 May 2007; Accepted 3 August 2007; Published online 31 January 2008.

Abstract

At any one time large numbers of people are attempting to control their weight. Women are the principal consumers of weight-control programs. Their options, outside the prescription drug market and surgical treatment, include diets and diet books, exercise alone or with supervision in exercise facilities, dietary supplements, group programs, doctors, dietitians, psychologists, and other health-care professionals. Non-prescription products available to help people control their weight cover a wide range, including herbal dietary supplements, diet drinks and portion-controlled foods, meal replacements, and low-carbohydrate diets and foods. The introduction of orlistat as an over-the-counter (OTC) product will provide the only Food and Drug Administration (FDA)-approved product for weight loss currently in that category since phenylpropanolamine (PPA) was withdrawn by the FDA. The FDA approval process is considerably more expensive than allowing untested herbal supplements to be marketed without testing, but the added safety evaluation by the FDA will reduce the risk of disastrous outcomes that have plagued many approaches to weight control. Support for a place for orlistat as an OTC product includes the inadequacy of current programs, empowerment of the public, lower cost, and bringing pharmacists into weight-control programs. The downside includes improper use of OTC orlistat that may not result in achieving individual expectations.