Is it worth it?

Stung by recent criticism that general practitioners were failing, among other things, to contribute to the thinning of the nation by not prescribing enough orlistat,¹ I carried out a brief audit of the patients for whom we had, in our practice, prescribed this drug over the previous three and a half years.

Fifty two patients lost 172 kg between them. Totalling up the cost of their prescriptions this worked out at a price of £74.34 per kilogram lost. Some of them actually put on weight while they were taking orlistat, and at least 12 put on substantial amounts of weight when they came off it. It is acknowledged that this audit was small and had many limitations, but it confirmed our gut feeling that merely prescribing medication is not the answer to the obesity epidemic, as Gareth Williams says in his editorial.¹ Most of these patients needed to lose at least 10 kg—for £740 they could have had a treadmill or several years’ subscription to a commercial weight reduction company or even a gym, and this would have benefited their general health much more.

It is a curious world that demands that we prescribe ineffective medication for people to lose weight and then in the next post asks us to prescribe sip-feeds to fatten up others.

And all this when we have been watching the news from Darfur the night before.