newsroom

TODAY Friday 16 May 1997 Each weekday. Conn Nugent on what's new in the world, on the site.

 

TODAY IN THE WORLD: Fat, Fat, Fat

As far as I'm concerned, the biggest news story yesterday was buried on page B10 of the Wall Street Journal. It was a report by Bruce Ingersoll with an underwhelming headline: "Hoffmann-La Roche's Obesity Drug Advances."

Ingersoll wrote -- clearly, calmly -- that something called the Endocrinologic and Metabolic Drugs Advisory Committee of the US Food and Drug Administration had unanimously concluded "...that the company had proven the safety and effectiveness of Xenical, the first obesity drug that blocks the absorption of dietary fat, rather than suppress the appetite of dieters."

A fat pill! My eyes raced ahead.

Sure enough, there have been two-year clinical trials with more than 4,000 patients, and the stuff seems to work. Ingersoll: "Most patients were put on a moderate diet and given Xenical or a placebo. After one year, 57% of those taking Xenical shed 5% or more of their body weight, as compared to 31% of those taking a placebo. Moreover, 27% of the Xenical patients lost 10% or more of their weight after one year, as compared with 11% of the placebo patients."

I guess one reaction is, well, Xenical sounds great but that placebo stuff seems to work pretty good, too. I mean, you put the state of Wisconsin on "a moderate diet," and you get a hundred million pounds right there.

But data are data, and there's no arguing (yet) about the efficacy of this new kind of drug -- a pancreatic lipase inhibitor, you can tell your friends -- that blocks the intestinal enzymes from absorbing all the fat you eat. The unabsorbed fat goes straight out the rear door. There is a little problem, though, for the many of us who immediately think of all-you-can-eat night at The Sizzler: there are unspecified "gastrointestinal problems" for people who "ingest too much fat."

I'm sorry, but I bet a lot of people would be attracted to Xenical for the precise purpose of ingesting too much fat. How bad are those gastrointestinal problems anyway? Are we talking stomach rumbles, flatulent trumpeting, the runs, what? People would put up with a lot if they thought they could eat a double-cheese pizza without its overnight conversion into love handles.

It will be a while -- but probably not too long -- before Xenical becomes a near ubiquitous diet aid for the body-fashion-conscious. For now, though, everything is couched in medical language, and the spin is that Xenical is a response to a problem of public health. The Centers for Disease Control say that 35% of American adults are overweight, an increase over the 25% figure of the 1970s (those golden years). The unavoidable C. Everett Koop says that obesity lags only behind smoking as a cause of death. It's emphasized that Xenical will be available strictly by prescription. Prescription or no prescription, this drug is going to be big, maybe bigger than Valium, bigger than Prozac.

I mention all this not merely because I wage war -- punctuated by hasty cease-fires -- against the 37-inch waste. But there also might be, well, some sort of issue here for us environmentalists. Is there an "environmental" response to Xenical? Some would think so, surely. And I don't mean people opposed to vaccination, for example, or any use of antibiotics. But there's a reasonable line of argument that might say that Xenical is just another manifestation of our apartness from nature, including our own natures, and that that breach precludes anything but a mechanistic and ultimately unsuccessful approach to the problems of ecological sustainability. So remote have we become from our sources of sustenance, so distanced are we from the functions of our own body, that now we don't even know how to eat food without fetishizing it or anathematizing it. Xenical, by this view, symptomizes a larger issue of values.

I believe that myself, more or less, but I don't know what to do with it. I was "against" conception outside the womb until a friend of mine had a baby, spawned in a Petri dish, who is now among the world's greatest girls. I'm "against" face-lifts, but wouldn't be able to talk to half my mother's friends if I wanted to make a thing about it. You can't watch a movie or walk down certain streets in New York without seeing strictly-cosmetic breast implants, which I "oppose." I don't "believe in" organ transplants (unless one of my kids needs one), hair plugs, or liposuction. Are these attitudes necessary conclusions drawn from a fundamental world view or just idiosyncratic, essentially aesthetic postures of one member of the chattering classes?

Avoid the moral high ground whenever possible, says Seamus Heaney. So I'm inclined to a shrug of the shoulders, ready to believe that a world of Xenical and plastic surgery is still a world that can treasure the natural and the wild. But I've got to admit, it gives me the willies.

 

TODAY ON THE SITE

Speaking of food and drugs, allow me to guide newcomers to the excellent work of Seth Zuckerman in the Hypermaterialism section. The idea of Hypermaterialism is to inspect closely the ecological stories embedded in the objects of day-to-day life. Seth leads off with the story of coffee: where it comes from and how it's grown and what's been happening lately in coffee cultivation that spells big changes for tropical ecology and thousands of migratory bird species. A good read with your morning cup.

 

5/15: Our Forthright Administration
5/14: Coral Reefs of the Sahara
5/13: (Life Before) Death and Taxes
5/12: Kids
5/09: Free Trade and Hormones
5/08: Sherry Boehlert, Republican
5/07: Fort Davis, West Texas
5/06: Europe (yawn)
5/05: Divorce, Mothers, Equality
5/02: Killer Grannies and the Highway Bill
5/01: China
4/30: Pity the Mangrove
4/29: Grizzlies off Battery Park
4/28: Mighty Monsanto
4/25: Growth
4/24: Refrigerator Wars
4/23: The Day the Earth Day Stood Still
4/22: Doorman Ecology
4/21: Toyota Steps Out
4/18: Victims of Extremism
4/17: Our White Guy Problem
4/16: Coca-Cola and the Merrit Parkway

Talk Back