Fat Drug Flies In Cyberspace

By Chris Taylor

It was only a matter of time before weight-loss drugs and the Internet got together. They're made for each other. More and more of us go online and, perhaps partly as a result, more and more of us meet the clinical definition of obesity (about 66 million Americans today weigh 30% more than they should). So it was no surprise that sales of Xenical, the diet pill that just won FDA approval, exploded across the Net last week. There is, it seems, no shortage of Doritos-gobbling geeks who would prefer to fight flab without doing anything more strenuous than clicking a mouse.

All this was good news for the rapidly fattening bottom line of Direct Response Marketing, a tiny pharmaceutical firm in the British Channel Islands that trades in trendy pills at the website lifestyledrugs.com To his inventory of Viagra (for impotence), Propecia (for balding) and Zyban (to quit smoking), owner Tom O'Brien last week added the much hyped Xenical. Result: a tidal wave of U.S. Web surfers that overwhelmed his staff of four. "We're averaging about 60 to 70 orders an hour," O'Brien reports. "It's wiped us out."

The great thing about buying online, of course, is that you don't have to face a doctor or even prove you really need the drug. O'Brien's customers just have an online "consultation"--which amounts to filling in a brief medical questionnaire--and promise to inform their physician.

Whether customers get the miracle they bargained for remains to be seen. Xenical, which blocks absorption of about one-third of fat intake, was only 5% more effective than a placebo in clinical trials and came with several unpleasant side effects, including flatulence and greasy stools. "The hazards are not very great," says Dr. Jules Hirsch, an obesity expert on the FDA advisory panel who voted against approval, "but the benefits are not great either. I'd just as soon they didn't sell it altogether."

Fat chance. In its first week on the market, Xenical was prescribed by an estimated 24,000 U.S. doctors in face-to-face consultations. If you wanted to fit into a smaller bikini and couldn't co-opt your GP into saying you were obese enough for the drug--well, you knew where to look. "Where can I get Xenical online without a prescription?" asked a correspondent in the newsgroup alt.drugs. A reply came from Pharmcom.com another offshore operation, this time in New Zealand. Like a good spouse, the online doctors don't call you on your weight claims. A height-to-weight ratio in the obese range is good enough for them.

All this makes even Hoffman-La Roche, Xenical's manufacturer, nervous. "We're trying to encourage patients to seek proper medical supervision," says president Patrick Zenner. Still, there's nothing they--or the FDA--can do about offshore pill pushers. (Besides, the feds have other online woes; last week they warned users against relatives of the so-called date-rape drug GHB, which are available online under names like Serenity, Enliven and SomatoPro.)

One thing is sure to keep Internet drug sales in check: the price. At as much as $232 a month for Xenical and $50 or so for some online consultations, your wallet's going to lose weight a lot faster than you are.

--By Chris Taylor