Dr Kerryn Phelps, Health Editor, with Tracey Grimshaw, Channel Nine, 'Today'

PHELPS: Good morning, Tracey.

GRIMSHAW: We are all getting fatter, I understand, but men, I believe, are refusing to acknowledge it?

PHELPS: Well, there has been a very significant increase in the number of overweight and obese Australians over the last 20 years.

GRIMSHAW: Yeah.

PHELPS: A lot of factors that have led to that, but certainly I think that men are having a little more difficulty coming to terms with that problem and doing something about it, than women seem to be. Women seem to be a little more aware of the problem.

GRIMSHAW: Is it more the danger for me that they are inclined to carry their weight around their vital organs, it's more certain inclined to be belly fat, and that's this issue isn't it? They can have skinny legs and the rest but…

PHELPS: Well, there is no question that men who carry the fat around their middle are at risk of a number of different diseases, being obese, being seriously overweight has with it a number of other health risks. It puts you at greater risk of type 2 diabetes, of heart disease, of arthritis. There are a range of diseases that are associated with carrying too much weight, and so it's something that's not just a cosmetic issue, it's something that really can affect your quality of life, your self esteem. You're more likely to be depressed if you're overweight, and all of these other physical ailments that can come with being, just simply carrying too much weight.

GRIMSHAW: Which brings us to these new fat busting pills. But before we talk about those, I've got to talk about this, you've brought this in, this is a kilo, one kilo of body fat, yeah?

PHELPS: Well, people often say to me when they are on a weight reduction program, 'you know, look, I have only lost a kilogram', and you say 'well, this is what you've lost'

GRIMSHAW: That's a lot!

PHELPS: It is a lot.

GRIMSHAW: I would never have thought it was that sort of volume.

PHELPS: It's quite extraordinary, when you think that people might be carrying 10 or 20 kilos extra, it just goes to show how much volume and how much weight they are carrying around with them every day, and how much of an achievement it is to lose some weight and get back towards your ideal body weight.

GRIMSHAW: Sure, okay so let's talk about the differences between these pills, Xenical, lets start with Xenical, cause that's been on the market for longer.

PHELPS: There are a number of reasons why people get overweight, and part of it is because they've become more sedentary over the years, people are spending more time at work, they're spending more time watching television, they're exercising less, and they're eating more takeaway foods, more high fat foods. So, what it takes is a comprehensive approach to how to lose weight, and taking a pill is not the be all and end all, for some people who are very obese, and it's causing them problems with their health. They may find medication may be useful for them, but it's not all…

GRIMSHAW: It's a kick start really, isn't it?

PHELPS: Yeah, it's not all roses. There are a few problems associated with them that people need to be aware of. So, if you're looking at a medication like Xenical, for example, it helps to train you not to eat fat, because if you eat fat, you know about it.

GRIMSHAW: You feel crook.

PHELPS: Well, what happens is that you get diarrhoea, because the fat, it stops the fat that you eat being absorbed, so it has to come out somewhere, and where it comes out is in your bowel motions, and that means you'll get some diarrhoea, and some people find that trains them very well, that after several months they say 'I know when I'm going to eat something that's got fat it in, I say oops don't want to take that', and that can train them not to eat fat in the future, and can just give them a bit of a kick start.

GRIMSHAW: So that's a bit more legitimate for behaviour modification, are we saying?

PHELPS: I think that it helps with behaviour modification in people, because you see a lot of people who are very overweight, will fib to themselves, and they'll say 'well, I eat like a bird, I don't eat breakfast', and that's quite often one of the major problems. They don't eat in the proper way during the day, and what they don't add is all the snacks they have in between and the packets of chips and the chocolates, but their lunch and their dinner is okay, but it's all the things in between. So it does train you to recognise when there is fat in something.

GRIMSHAW: Let's talk about the other one, cause that's a bit newer and there is a bit of interest in it. Reductil, what does that do?

PHELPS: Well, there has been a lot of interest in it, but once again it is not without its difficulties. The advantages are it acts on the brain so that when you eat, you don't feel hungry again straight afterwards. So it helps you feel satisfied when you've had a certain amount to eat, and it supposedly also keeps your metabolic rate up so that your metabolic rate doesn't drop when you eat less.

GRIMSHAW: How does that differ from, say, appetite suppressants…

PHELPS: It is an appetite suppressant.

GRIMSHAW: Okay.

PHELPS: So it acts on the brain, now one of the issues to do with that is there are certain people who cannot take it. For example, people who have high blood pressure, people who are on medications like anti-depressants, migraine drugs and so forth, that also act on the brain, because there can be some interactions. But also, people may notice they get side effects from this one. They can get hot flushes, you have to monitor closely blood pressure and pulse because it can cause problems there, with increases in blood pressure and pulse rate, and it can also cause hot flushes, and sleeplessness, because acting on the brain it's a stimulant, and it can keep you awake.

GRIMSHAW: I want to move on to Listeria because we need to talk about that. But is that more of a last resort Reductil, say, then Xenical, would you say?

PHELPS: The issue with taking medications is that they should always come after a trial of diet and exercise. You know, try and work on the diet, work on the exercise, be honest with yourself about wether you are actually doing what you can do to reduce your weight, and then talk to your doctor about other options.

GRIMSHAW: Okay. Now, Listeria is back in the news, and maybe it's time to remind particularly pregnant women about the dangers of Listeria, because we have had two unborn children die as a result of Listeria infection in their mothers.

PHELPS: That's tragic, because otherwise normal healthy foetuses and women not knowing that they are eating a food that they're going to be putting their baby at risk. Now, the foods that you need to be wary of are salads that have been sitting around in the salad bar for sometime, soft cheeses, raw seafood, and pate. Now, I think it is very important if you're concerned about this you can contact your local department of health and they will give you information on Listeria. It's a bacterium that can get into these types of food, and normally with people who aren't pregnant, who are generally healthy, they won't even notice if they've ingested some Listeria. The main problem is that it can cause miscarriage in otherwise normal babies.

GRIMSHAW: Okay. Thanks, Kerryn. Please take your fat with you, because we don't need it around here.

PHELPS: Thank you.

Ends