Alli weight loss drug

Perhaps you’ve already heard the hype and read the news about Alli, the only FDA approved, over-the-counter weight loss drug. I heard the hype and dismissed the product as another lame weight-loss gimmick. But, GlaxoSmithKline, the creators of Alli, have stayed around long enough (over one year now) to sell their product to over 4 million people. And to Glaxo’s credit, the product does work.

Studies have shown for the past decade (and continue to show) that Orlistat (the active ingredient in Alli) can increase weight loss and reduce later weight gain versus diet and exercise alone. Here are a few studies that demonstrate these findings:

Orlistat in primary care settings

Reduced risk of diabetes and greater weight reduction with orlistat

2 year study finds increased weight loss and decreased weight gain (maintenance phase) with orlistat

Alli claims, “You can lose about 50% more weight than with just dieting alone.” Unfortunately, Alli has grabbed some of the higher statistics to stake that claim- potentially interpreting findings from research on higher doses of orlistat (i.e., 120mg vs 60mg). Some research has found using orlistat versus a placebo may only equate to a few extra pounds of weight loss per year (for the orlistat group). Nonetheless, you will most likely lose more weight with Alli than with dieting alone.

Here’s the bad news…

Orlistat is an interesting product. It’s been researched for over 10 years now and hasn’t hinted to any life-threatening side effects. Be advised however, that “long-term” in the research community can be a study lasting as little as 1 or 2 years. So, orlistat (along with many other drugs) could have long-term side effects that have not been discovered.

Orlistat enters the digestive tract and disables an enzyme (Lipase) that breaks down dietary fat into workable bits. At the 60mg dose, orlistat prevents about 25% of the ingested fat from breaking down to be used for energy or stored in the body. So where does all this undigested fat go? Yup, you guessed it- right down the chute and out of the body. I like the disgusting visual that Alli provides:

“The active ingredient in alli attaches to some of the natural enzymes in the digestive system, preventing them from breaking down about a quarter of the fat you eat. Undigested fat cannot be absorbed and passes through the body naturally. The excess fat is not harmful. In fact, you may recognize it in the toilet as something that looks like the oil on top of a pizza.”

Ewww. GlaxoSmithKline just ruined my love for pizza. Alli continues:

The fat passes out of your body, so you may have bowel changes, known as treatment effects. You may get:

• gas with oily spotting
• loose stools
• more frequent stools that may be hard to control

Funny that Alli provides the same “treatment effects” as you might get from a cheese curd binge at the MN state fair. Thank God for the portable “treatment effect” toilets placed conveniently throughout the fair grounds. On their website, Alli attempts to ease your concerns with the following tips (the underlined ones are my personal favorites):

Learning how to manage treatment effects is an important part of being successful with alli. Here’s how to take control:

• Start trimming fat from your diet now, even before you begin taking alli. Then pick a day to begin taking alli, such as a weekend day so you can stay close to home if you experience a treatment effect. Make the timing work for you. If you’re getting ready to travel or attend a social event, hold off on starting with alli until the event is over
• While no one likes experiencing treatment effects, they might help you think twice about eating questionable fat content. If you think of it like that, alli can act like a security guard for your late-night cravings
• You can’t “save fat grams” from lunch and “spend them” at dinner. Spread your daily fat gram allowance of 15 grams on average per meal over the whole day
• You may feel an urgent need to go to the bathroom. Until you have a sense of any treatment effects, it’s probably a smart idea to wear dark pants, and bring a change of clothes with you to work
• You may not usually get gassy, but it’s a possibility when you take alli. The bathroom is really the best place to go when that happens
• You can use a food journal to recognize what foods can lead to treatment effects. For example, writing down what you eat may help you learn that marinara sauce is a better option than Alfredo sauce

Everytime I read those tips I giggle… So, is Alli a good option? I have three main concerns:

• Emotional: Orlistat relies on a strange technique to modify behavior. Specifically, if you eat too much fat you get punished in a potentially embarrassing manner (Oily farts and hard to control stools?!). Approaching weight loss with this mindset may not be the most successful technique. While using a product like Alli, weight loss might become equated with fear and embarrassment. The experiences of becoming more in tune with your body are dismissed over the ultimate goal of not ending up having to change your pants in the middle of a dinner party.
• Physical: We’re losing valuable fat-soluble nutrients here. They’re going right down the toilet. With continued or excessive use, nutritional deficiencies could become an issue. Additionally, excreted healthy fats (omegas for instance) could also put the body in a nutritionally deficient state. And let’s not forget the bowels. The poor bowels! They are not happy; in fact, they are screamin’ mad when they meet a high-fat meal and an orlistat chaser.
• Cost: Alli costs a minimum of $35 dollars per month. Add to that the cost of taking a really good multivitamin to make up for any potential nutritional deficiencies (minimum of $45 per month). And don’t forget the expense for lots of extra toilet paper, a fresh pack of undies, an emergency stash of depends and a few new pairs of pants (minimum $50).

My opinion:  Don’t waste your money for the few extra pounds. Instead, use that money to buy some rollerblades, get a massage, purchase organic foods or work with a personal trainer one time per month. Find something that fills your soul, makes you smile and ultimately gives you a positive motivation (not a punishment) to begin your weight loss.

Breathe in, Peace out…

Aimee

P.S.  If you’ve tried Alli, share your experiences here (by commenting on this post). Did you have success? Any side effects?