Fat-blocking Alli is no magic bullet
Jun 29,2007 00:00 by R.J. Ignelzi

Standing in front of the large Alli display, Mary Chase read aloud from the box of the over-the-counter weight-loss drug.

"It says it can help you lose 50 percent more weight than dieting alone," said Chase, 66, of Oceanside, Calif.

Other shoppers in earshot drew closer to Chase and the display.

"It says it can block 25 percent of the fat you eat," she continued, glancing with raised eyebrows at her sister, Leanna Willis, 68.

Chase looked around at the other curious shoppers, peered again at the box and then tossed it in her cart.

"It's worth a try, I guess," she said.

Marianne Schultz, 53, didn't think so.

WEIGHT LOSS - Alli, a FDA-approved weight loss product available without prescription, will soon be on shelves in stores nationwide. CNS Photo by GlaxoSmith/Kline.

"It's supposed to give you bad diarrhea and cramps. It's supposed to make you feel sick," she said. "It's not for me."

Shoppers seemed to epitomize the conflicting opinions about the new fat-blocking pill that had crowds in Los Angeles lining up to buy it as soon as it hit the shelves.

As the initial hype wears off and the buying frenzy slows, many shoppers seem to understand that the new weight-loss aid is no magic bullet.

Although Alli (pronounced "ally") may help prevent some extra fat from gathering around your waist, it won't allow you to gobble double-fudge chocolate chip ice cream by the pint. If you do, you'll not only gain some unwanted pounds, but also some nasty gastrointestinal side effects.

"While it's wonderful to have an over-the-counter (fat-blocking) drug that's approved by the FDA, people have to be prepared to make lifestyle and dietary changes so it can work properly," said Dr. Michael W. Lee, an endocrinologist with Scripps Clinic's Center for Weight Management in San Diego. "If used by itself, it's not very effective."

Alli, which is sold in drugstores, vitamin shops and some department stores, prevents the body from absorbing about 25 percent of the fat that is ingested. When used with a healthy diet plan and regular exercise, about half of the people taking the drug in clinical studies lost 5 percent of their body weight in six months, according to information from the manufacturer, GlaxoSmithKline.

"There are certain enzymes that are released in the body which help break down fat so you can digest it. The drug simply inhibits those enzymes from working," Lee said.

Fat that is not absorbed by the body ends up in the toilet.

For Alli to work without significant side effects, fat intake must be curtailed. Lee recommends no more than 10 grams of fat per meal. Alli instructs users to consume no more than 15 grams.

"If your fat content is higher than that, it can cause problems like flatulence, bloating, cramps and incontinence," said Lee, noting that in clinical trials for the drug, adult diapers were made available to participants. "It can be very socially and personally disruptive."

Users who are on a very low-fat diet may see little weight loss results from the drug.

"I think a lot of people will be interested in Alli, especially at first. But that could change in a month," Lee said. "If people don't make lifestyle and dietary changes, they will get the side effects, and people will be turned off by that."

According to the manufacturer, Alli users can lose about 50 percent more weight than they would dieting without it.

Lee is more conservative and predicts a 5 percent to 10 percent loss from a user's original weight.

"If you weigh 200 pounds, for example, you may lose up to 20 pounds with the help of the drug," he said. "But it's not going to make you lose half your weight, as some people would like."

Alli is a 60-milligram over-the-counter version of orlistat, the weight-loss drug sold by prescription since 1999 under the brand name Xenical (120-milligram capsules). A container of 90 tablets, or a month's supply, costs $59.99. Because of this steep cost, some drugstores are selling Alli from behind the pharmacy counter.

Besides the gastrointestinal side effects, there are few other medical problems associated with the drug, and Lee called Alli "really quite safe."

It's not absorbed by the body. It doesn't affect blood pressure, metabolism or mood. Alli is indicated for use in people 18 and older and is not recommended for pregnant or nursing women, anyone with an immune deficiency or patients planning organ transplants.

© Copley News Service