What's the skinny with Alli?

I have received a lot of questions from readers about this drug recently, and I am not completely sure why, but it maybe because warm weather is right around the corner and that means bathing suit season???  So many people think that they can just take this pill, shed unwanted pounds, there are no side effects; a magic pill!  Well, I hate to be the bearer of bad news, but there are no magic pills, but this can be a really useful diet aid for those struggling with weight loss, and one of the major side effects helps you to eat a healthier diet.

What exactly is Alli?
Alli is an over the counter medication, that is a lower dose of a prescription medication known as Xenical (orlistat).  Alli is 60mg versus Xenicals dose of 120mg.  And, Alli is only available over the counter to adults (age 18 and over) in the United States.

How does it work?
Well, Alli is a fat blocker, basically, so it aids in weight loss.  The way it works is kind of two-fold: it decreases the fat absorption ability of your intestines, and also it effects your lipase, which is an enzyme secreted from your pancreas that helps to break down fat to an absorbable form, so that it no longer works.  You are encouraged to eat a low-fat diet, you need to eat small amounts of "good fat" in your diet to be healthy, and eat a healthy low calorie diet, getting in lots of fiber and protein.  And you are encouraged to take it three times a day with a meal.

Side effects?
Well, here's the kicker, Alli is made to be taken by obese people who need an assist with losing small amounts of weight in addition to a healthy diet and exercise.  So, if you take the drug and eat a high fat meal, watch out!  You can have urgent bowel movements, diarrhea, and gas with oily discharge (a "shart" as some might know it). Some people have even noticed these side effects with lower amounts of fat in their diet. Yikes!!  As well, your bowel movements will be very oily and the oil will separate in the toilet, not really something that is horrible, but it can be a little off putting when you first see it.  And, the biggest "side effect" that has been associated with Xenical (the sister drug of Alli) is liver dysfunction, so you need to stop taking the drug and see your HCP immediately if you notice jaundice (a yellowing of the eyes and skin), extreme fatigue, or urine that is so dark it looks like a pilsner beer (almost brown).

Does it work?
The deal is that Alli is FDA approved, but most of the studies done that show proven weight loss is from the prescription drug Xenical, which shows (per research) to have an average extra 5-7lb weight loss per year, and it is assumed that using the 1/2 dose of Alli, there will be a 3-5lb weight loss.  And, it needs to be re-stated that this is weight loss that HAS to occur along with a change in diet and exercise.  To put this all in perspective, it is estimated that the average person, with just diet changes and adding exercise to their regimen, loses 8-12lbs a year.  Most of the weight loss occurs within the first 6 months of taking it, and users state that they regain all the lost weight when they stop taking it, so you will most likely need to stay on the medication indefinitely to keep the weight off.

Who Shouldn't take this medication?
-If you are of normal weight/ Body Mass Index [(weight lbs)/(height in)2] x 703.  (average for adults: 18-5-24.9)
-If you are taking immunosuppressant drugs (i.e. cyclosporine) post organ transplant
-Have a baseline of difficulty absorbing food (IBS, Chron's, etc)

It also needs to be noted, that because this is a fat blocking medication, you will have difficulty absorbing fat soluble vitamins (A, D, E, & K) so you will need to take a vitamin at some point in the day between Alli doses, so that you will prevent vitamin deficiencies.  And, despite tis being and over-the-counter medication, I strongly urge you to talk to your HCP and let them know that you are taking tis medication so that they can track your progression and make sure that there are no other side effects occurring.  So, if this is a drug you want to use, talk to your HCP, make a plan, and eat low fat....or bring a change of undies!!!

Yours in Good Health
B