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Is alli Your Ally?

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What's my opinion on alli? I would have to say mixed. alli is the weight loss drug approved to be sold over-the-counter by the Food and Drug Administration (FDA). It went on the market this week and has been selling like hotcakes. But make sure those hotcakes don't come with too much fat!

Briefly, alli is the same as prescription Xenical but in a smaller dose. Both contain the drug Orlistat that blocks some fat digestion in the intestinal tract by inhibiting fat digesting enzymes. (Xenical contains 120 milligrams per dose while alli is 60 milligrams). Sounds great.. but what happens to the fat that's not digested? Something potentially unpleasant. That fat is excreted along with the feces and can result in "leaky" or "loose" stools, flatulence, foul smelling stools and any other number of symptoms related to gastrointestinal distress.

The makers of alli, Glaxo/Smith/Kline (GSK) claim if taken as directed such "changes in bowel habits" are minimized and the dieter appropriately adjusts. According to GSK, when alli is taken with a meal it blocks 25% of the dietary fat consumed in that meal. GSK further instructs alli should only be used as part of a low fat, reduced calorie diet. Only one 60 milligram pill should be taken with each meal and no more than 15 grams of fat should be consumed at that meal. If more than 15 grams of fat are consumed, or more than one alli pill is taken, then the dieter will surely experience the "unpleasant" side effects (and probably not pleasant to be around either). Thus, keep your meals low fat if you're popping alli.

GSK says the side-effects make the drug self-limiting. If not taken as directed, the dieter will surely suffer the disagreeable consequences, which in turn ought to prevent such practice in the future. Apparently, that theory has been played out with dieters who took the prescription dose Xenical. Nobody enjoys gastrointestinal distress!

So what do I think? I think alli can be one tool in a comprehensive weight loss effort. It is by no means the magic pill or answer to one's weight loss fantasies. If you take alli, you still need to follow a low fat, reduced calorie diet. So it can reinforce some good habits. alli won't have dramatic results (something we all hope for but can never find), but rather acts as a "supplement" to weight loss efforts. I repeat it's not a magic pill!

Is there potential for abuse? Of course there is (it has been flying off pharmacy shelves, so I am sure we will hear plenty of stories about its after effects).. but once alli is abused, it is unlikely the dieter would want to go through that experience again.

My advice, if you want to try it, do your due diligence. Learn as much as you can about it, how it works, what you can reasonably expect and then make your own informed decision.

GSK has a website for consumers at myalli.com, but I also suggest you visit the FDA's website for unbiased information at http://www.fda.gov/cder/drug/infopage/orlistat_otc/index.htm. If any of you decide to use it, I am anxious to hear feedback!

Easy on the avocado if you're on alli.
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About the Author

Registered dietitian Andrea N. Giancoli is a nutrition advocate, consultant and educator.

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