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Over the Counter Weight Loss Drug
Dietitian's Report: Alli Weight Loss Pills

Does the Alli weight loss pill work and what are the side effects? Juliette Kellow BSc RD gives the facts about the use of Alli Orlistat pills to aid weight loss.

Alli Weight Loss Aid

By Dietitian, Juliette Kellow

The new Alli weight loss pill is now available over the counter but before you reach for your purse read dietitian, Juliette Kellow's (BSc RD) verdict.

If you’re looking for a way to shift those pounds quicker, you might be tempted to try Alli, the latest over the counter weight loss drug to hit the shelves of your local pharmacy.

You can use Alli in conjunction with wlr. Simply set your calorie allowance for 2lbs a week and you should lose around 3lbs a week with Alli's help. Just use your food diary to make sure you keep your fat intake low, essential when using Alli.

Headlines have claimed Alli weight loss pills can ‘help rapid weight loss’ and hailed it as a ‘weight-loss wonder drug’.

Very interesting . . . Let's take a proper look behind the hype. 

Alli - Brand New Slimming Tablets?

Not exactly . . .

Alli is simply a lower dosage of a drug Orlistat that’s been on prescription for more than a decade in the UK.

Unsurprisingly though, it’s got plenty of members talking, so at WLR we thought it was time to set the record straight and separate the science fact from the science fiction. Here’s the low-down on Alli…

What is Alli?

Alli is a weight loss pill designed to aid weight loss that you will soon be able to buy from your local pharmacy. It’s been sold in pharmacies in America since June 2007. But in January 2009, Alli received approval from the European Commission (EC) to licence it as a non-prescription product, which means it can now be sold in pharmacies in all 27 EU member countries, including the UK.

This is the first time the EC has approved a non-prescription tablet for weight loss, making it a big news story.

What Does Alli Contain?

Alli is the brand name for a drug called Orlistat that comes in a 60mg dosage. Orlistat has been available on prescription in the UK for more than a decade in a 120mg dosage under the brand name Xenical. In simple terms, Alli and Xenical are both based on the weight-loss drug Orlistat – Alli is simply a tablet that contains half the dosage of the drug.

How Does Alli/Orlistat Work?

Orlistat blocks the action of lipase, the enzyme that digests fat in the intestine. Unlike some weight-loss pills, Orlistat has absolutely no impact on the brain and instead works simply in your digestive system.

Clinical trials have shown that when it’s taken in a 120mg dose (as is the case with Xenical), this stops around 30 percent of the fat you’ve eaten from being absorbed. When it’s taken in a 60mg dose (as is the case with Alli) it’s been shown to prevent around 25 percent of the fat eaten from being absorbed.

As a result, taking the higher dose means your body loses around a third of the calories provided by fat, while taking the lower dose means you’ll lose around a quarter of the calories provided by fat.

Bottom line: with either slimming tablet you will lose weight.

Is There Any Proof That Orlistat Works to Help People Lose Weight?

Orlistat has been used in more than 30 million patients and is the most extensively studied weight loss pill that’s currently available. Research shows that the amount of weight you lose is dependent on the dose you receive, so in other words, you can expect to lose less weight on a 60mg dosage (as is the case with Alli) than you would on a 120mg dosage (as is the case with Xenical).

However, Alli still has 80 percent of the strength of Xenical so having half the dose doesn’t mean half the weight loss.

Orlistat Study

In one study, adults who were treated with 120mg of Orlistat lost 7.9kg after a year, whereas those who were treated with 60mg of Orlistat lost 7.1kg in a year – not actually that big a difference.

Similarly, 29 percent of the adults on the higher dose lost at least 10 percent of their weight after a year, compared to 24 percent of the adults on the lower dose. Other studies have shown that when it’s used in conjunction with a reduced-calorie, low-fat diet, it helps adults lose 50 percent more weight than by dieting alone.

In other words, for every 1kg lost by dieting alone, the Alli diet pill could help you lose another 0.5kg.

Alli Health Benefits

One clinical trial has shown that Alli helped to reduce blood pressure in adults who took it for a year.

Far more research has been undertaken with Xenical though. Patients who lost more than five percent of their weight after three months showed a significant reduction in blood pressure, blood glucose and triglycerides (a type of blood fat) – all of which are risk factors for heart disease.

Another large study found that adults who took Xenical in combination with a diet and exercise plan reduced their risk of developing type 2 diabetes by 37 percent compared to those who simply followed the diet and exercise plan.

There haven’t currently been any studies evaluating the role Alli may have in preventing type 2 diabetes, but it’s only a matter of time.

Alli Available Over the Counter

There’s a big difference in how you get hold of the drug.

Xenical, with its higher dose of Orlistat, is currently only available if it’s prescribed to you by your GP and is likely to remain this way in the future. In contrast, you will soon be able to buy Alli from your local pharmacy.

Although an exact date hasn’t been announced for its launch, pharmacists believe it will be available from April 2009. The drug will be positioned behind the counter so you will need to ask for it. You will then need to be seen by the pharmacist to assess whether or not you are a suitable candidate for the drug.

Can Anyone Take Alli?

No! Alli is only suitable for people who are 18 years or over and who have a Body Mass Index (BMI) of 28 or more.

Pharmacists have an important role to play in terms of assessing the suitability of the drug for each individual who wants to buy it. In theory, the first time you buy Alli, you’ll need a short consultation with the pharmacist.

How Will this Consultation Work?

Currently, a protocol for pharmacists is being written. However, it’s worth bearing in mind that pharmacists have been involved in dispensing Orlistat in the form of Xenical for many years.

According to Sultan (Sid) Dajani, community pharmacist and pharmaceutical advisor to GlaxoSmithKline, manufacturers of Alli, pharmacists will be involved in every sale of Alli.

“Customers who’ve not taken the drug before will receive a 10-15 minute consultation, which should take place in a separate room or quiet area to ensure confidentiality,” he explains.

“The pharmacist will assess the customer’s BMI, check the product is for them and ask questions about any other weight loss programmes they’ve tried and how long they have been overweight. They will also be asked about other medications they’re taking – not because Alli interacts with other drugs, but because some medications are based on an individual’s weight and so will be affected by weight loss.”

Pharmacists will also give brief diet and exercise advice to back up the information that comes with the drug itself and will advise that it should never be given to anyone else.

Alli Is A Weight Loss Aid Not Cure

No! The drug is most effective when it’s combined with lifestyle changes that include following a reduced-calorie diet and taking more exercise.

Because the drug works by stopping some of the fat in your diet from being absorbed, it’s essential to follow a low-fat diet.

Take this drug and eat a high-fat meal and you’ll suffer unpleasant digestive problems such as severe flatulence, sudden bowel movements, stomach cramps, bloating and an oily discharge that takes a while to flush away.

Experiencing these just once is often enough to encourage people taking the drug to limit their fat intake.

You take one capsule with each meal, so three a day.

“It’s best to take each capsule half to one hour before a meal, and no more than an hour after eating,” explains Sultan.

Alli Side Effects

Side effects such as wind and bloating may occur for a few days when you first start taking Alli, although these symptoms will be less prominent if you’ve already been following a relatively low-fat diet.

After this time, unpleasant side effects will usually only occur if you have a high-fat meal.

“With most medicines you can’t miss taking a dose,” says Sultan.

“However, Alli only stays in the digestive system for about six hours so if you know you are going to have a high-fat meal – for example, to celebrate a special occasion – it’s possible to skip taking a capsule with that meal. Although, the more times you do this, the less effective the treatment will be in helping you to lose weight, so it’s not something you should do on a regular basis.”

There’s no need to worry that taking the Alli diet pill will wipe out any of the good bacteria in the gut.

“Alli works solely on blocking the enzyme that digests fat and so has no impact on probiotic bacteria in the digestive system,” explains Sultan.

How Much Does it Cost?

In credit crunch times it’s not cheap! The price still hasn’t been confirmed but a 28-day supply of Alli l is likely to cost £40.60 – that works out at £1.45 a day.

Effectively, it costs around six times more to buy this product from your pharmacy than to get a 28-day supply of double dose Orlistat in the form of Xenical prescribed by your GP for a prescription charge of £7.10. That’s just 25p a day.

What Do Experts Think?

Many health professionals are supportive of the fact that a well-trialled drug for weight loss will soon be available without the need for a prescription.

Dr David Haslam, GP and chairman of the National Obesity Forum is one of them.

“Having a weight-loss treatment available from pharmacies opens up the area of weight management to many more people. It’s likely that more people will now seek and receive healthcare advice and that can only be a good thing.”

Dr Haslam does agree th ough that pharmacists will need appropriate training in this area.

“Selling a weight-loss drug over the counter creates a whole new order of care for helping to treat overweight people. It’s essential that pharmacists selling the drug are able to give the same level of lifestyle advice as GP’s, so that in addition to taking the medication, consumers can also make alterations to their diet and exercise habits.”

Read dietitian, Juliette Kellow's verdict

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Using the food diary and tools in WLR can help you lose weight without pills, and can provide the low calorie, low fat diet that most slimming pill manufacturers recommend. We'd advise keeping a food diary for a couple of weeks before making a decision about pills - many people find that just making a few, relatively minor, changes to their eating habits sets them on the path to sustainable weight loss. Try the WLR Food Diary free for 24 hours.

Take our FREE trial »


Start a Free Trial Today

Using the food diary and tools in WLR can help you lose weight without pills, and can provide the low calorie, low fat diet that most slimming pill manufacturers recommend. We'd advise keeping a food diary for a couple of weeks before making a decision about pills - many people find that just making a few, relatively minor, changes to their eating habits sets them on the path to sustainable weight loss. Try the WLR Food Diary free for 24 hours.

Take our FREE trial »

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