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 BSc RD

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

If you’re looking for a way to shift those pounds quicker, you might be tempted to give Alli a go to help you.

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

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.

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

What Is Alli?

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

Unsurprisingly though, it’s got plenty of WLR members talking. So we thought it was time to set the record straight and separate the science fact from the science fiction.

Here’s the low-down . . .

Alli is a weight loss pill designed to aid weight loss that you can buy from your local pharmacy.

It’s been sold in pharmacies in America since June 2007 and in the UK since January 2009.

Interesting fact:

It's the first, non-prescription tablet for weight loss approved by the EC.

Alli is the brand name for a drug called Orlistat that comes in a 60mg dosage. Orlistat is normally prescribed with a dosage of 120mg under the brand name Xenical. 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 doesn't have any impact on the brain. It works in your digestive system.

Clinical trials have shown that when it’s taken in a 120mg dose (as is the case with Xenical), it 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. Taking the lower dose means you’ll lose around a quarter of the calories provided by fat.

Would you still need to watch what you're eating?

Yes . . .

The drug is most effective when it’s combined with lifestyle changes. That means following a reduced-calorie diet and taking more exercise is still important.

One of the changes advised is following a low-fat diet. That's because the drug works by stopping some of the fat in your food from being absorbed.

Take this drug and eat a high-fat meal and you’ll suffer unpleasant digestive problems. Some of these problems can be quite 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.

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. 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).

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 treated with 120mg of Orlistat lost 7.9kg after a year. Those who were treated with 60mg of Orlistat lost 7.1kg in a year – not actually that big a difference.

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.

A 2011 study, supported by manufacturers GlaxoSmithKline, did prove a link between taking the 60mg dose of Orlistat (Alli) and improved insulin sensitivity.

Possibly good news for those in danger of Type 2 Diabetes.

Alli Available Over the Counter

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

You can only get Xenical, the higher does of Orlistat, on prescription from your GP.

In contrast, you can buy Alli from your local pharmacy.

But is it Alli available to everyone?

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 theory, the first time you buy Alli, you’ll need a short consultation with the pharmacist.

How Do I Get It?

According to Sultan (Sid) Dajani, community pharmacist and pharmaceutical advisor to GlaxoSmithKline, manufacturers of Alli, pharmacists are 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.”

During the consultation, the pharmacist will give brief diet and exercise advice.

They will also make sure the patient is aware that the drug should never be given to someone else.

We tried to buy Alli online at Boots and Lloyds Pharmacy. Before we could check out we had to fill in a questionnaire to confirm suitability for the drug.

Alli Side Effects

Side effects such as wind and bloating may occur for a few days when you first start taking Alli. 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?

It’s definitely not cheap!

Boots Lloyds
1 month supply - £49.95 1 month supply - £35
2 months supply - N/A 2 months supply - £50
3 months supply - £149.85 3 months supply - £75

It would be four times cheaper to get this double dose version on prescription from your GP. With today's prescription charge of £8.60, that works out at just 30p a day.

What Do Experts Think?

Many health professionals are supportive of the fact that a well-trialled drug for weight loss is 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 seek and receive healthcare advice and that can only be a good thing.”

Dr Haslam does agree though 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.”

WLR Member's Comments

We decided to see whether any of our members had tried Alli or Orlistat.

Check out what they said . . .

"I was prescribed Xenical at the start of my weight loss journey. They worked for me. They encouraged me to stick to a low fat diet, which encouraged me then to think about portion sizes and my relationship with food became more focused. I never had any side effects as I made sure what I ate wasn't too high in fat." WLR Member

"They are not the be all and end all in dieting terms, but I think they can help to get your head get in the right mindset for weight loss. I think alot of my weight loss came down to the fact I started exercising alongside watching what I ate. I was a lazy bum before and didn't do anything productive. Exercise was truly the kick start my body needed to become a fitter and less fatter me." WLR Member

"I was given Xenical by my doc a few years ago and instead of flushing the fat out, it all got stored in my liver making me very poorly." WLR Member

"I have always been an advocate of it! I was prescribed Xenical (stronger same thing) and have lost 7 stone with that, healthy eating and lots of exercise. I saw it as something to just help me speed up my weight loss, an extra to keep me going." WLR Member

"I was prescribed the full strength version by my GP back in 2006 when I first started out - it helped me get started back when I was one of those misguided people who was convinced that I 'couldn't lose weight, because I didn't actually eat that much', though in retrospect I probably could have done the job without it. It did help to provide the psychological boost that I needed to get me off what was at that point my 19 stone plus backside and do what needed to be done. It won't work unless you sort out your diet and take some exercise, so you do have to do the work yourself as well." WLR Member

"I tried Alli for a while; you really need to keep your fat intake very low (to avoid unpleasant side effects) and it was in looking for a way to monitor the fat, that I first came across WLR, so I'm grateful for that." WLR Member Porgy

"The side effects were pretty grim. I didn't manage more thana week on them." WLR Member

"I didn't really get on with it. I didn't feel I was losing anymore weight, that I was just sticking to the WLR formula of 1-2lbs a week. So all in all it became an expensive extra and also it really messed up my energy levels which had a knock on effect with my exercise so I wouldn't recommend it to anyone." WLR Member

"I used them to get most of the 7 stone off and swore by them. Never had any nasty 'accidents' or problems with them. Was monitored by my Doctor on a monthly basis as well which really helped. I just popped one with each meal and did everything through WLR." WLR Member

"Yes, I used it. It worked very well for me with no side effects. Looking back I could probably have lost the same amount of weight without it, except that when I was prescribed it I didn't believe I could lose weight, so it was a very useful psychological boost." WLR Member smtfhw1

"I used it to train my body to keep to a low fat diet, and it worked. Now if I look at something that's high in fat I feel a bit queasy and I don't take it anymore." WLR Member

"The fat that my body didn't dissolve was like a 'leak' that could not be stopped . . . If you don't get it then you won't but if you do there is no way to stop it!" WLR Member

"I've been on Orlistat (prescribed, higher dose version of Alli) . . . I think they're amazing! Yes the side effects can be nasty but there is a plus side to that . . . I know if I eat things too fatty then I spend the following day on the loo . . . it's not very nice so it makes me steer clear of the fatty foods!" WLR Member

Read dietitian, Juliette Kellow's verdict


References and Sources:

JAMA - Weight control and risk factor reduction in obese subjects treated for 2 years with Orlistat

Medicines and Healthcare Regulatory Agency UK - Public Assesment Report - Orlistat

International Journal of Obesity Related Metabolic Disorders - Sibutramine: A novel anti obesity drug

Journal of Scientific Research and Reports - The effects of low dose Orlistat on weight loss and markers of metabolic disease in obese subjects

Diabetes Care - Xenical in the prevention of diabetes in obese subjects (XENDOS) study

Journal of Hypertension - Effect of orlistat induced weight loss on blood pressure and heart rate in obese patients with hypertension

Alli - Side effects

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