You Might Want to Read That Fine Print

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You may have heard recently that the latest “miracle” diet drug is now available over the counter.  It is called “Alli” (pronounced AL-eye) and I’ve got to say, you are a complete moron if you take this.

No, this isn’t a debate. If you take this in an effort to lose weight, you have more money than brains. Don’t mean to offend any of you that have already gone and bought this, but facts are facts. You are a moron.

Here is an article posted on my personal training business website that I wrote over a year ago, before Alli was available. Time hasn’t changed my opinion.

~Dave

The Next “Miracle” Diet Pill
2/20/2006

Get ready folks, there is another new “miracle” weight loss pill coming soon. A few weeks ago, an FDA panel voted 11-3 to recommend approval of an over-the-counter (OTC) version of the drug Orlistat, currently available by prescription only as Xenical.

Excuse me for being a little blunt, but what the hell is wrong with those 11 supposedly intelligent people who voted for this? Are you kidding me?

Okay, let me step back from the ledge here and first explain what Orlistat/Xenical actually is. Unlike most diet pills, it does not work by suppressing appetite. Instead, it functions by blocking an enzyme in the intestinal tract, Lipase, whose job it is to convert dietary fat into a form that can be absorbed by the body. If Lipase cannot do its job, some dietary fat will not be absorbed by the body, but will pass through the digestive system and be excreted. If the fat is not absorbed, then it is like the calories were never eaten.

If only that were the case. Let me warn you, the following is not pleasant, but you simply cannot discuss this drug without bringing up some extremely unpleasant side effects, and trust me, there is no way to candy coat this.

Unfortunately, there will be ample evidence that those fat calories were eaten. According to the product’s web site, among the potential side effects of taking Xenical are: oily spotting, flatus with discharge, fecal urgency, fatty/oily stools, oily evacuation, increased defecations, and the always popular fecal incontinence.

Hey, where do I sign up?

In studies cited by the manufacturer (Roche Laboratories) on its web site, in year 1 of use

• almost 27% of test subjects experienced oily spotting
• 24% enjoyed flatus with discharge
• 22% had fecal urgency
• an even 20% had fatty/oily stools
• 12% suffered oily evacuation
• 11% passed the time with increased defecation
• and 8% enjoyed the benefits of fecal incontinence.

Nothing like fecal incontinence to liven up a dinner party.

The best news is, they got to enjoy all of this just so they could lose approximately 1 pound more per month in the first six months of treatment than someone taking a placebo, and even less than 1 additional pound per month than placebo takers over the course of 1 full year of treatment.

Sounds like you should just find out what the placebo was and go with that.

Is it any wonder that sales of Xenical have fallen dramatically since it was introduced? And now, since the prescription market is drying up, Roche plans to team up with GlaxoSmithKline to introduce a lower dose, OTC version of this wonder drug called Alli (pronounced like ally). They, along with industry analysts, are predicting sales in the billions of dollars, and they are probably right.

Sadly, millions of people waiting for the next quick fix will line up, willing to risk fecal incontinence if they believe it will come with weight loss in a bottle.

I am obviously making light of aspects of the situation, and it is hard not to given how preposterous this proposal is. There is a very serious side to all of this though, and it revolves around the potential for abuse and misuse should this drug become available over the counter.

One of the benefits of its prescription-only status now is the ability to keep it out of the hands of those diagnosed with eating or body image disorders such as bulimia or anorexia nervosa. Put this on a shelf next to the Dexatrim though, and suddenly that control is gone.

Other potential harm exists because, regardless of what the manufacturer recommends, some people will take the use of this product as license to eat whatever they want. Not only does a high fat diet increase the likelihood of the side effects listed above when taking this drug, but there is no guarantee that positive results will be seen in that case. When that occurs, it is to be expected that a certain percentage of users will self-prescribe higher doses than recommended in the hope that more is better, even when evidence to back that up does not exist.

Roche also admits that the drug may block absorption of fat-soluble vitamins (A,D,E, & K) and beta-carotene, so users not aware of that may run the risk of vitamin deficiency if they do not add a vitamin supplement to their diets.

The biggest problem with this drug, and the proposal to make it available over-the-counter, is that it is just really not needed by the general public. Roche recommends a diet with 30% or less of calories coming from fat when taking this drug. The drug is then supposed to block absorption of a third of that fat, bringing calories from fat intake to about 22% of the daily calorie intake total.

Well Sparky, instead of relying on a pill to do this, how about just cutting some fat from your diet? Maybe try some exercise.

What ever happened to people taking responsibility for their actions? Switch to skim milk. Buy nonfat yogurt. Skip the cheese when making your sandwich. These are not hard things to do, and in the end will be a lot better for you than fecal incontinence.

Every day I tell clients that there are no quick solutions, no magic pills, no weight loss in a bottle. The truth is, if you want to lose weight and keep it off permanently, you need to eat right and exercise. A drug as stupid as Orlistat/Xenical/Alli only serves to prove this point for me.

You might also like:

1. It’s a new “miracle” drug!
2. How Food Manufacturers Lie to You
3. Low-Carb Wins After All?