It's no secret; we are simply looking for a miracle.  Every year, overweight people in the US spend more than $1 billion on unproven, quick-fix supplements to help lose unwanted inches.  We've all seen the ads on TV, in magazines, drug store aisles and almost every web-site from Amazon.com to Drugstore.com.  The idea of a pill that offers convenience and the belief that someone has done all of the work for you.  It's a shame how easily we forget that the solution to our problems can't be found in a bottle, but in ourselves.  There will always be someone who won't read beyond the fine print, someone who is desperate to find a miracle for weight loss and believes that they have found the magic bullet.  It never ceases to amaze me how many people are willing to risk public humiliation to shed a few unwanted pounds.  I'm sure that curiosity has gotten the best of some of you.  You may have even picked up the box, gone as far as to visited the products web-site or asked your doctor or pharmacist his/her opinion about our newest friend on the market Alli. 

In mid-June, the FDA approved the drug product Alli (also known as Orlestat) as an over-the-counter weight loss aid.  But what you may not know is that Alli is the prescription weight loss drug Xenical.  Xenical was approved by the FDA in 1999 and records show that overweight people have tried the diet drug more than 25 million times, but Xenical sales peaked in just one year!  The hype came and left very quickly and it was clear that Xenical wasn't very successful at all.  Personally, I believe that there are two main reasons why Xenical failed: the side effects were humiliating and the small amount of actual weight lost was disappointing. 

 Eight years later this once popular pill has emerged again but this time with a different name-Alli.  The new over the counter version is the same drug but half the original strength.  This new and improved version may be more available, but still has the same side effects that contributed to the demise of its predecessor.  I would commend GlaxoSmithKline (the creators of Alli) for making an effort to point out that Alli "only works if you work" and that it is "not a miracle pill or a quick fix" but I'm not!  Users are persuaded to use the product in conjunction with exercise and a reduce calorie low- fat diet.  But will America listen?  

Studies conducted by the company show that when using the Alli program (pills, diet and exercise) correctly, individuals can lose up to 50% more weight than dieting alone.  How do we know if these results come from the drug itself, exercise, diet or perhaps a combination of the three?  While 50% more weight sounds like a lot, but it's really not.  If you used the Alli program, you could lose 1 pound instead of 1/2 pound in the same amount of time doing the same things.  How about that!  These results aren't as dramatic as they sound; after all, you still have to diet and exercise for it to work.  If the full-strength prescription version of Xenical, didn't live up to its promise, how would we expect the less potent Alli be any better?

 Alli helps weight loss by decreasing the absorption of fat by 30%.  Hmmm, I wonder what would happen if you just simply ate 30% less fat?  Sounds like a no brainer to me.  The drug works by blocking the absorption of fat in the stomach and small intestine.  As some of you have already guessed; the unabsorbed fat has to go somewhere and that somewhere is often your underwear!  Alli's manufacturer is up front and honest about the potential side effects not because they want to be, but because they have to be. It's the law!  Just look at what they state in their own literature. "Alli users can experience gas with oily discharge, inability to control bowel movements, oily or fatty stools, and oily spotting".  Proponents of Alli would claim the side effects to be "positive" to help modify eating habits.  So if you eat a high-fat meal and have an accident, then you'll be less likely to eat those foods again!  Nice argument, but If users of Alli suddenly were forced to carry around Depends, I guess that would change my behavior too! 

 So, the Alli "program" recommends a reduced-calorie diet which is based on your current weight (which doesn't take into account body types) and recommends an equal intake of protein, carbohydrates and fat (about 30-33% each).  While that may be a reduced calorie diet, it is certainly far from being low in fat!  I feel sorry for those who follow this plan only to find that they continually have accident after accident despite their efforts.  Ideally a diet that contains 55% carbohydrate, 25-30% protein and less than 20% fat is ideal for fat loss!  Especially if you are working out!  So by following the recommended diet, even though it may be lower in fat than your current diet, you may still not see the desired weight loss.  What a waste. literally!  If you ask me, there is a huge conflict of interest with this medication.  One would almost have to eat more fat in order to see any noticeable effect from using Alli.  No sane person would ever consider doing that to try and lose weight.  Or would they? 

 According to the manufacturer" Alli is not for people who have problems absorbing food or for those who are at a healthy weight".  Individuals who have problems absorbing food may not be aware of that condition, or perhaps those who just had gastric bypass may want to maximize their weight loss by popping a pill or two.  What is the FDAs definition of "overweight"?  What about those who want to lose a mere 5-10 pounds without a whole lot of effort?  How could the FDA possibly approve this drug to be sold over the counter when most Americans are not educated on sound nutrition or what steps to take to care of their own health? 

 There are many other individuals who are not candidates for this new drug. Those under the age of 18, people with kidney disease, patients on blood thinners women who are pregnant or breast-feeding women, those with thyroid disease, diabetics, gall bladder problems, kidney stones or those with organ transplants.  But are consumers wise enough to head the manufactures warnings?  Or will they take the typical approach and tell themselves that regardless of their medical conditions "using it for a short period of time" won't hurt?  After all, in a moment of desperation, isn't that always the case?  With such a long list of individuals that should avoid the drug, why should this product be readily available to the public?

 Part of Alli's marketing claims that a weight loss of 5% of body weight can prevent health problems and improve one's health.  With those claims, no one would ever consider the fact that Alli may cause secondary medical conditions that can seriously affect your health.  Alli not only blocks the fat, but it interferes with the absorption of fat soluble vitamins.  The drug company recommends taking a vitamin/mineral supplement, but that is by no means a guarantee that your body will absorb all nutrients needed?especially those that need fat to be absorbed.  Deficiencies in these fat soluble vitamins (A, E, D and K) can lead to impaired vision, decreased immunity, bone loss, reduced strength of cell membranes and prevent blood clotting.

Alli does not discriminate.  It doesn't care whether the fat you eat is from a burger and fries or from healthy fish like salmon.  Regardless of how healthy your fats are, both good and bad fats are blocked from absorption.  Healthy fats are important for your overall health, and blocking them can have negative effects.  These effects can cause secondary conditions such as dry skin, eczema, hair loss, hormone imbalance and interfere with normal body processes. Realize that those who lose weight and keep it off almost always follow the same strategy: balanced nutrition with portion control, daily exercise and especially important, they find a long-term motivation to change their lifestyle.  Those are the keys to long-term success when it comes to weight loss.  Even though Alli is FDA-approved, it doesn't mean it is safe for long -term use.  The FDA-approval guarantees safety and potency of a product, based on the research that is available thus far.  Most pills and drugs that are approved by the FDA are safe.  However, the FDA has made mistakes in the past and has later removed potentially threatening and deadly products from the market even after they were approved and considered safe.  Is the discomfort, embarrassing side effects and potential health risk worth a measly extra 4 ounces?