Alli, the New Diet Pill

By Liz Neporent

Exercise regularly, eat right and oh, you may want to wear dark pants.

That's the message, GlaxoSmithKline, the manufacturers of the just-released diet drug, Alli, is sending out to consumers.

Alli, a reincarnation of the prescription drug Xenical (formerly known as Orlistat), is the ever over-the-counter weight loss pill approved by the FDA. It's half the strength of the prescription dose and works by preventing a quarter of the fat calories you consume from being absorbed and digested. Studies suggest that Alli consumers who also diet and exercise can lose 50 percent more weight for the same effort. That translates into 2-3 extra pounds for every five pounds of weight loss.

What happens to the unabsorbed fat? It's removed in the digestive system through bowel movements. The catch is that users who overindulge on greasy, fatty foods can expect messy side effects like gas, oily discharge and diarrhea. Hence, the suggestion in the supporting materials that come with the Alli starter kit to wear dark pants and bring an extra change of clothes until you've properly adjusted your eating habits. You may want to take off a few days from work as well.

These so called "treatment effects" are short-lived and don't appear to carry any long term safety risks despite protests from a few consumer groups citing studies that link the prescription strength to precancerous changes in the intestines of mice. And, with Alli practically flying off the shelves, they don't seem to have deterred dieters -- hungry for a weight loss aid that lives up to its promises -- from giving it a try.

C.J. Martin is one such diet pill veteran who recently purchased Alli. After experiencing the racing heart, dry mouth and sleeplessness that accompany most of the other products she's tried, the 35-year-old insurance agent feels like a little intestinal distress is a small price to pay if Alli actually does the trick.

"I figured if it can help me lose weight faster I'm more likely to stay motivated and not stray off into bad eating habits," says Martin. "Plus, the effects could provide feedback that you are over doing the fat intake."

In a refreshingly candid marketing campaign, Alli's makers are taking great pains to ensure consumers get the message that Alli is no quick fix or magic bullet.

"This is not for someone who wants the pill to do the work for them," warns Glaxo's weight control brand manager, Debbie Weis. "It's for people who understand that losing weight takes hard work and are looking for something to help guide them and stay on track."

Capsules are packaged with seven advice booklets, a fat and calorie counter plus a daily eating journal. The myAlli.com official Web site features support groups, message boards, progress trackers and "ask the expert" forums.

Weis says that the company realizes that in order to win the trust of a dieting public weary of outrageous, unfounded claims, they need to be honest and upfront from the start about what Alli can and cannot do.

Alli comes in 60-milligram tablets that are taken three times a day with meals. It costs about $50 a month, or about two dollars a day. Because it also blocks the absorption of fat soluble vitamins A, D, E and K, medical experts recommend taking a vitamin pill to prevent deficiencies. It's not intended for use by minors, people with kidney disease, patients on blood-thinners, pregnant or breast-feeding women and those at their ideal weight.

Alli clears the body's system after every use so there's little concern prolonged use carries any long-standing health risks like those connected with ephedra or phen-phen, past fad diet aids that were yanked from the market for causing serious heart damage. There's not much opportunity for abuse either, since taking more than the recommended dosage offers no additional weight loss advantage and doesn't ratchet up the nasty side effects.

As for its long term impact on the nation's ever-expanding waistline, the jury's still out. Numerous studies of the prescription version showed only modest weight improvements; drop out rates were high and it's unclear whether or not lost pounds stay lost.

Although Americans spend more than $1 billion a year on herbal formulas and other supplements that promise quick and easy weight loss, none of them have demonstrated any real effectiveness and certainly none other than Alli have the federal government's backing. Earlier this year, the FDA nixed the sale of another promising weight loss pill, rimonobant, because of concerns over mental health issues and suicidal thoughts; other viable weight loss drug candidates are years away from seeking approval. So for now, Alli seems to be the best diet tool available.