Alli May Not Be Your Ally

Last year, the Food and Drug Administration approved the first officially sanctioned weight-loss drug to be sold without a prescription. The drug, Alli, became available last summer and is the lone government approved alternative to other over-the-counter remedies. Currently Americans spend around $1 billion a year on supplements that advertise fast weight loss.

Before jumping on “The Miracle Weight Loss Drug” bandwagon, there are some specifics we should explore in order to keep emotions from overriding rational thought. In other words, the more we know about Alli, the less likely we will be to buy into something that may not deliver the results we are seeking.

Alli is an over-the-counter version of the prescription drug Xenical, which has been on the market since 1999. It is not an appetite suppressant. Instead, it inhibits fat absorption by interfering with the digestive enzymes that convert indigestible triglycerides into digestible free fatty acids. The result is that some fat that might have been used as energy remains in the digestive tract until it is excreted.

Common side effects of this drug include loose and oily stools, fecal urgency, flatulence and incontinence. Dr. Jana Klauer, a weight-loss and nutrition specialist, stated that these side effects had been a deterrent to Xenical as a prescription drug. “I haven’t had much success with it,” Dr. Klauer said, “My patients just don’t like the side effects.” Another drawback is that by blocking fat absorption this drug is also, albeit inadvertently, inhibiting the transport of fat-soluble vitamins.

Is there a place for a drug, like Alli, in the fight against obesity? Perhaps there is, in cases of chronic obesity when it is used along with proper nutrition and exercise. However, when a drug is made available over-the-counter, those looking for a short cut to a better body will try it and possibly abuse it. Also, people who may actually benefit from it will be short-changed, as the guidance of a physician will be nonexistent.

Herein lies the real danger. If people believe a drug will prevent calories from being absorbed, a significant percentage will feel the drug allows for less dietary control. "I can have the extra cheese and sausage if I take my pill" is an inevitable conclusion that many in our overweight population will draw. As long as people seek solutions in a pill, our over-fat population will move farther away from taking responsibility.

What if those who will be tempted to buy into this simply reduced fat intake, instead of relying on a drug? What if they traded some of their saturated fat intake for healthy EFAs? What if they walked an extra mile a day, performed 15 minutes of resistance training, and increased their protein intake by 20%? In other words, what if they decided not to rely on a pill but to live responsibly?

Here’s the bottom line: there are no weight loss drugs that in and of themselves deliver a lean, fit, healthy body. The only places where magic potions work are in fairy tales! For those of us in the real world, lean, fit bodies are forged from sound nutritional habits and progressive exercise.