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Orlistat / alli - FDA approves OTC loose-stool drug
Filed Under (Medicine, Weight Loss) by 
Cris Harshman on 08-02-2007
Tagged Under : alli, fda, fitness, health, Medicine, orlistat, Weight Loss
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Loading ...What do you think about alli? Take my poll.
The FDA approved an over-the-counter version of Orlistat today, alli. My opinion? Eat less, exercise more, keep a journal, and pocket the money you would spend on alli. Even the FDA says
“This drug is only going to be effective if it’s used along with a weight-loss program,” [Dr. Charles J. Ganley, the FDA's director of the Division of Over-The-Counter Drug Products,] said. “That means a reduced fat diet, decreased calories and an exercise program.”
“If someone uses the drug without a weight-loss program, it’s not going to be very effective,” he added.
Why do I think this drug is stupid and useless? Let me break it down:
It will be marketed as a weight-loss pill, but it still requires lifestyle eating changes. Calorie-counting, general awareness of the fat and caloric content of the foods you eat, limiting your caloric intake, reading labels, exercise - these are all lifestyle changes suggested by GSK before taking Orlistat / alli. In fact, the pill itself is being promoted as only one part of a package:
Unlike other products on store shelves, alli is a proven medicine with a comprehensive support program. To help consumers get off to a successful start, the alli package will include Welcome and Companion Guides, a Guide to Healthy Eating, a Daily Journal, a Calorie and Fat Counter, Quick Fact Cards, and free access to an individualized online action plan at myalli.com.
“With alli, we’re excited to offer a revolutionary approach to weight loss,” says Steven L. Burton, Vice President, Weight Control, GlaxoSmithKline Consumer Healthcare. “alli is more than a pill - it’s a comprehensive program that works in conjunction with a sensible diet to increase weight loss. Because weight loss doesn’t happen overnight, we’re starting to educate consumers now about the importance of realistic expectations, gradual weight loss and lifestyle changes. That’s the way to see results, and with alli, we know they can do it.”
A comprehensive program in a bottle? I can just implement the components of the program and lose weight without the side-effects of taking patent medicines. When the pill is marketed, regardless of what verbage GSK puts in their commercials to appease the FTC, people will react to alli as if it’s a magic weight-loss pill, take it until their digestive side-affects become too unbearable, and stop - all without making the necessary lifestyle changes. Meanwhile, GSK makes a killing - until the inevitable class-action lawsuit, of course.
The suggested maximum fat intake alone will help people lose weight without alli. Quoting from the GSK alli press release,
Taken at meal-time, alli works by blocking about 25 percent of the fat in the food a person eats. Because of the way it works, alli must be used in conjunction with a reduced-calorie, low-fat diet containing about 15 grams of fat per meal.
MedlinePlus adds the following:
Each time you take orlistat, your meal should contain no more than about 30% of calories from fat.
Fat is 9 calories per gram. By cutting your fat intake per meal down to GSK’s recommended allowance, you are limiting your meal to 135 calories from fat. If you’re eating a daily caloric amount of 2300 calories, for instance, you are limiting your daily fat intake to 690 total calories before even taking the pills. I would guess that change alone will account for substantial weight-loss in most people taking this pill! As quoted above, the pill blocks 25% of your fat intake during meals. So, the pill will block a futher maximum amount of 172.5 calories a day. Realistically, you could cut 180 calories out of your daily eating and have the same benefits of the pill, without the disgusting side-effects.
I talked about lifestyle diet changes required before even taking this pill. Let’s look at some foods you can no longer eat. An obvious one is fast-food: KFC (153 [or 45%] calories from fat per serving, original recipe chicken) is out. McDonalds fries (270 [or 47%] calories from fat per serving), burgers (263 [or 32%] calories from fat per sandwich [105g]) - even some salads (asian salad has 90 [or 29%] calories from fat per serving) are all out. I doubt anything else is good - it’s all smothered in dressing, cheese, refried beans and breads. Classic Americana cuisine like peanut butter & jelly sandwiches (one serving of peanut butter has 145 [or 72%] calories from fat per serving) and hot dogs (167 [or 52%] calories in one dog w/bun and ketchup) are also too high in fat content.
So those are all “unhealthy foods” we shouldn’t be eating anyway. Did you know the average salmon has 56% calories from fat per serving? Lean top sirloin has 30% calories per serving? Sure, salmon might have “good fats”, but it’s still fat, which leads me to my next problem with alli:
Orlistat makes no distinction between which fats are blocked. Our bodies need fat. Some vitamins are fat-soluble (like A, D, E and K). Fats are important to cellular health and hormonal function. Monunsaturated fats may protect against heart disease. Orlistat blocks 25% of all fats, which may block our intake of fat-soluble vitamins and have other affects we aren’t yet aware of. It also indirectly promotes the use of multivitamins and herbal supplements, which may not be as healthy or reliable a source of vitamins as food. (As a related side note, I’m finishing Dan Hurley’s Natural Causes, a fascinating book that I’ll talk more about later.)
Orlistat only blocks calories from fats. High-fructose corn syrup, carbohydrates, starches, simple sugars - many sources of weight gain are not blocked at all.
Orlistat is “taken with meals”, but we consume fats and calories from drinks too. The Coffee-mate powder sitting in my desk has 3g of fat per serving, or 25(4%) - one serving is 4 tsp, and I doubt I use just 4 tsp per cup of coffee. 1 bottle of Dr. Pepper has 150 calories and none from fat - all 150 calories slip right on through, Orlistat or not. Whole milk has 146 calories per cup, 71 from fat - if not consumed with a meal, Orlistat doesn’t help block those fats either. People on alli may become a little more conscious of what they eat, but still drink beverages high in syrups and calories.
The alli way: make lifestyle changes, spend $25/week to lose up to 50% more pounds per week than lifestyle changes alone, and have runny underwear and gas.
My way: make lifestyle changes, invest $25/week in a 5.05% APY savings account (which will leave me with approximately $1260 at the end of the year - almost a Disney trip!), and enjoy clean underwear.
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My question is how similar to Olestra is this stuff. Sounds like the same damn thing down to the leakage.
Alli might not be a miracle drug, but if you look at the research, it is pretty well established that it is more effective than the diet with placebo.
How so? While I acknowledge that there are people with genetic issues that prevent the regular loss of weight, I for one was able to do standard caloric reduction and Cris was able to do it similarly while working on some of the mental associations.
Got links to those reports? I’ll see what I can find. In fact I would love to look at the chemical nature of this stuff and Olestra. Any chemists around that can help?
Thanks for the comment.
In controlled studies, you enforce the lifestyle changes on the participants, like how many calories you consume in a day and how many of those calories come from fat. In real life, people will not adhere to the suggested lifestyle changes - rather, they will see the pill as it’s marketed, a diet pill, and rush to the pharmacies for a “clinically proven weight-loss pill” with no concern for caloric intake and maximum levels of fat consumption. Plus, there are no studies on the long-term effects, and I have not seen a suggested maximum duration of taking the pill. Blocking the body’s fat consumption may have harmful effects that we can’t foresee - much better to just cut your caloric consumption instead.
Besides that, as I pointed out, if you do the math the impact of the drug is pretty minimal. Don’t get me wrong - if this pill is a short-term catalyst for someone jump-starting a fit lifestyle, I celebrate and congratulate their choices. However, I sincerely doubt the majory of people trying alli use it in that manner. We’ll have to see.
I found the their website to be pretty interseting…. http://www.myalli.com no real overpromise, they tell you exactly what you can lose, and if you watch their videos, they will even tell you that it is not right for everybody. sure you may not lose tons of pounds, but for a few folks out there, it might actually help a little. And you get the plan with it, so even if you are buying just the plan, that can help. sometimes people need to think they are doing something. also, look at http://www.alliHCP.com to see what else they are telling the medical community.
Got a response back from my chemist friend. So the olestra is a fake sugar derivative (made from sucrose) vs alli. And apparently wiki is fairly accurate.
I USED IT AND HAD TO STOP. IT MADE ME SICK.
GAS GAS GAS GAS GAS. PAIN
I WOULD HATE TO BE AROUND SOMEONE TAKING THIS DRUG . THE SIDE EFFECTS ARE NOT WORTH IT.GAS,RUNNING TO THE TOILET,STOMACH PAIN. THIS OVER THE COUNTER WILL FAIL. I AM A HEALTHY PERSON 1 OR 2 POUNDS OVER WEIGHT.