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About Alli

According to headlines, Xenical (which is orlistat) may become the first over the counter diet pill.

Xenical is currently sold by prescription only. It's the only drug approved by the FDA for weight loss that works by blocking fat absorption by blocking the digestive enzyme lipase.

The fat-blocking prescription pill Xenical, made by Roche, was originally approved in 1999. A year ago, GlaxoSmithKline bought the rights to market Xenical in the United States from Roche.

On January 24, 2006 after an all day hearing, federal health advisors voted 11-3 to recommend approval of an over-the-counter (lower dose) version of Xenical.

GlaxoSmithKline is hoping this little blue fat-blocking pill will be available at your local drugstore without a prescription before the end of the year. If the FDA gives final approval, the over the counter version will be called Alli.

What they don't tell you is that this little wonder pill can make you crap your pants!
The truth is, if you are really thinking long term and you are not morbidity obese, ill, or in need of a last resort, then taking any pill to lose weight just doesn't make sense.

Drugs do not "cure" diseases nor do they heal your body. They can help but in most cases drugs are used to treat symptoms and hide the ailment. Just because you sweep the dirt under your rugs doesn't mean your home isn't still filthy. And drugs can only temporarily relieve symptoms. Did you ever consider for a moment that body fat is a symptom? Before you begin any diet or weight loss drug have your thyroid checked to make sure that isn't the problem.

Aside from thyroid problems, being overweight is usually a result of one of the following:
  • Inactivity
  • Poor nutrition
  • Accumulated poor lifestyle choices
Taking drugs for weight loss is like clipping leaves off the weeds to try to keep them out of your garden, but the only way to keep the weeds out of your garden is to PULL THEM OUT BY THE ROOTS!

Plus, every drug - including over the counter drugs - has side effects - sometimes extremely serious side effects. That doesn't mean no one should ever take any drugs. It means you must consider the risk to benefit ratio of any drugs you take before making a decision.

When you combine a healthy nutrition program that feeds and maintains muscle, consisting of natural, unprocessed foods, with a lifelong exercise program that burns fat, then you have a long-term health solution.

Making this drug over the counter is a big mistake. Why? Well, first of all, if it goes OTC, it may encourage people to start becoming fat phobic again. We just went through an entire decade of low fat and low carb diets.

A balance between macronutrients is ideal, not removal of an entire food group, whether that is fat or carbs or whatever, think balance.

First, Dietary fat doesn't make you fat, and most people are woefully lacking in good, healthy essential fats like those found in fish, fish oil and flax. Using fat blockers means less absorption of the good fatty acids necessary for good health.

Second, this drug also has great potential for un-policed misuse and abuse if it goes over the counter. People tend to think, "if I take more, it will work faster," what a misconception that is!

Third, Xenical, and Alli if approved, may encourage people to eat more fatty junk food instead of less because they may think that part of it won't be absorbed.

Fourth, another problem is that fat-soluble vitamin intake will go right through you, along with the fat. Doctors usually recommend a multi vitamin supplement to patients taking Xenical for this reason.

If a doctor tells you that you have diabetes or high blood pressure or high cholesterol... or even that you were suffering from depression, what would your response be? Most people would instantly say, 'OK what drug should I take?" and the physician would be quick to prescribe it even for long term.

Many physicians and health professionals consider obesity to be biggest disease in the world, and they say that it should be treated like one. The truth is that obesity is one of the biggest businesses in the world and is being treated like one!

Weight loss is potentially the biggest market on Earth for drug sales, and the stakes couldn't be higher.

The Glaxo company estimated that 5 to 6 million Americans a year would buy the drug if offered over the counter. Those numbers could mean at least $1.5 billion a year in retail sales.

Glaxo also says that Alli would cost from $12 to $25 a week. Sounds like a hundred bucks a month down the toilet to me (literally!)

The clinical trials showed that patients taking xenical lost on average 5.3 to 6.2 pounds more in weight than the group taking a placebo. In 6-month clinical trials for the proposed over the counter drug, patients on Alli lost 4 to 5 pounds more than the group taking a placebo.

Our Opinion

Maybe the subjects ate less fat because they feared the possibility of leaking stools. One patient answering a survey said, "The drug forced me to avoid fatty foods if I wanted to keep my underwear clean. I lost a lot of weight".

Maybe some of the subjects in the studies felt that it wasn't working so they dropped out. Diet drug studies have very high drop out rates, so the people remaining are the ones who get the best results. Maybe if the control group and the placebo group were put on the same caloric intake, then the group taking xenical lost more weight simply because fewer dietary fat calories were absorbed!

Do you think if you weren't in a controlled study environment where your food intake was monitored, you would really control your intake, or would you be more likely to eat a bunch of greasy junk because you were thinking your body wouldn't absorb it?

Translation: Study results are often biased, skewed and misleading.


We think that our medical doctors should start prescribing exercise and sensible eating first, and drugs only as means of last resort.

Note to the legislators and government agencies involved: You are making a big mistake making this drug over the counter. If you keep it by prescription then only doctors can supervise its use and people who really don't need it won't abused it.

Anyone who wants to get healthier and leaner should learn to burn the fat and feed the muscle. Make that your mantra!

Over-the-counter Alli is also available online.

Feedback on Alli

Subj: Alli
Date: 7/1/2007
I have been on xenical for about two weeks, what really is the difference in name for the drug xenical or alli, both orlistat but different doses??? Is the dosage the only difference? I have friends that are taking two pills of Alli which equals 120mg of orlistat, they are seeing results. I have lost five pounds so far, it's been two weeks and inches are coming off. Is it dangerous for my friends to do this? Why is it important to be seen by a doctor while on xenical (orlistat/Alli)? I understand a daily vitamin also is needed daily but what else needs to be monitored? Thank you.

AskDocWeb: Alli and Xenical are both orlistat, Alli is just a reduced dosage. Even over-the-counter drugs can be dangerous when not used as directed.

Subj: Alli feedback
Date: 7/19/2007
I started taking Alli about 3 weeks ago. Monday afternoon I started feeling this serious pain in my right leg. By Monday night, it hurt so badly that I couldn't sleep so I took some Motrin. Tuesday morning I woke up in excruciating pain and couldn't walk. I had to crawl down the steps to get to my office. I was in TEARS it hurt so bad. I am a bit of a hypochondriac, and don't take stuff lightly, so I called the doctor that morning and they saw me around 11:15. She was afraid I might have a blood clot (which could kill you suddenly) so she sent me for an ultrasound. That came back normal. I was out of work for 2 days and really should have stayed home today but came in anyway. I am on anti-inflammatory drugs and feeling MUCH better, but I still have some stiffness and pain if I move a certain way. I was trying to figure out what it could be because I didn't injure myself, have never been an athlete, and haven't worked out in a couple of weeks. I started thinking about what was different that could have caused this and thought about the Alli. I went to the Internet, and low and behold, leg pain and tendonitis, and arthritis are also side effects. I spoke to my Dr. today and she said that Alli could very well be the culprit. I also have a small rash on my face, which is also listed as a possible side effect. I WILL NO LONGER BE TAKING ALLI for the purposes of trying loose a few pounds! That mess scared me to death, and I just pray that I don't have recurring episodes.

Subj: Gallbladder problem
Date: 3/7/2009
I used alli the over the counter equivalent for xenical faithfully for 8 months. The use showed significant weight loss. With no warning at all pain started in the middle of my abdomen; after several test, physician decided my gallbladder was not functioning an two weeks later a cholecystectomy was completed.

Subj: Alli on drug test?
Date: 5/14/2009
My wife recently had a urine drug screen return positive for amphetamines, which she has never used in her life. Does the new OTC diet aid Alli have any ingredients which would cause this?

AskDocWeb: Not that we know about and there have been no reports of false positives with Alli.

Subj: Increased frequency of losing water
Date: 6/4/2009
I have been taking alli for 4 days, but I have not had any accidents of orange oily stools as described by others. I have however, noticed increased frequency of losing water. Is this normal?

AskDocWeb: Increased urination is not listed as a possible side effect.

Subj: Alli
Date: 8/17/2009
I am 12 lb overweight and I can not lose it. I eat very healthy and I am a runner. I heard about Xenical from one of my friend but I bought Alli instead. It is half dose of Xenical but you can buy it over the counter or online. I tried for one week and I was OK. The second week I took double dose(Xenical dose) and after few days I got so dizzy and weak, now I scare to try it again.

Subj: Frequent urination
Date: 1/5/2010
Okay, not sure why one of the side effects on Alli is not listed as frequent urination but since I've been on the program I urinate twice as much in the evening and am constantly up at night. Does cause quite a bit of gas and causes you to void if you eat anything doesn't matter how low in fat it is. Just think frequent urination needs to be documented as part of the side effect.

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Most recent post: January 30, 2013

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This consumer advocate website is protected by copyright 2007-2013 Askdocweb, Inc. All Rights Reserved. This is a layman's report Alli and is not intended to replace discussions with a health care provider. Do not use the information on this forum as a substitute for your doctor's advice. Always consult your doctor before taking any drug and follow your doctor's directions. Source material: Food and Drug Administration, Medline, Physician's Desk Reference, and the largest community of people in the world, those who are concerned about side effects and healthcare.
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