The diet pill section of the pharmacy can seem like the Wild West, as most products are considered dietary supplements and therefore not subject to U.S. Food and Drug Administration regulations. However, in June 2007, one drug became the first FDA-approved diet pill that is available without a prescription. Despite its high price tag, uncomfortable side effects, and small potential benefits, it has been flying off the shelves.|
What is Alli?
Alli is a less-potent version of the prescription diet pill, Xenical (orlistat). At half the dosage of the prescription version, experts think that its potential for abuse and overall risk is low enough to be safe for over-the-counter use. You can expect to pay between $50 and $60 for a 30-day supply of Alli, which can be bought in supermarkets, drug stores, and online.
How Does Alli Work?
Put simply, Alli is a fat blocker. You take a pill with each meal. The main ingredient in the pill binds with the digestive enzymes that would normally break down fat from the meal that you consumed. Because Alli attaches to these enzymes, it prevents them from digesting about a quarter of the fat you just ate, allowing it to pass through the digestive system and out of the body, undigested and unabsorbed. Overall, fewer calories from dietary fat are stored as actual body fat.
Sounds easy, right? There’s more to it than that. Alli isn’t a magic weight loss pill, and its makers don’t claim that it is. They are adamant that daily exercise, a reduced-calorie diet, and a specific diet plan that limits the amount of fat you eat accompany the use of Alli. If you overeat on carbohydrates, protein and/or fat, you will not lose weight by taking Alli. If you eat more fat than is recommended in a single meal (15 grams or less), you’ll experience some pretty embarrassing and serious side effects (see Pros & Cons below), and still might not lose weight by taking Alli. Just like any old weight loss plan, it involves counting and cutting calories, reading food labels, limiting high-fat foods, and exercising regularly. It takes willpower, determination and consistency to see results.
What the Research Shows
At most, you could lose a few more ounces (1/4 to 1/3 of a pound) per week by using Alli, which is expensive and has some serious side effects. Is it really worth it?
SparkPeople's experts believe that healthy lifestyle changes are the key to long-term success at weight loss and health improvements. Along with that, our fitness and nutrition experts recommend staying away from quick fixes and other unsafe or questionable practices. When it comes to diet pills, we have always advised against them. And even though Alli is FDA-approved, making it safer than any other diet pill on the market, we do not endorse it. Instead, we encourage you to discuss Alli with your health-care provider as you would any over-the-counter or prescription medication. Here's why:
Alli's "treatment effects" can seriously interfere with your daily life and well-being. You may have to take time off work, wear feminine or adult products to protect against accidents, and deal with other digestive woes. Imagine sticking to a fitness routine and everything else in your daily life while worrying about these things.
According to SparkPeople dietitian Becky Hand, Alli does interfere with the absorption of fat-soluble vitamins. It's important to take a multivitamin/mineral supplement (at bedtime) while taking Alli, but that is no guarantee that your body will still get and absorb all the nutrients that it needs—especially those that need fat to be absorbed.
Alli doesn't care whether the fat you ate was from a Big Mac or a healthy serving of salmon. Even though all types of fat aren't bad for you, Alli will take both good and bad fats out of the body. Dietitian Becky thinks this issue is "very important," despite its lack of mention in the press and in the Alli support materials. Healthy fats are important for your overall health, and blocking them can have negative effects.
According to the Alli diet, a person will take in about 450 calories from fat (50 grams) each day. "This guideline is similar to those establishes by the National Academy of Sciences," says Becky. The Alli pill will result in 25% of those fat grams (113 calories' worth) to be excreted and unused each day. Over the course of a week, the calories you save would result in about 1/4 pound lost. If you consume less fat than Alli recommends, your weight loss results will be even smaller—a matter of ounces.
"There's almost a built-in conflict of interest with using Alli," says SparkPeople Coach Dean Anderson. "You have to get the fat content of your diet up high enough for the pill to have any noticeable effect, but doing so increases the risk of side effects and pushes people towards nutrient ratios that wouldn't make any sense on a normal diet."
The Bottom Line
Taking a pill doesn't teach you how to create a healthy lifestyle that you can live with long-term. However, Dietitian Becky does praise the resources that Alli provides in their Starter Kits and online.
"Alli provides helpful tips on a variety of topics," she says. "Menu planning, cooking ideas, grocery shopping, low-fat food selections, foods to avoid, dining out, and the many benefits of tracking your food intake are all covered." By making permanent changes to your diet that you can actually stick with, you're likely to keep the weight off for good. Alli does require some dietary changes, but it isn't a long-term solution to the battle of the bulge. Dietitian Becky says that there are many reliable weight-loss books, cookbooks, resources and websites, including SparkPeople, that are much less expensive than Alli is. "If someone really needs an expensive pill to stay accountable regarding fat intake, than Alli may be a wise choice," she says. "But for most people, losing only an extra quarter pound weekly is not worth the discomfort, cost, and embarrassment that Alli causes," she explains.
At SparkPeople, we realize that our members won't always heed our advice when it comes to other diet plans, supplements, or even exercise routines. "What's great about the SparkPeople program," says SparkPeople Coach Jen Mueller, "is that you can modify your trackers, learn from our helpful articles, and get support from a positive Community, no matter what diet program you choose to follow." To learn more about Alli, visit the manufacturer's website at www.myalli.com. You can also discuss Alli with other SparkPeople members on our Message Boards.
This article has been reviewed and approved by SparkPeople fitness and nutrition experts Dean Anderson, Becky Hand, Tanya Jolliffe, and Jen Mueller.