This story as referenced from CNN.com’s health section
(http://www.cnn.com/2008/HEALTH/diet.fitness/06/12/alli.sales.ap/index.html)
was not surprising to many in the nutrition field.
Alli is basically a lower dose of a prescription medication known as Orlistat. Orlistat and Alli are both “fat blockers”, blocking the secretion of an enzyme known as lipase from the pancreas. Lipase functions to help your body break down fats in your digestive system so you can use them as energy. However, fat of all the macronutrients, has the most amount of energy (9 calories) for every gram as compared to both carbohydrates and proteins. So, if you can block the absorption of 9 calories for every gram of fat you consume, theoretically you will be eating the same amount of food but absorbing less calories. Great, right! Not so fast.
As the article goes on to say, the main side effect is the possibility of unpleasant leakages or oily discharge. This unfortunately, may be one of the reasons why sales of this potential blockbuster has become the butt (no pun intended) of many jokes.
Expectations for the sales of Alli should have been tempered by how Orlistat has been received for the past 10 years since it first came to the market. While study after study shows the benefits of Orlistat if taken appropriately, once physicians say those two magic words “oily diarrhea”, few brave souls are left to give this medication a try as a weight loss tool. That is not to say all weight loss drugs work this way. On the other hand, it is important to realize that Orlistat is one if not the only medication on the market which forces lifestyle changes on the dieter rather than simply making them “forget” about eating.
Several other prescription weight loss medications such as Phentermine, Meridia, Diethylproprion work on the sympathetic nervous system, or “fight or flight” system. In other words, when was the last time you were hungry running from a bear! Other medications such as Topomax or Zonisamide work in ways we still not fully understand but often times patients state they just don’t feel hungry. Overall, prescription medications do work and when used appropriately, dieters can experience much success. Unfortunately, more often than not, dieters take medications with the full intention of changing their lifestyle while on it, but simply don’t since weight loss seems effortless. But once you take away the medication, without lifestyle changes, the weight comes back.
I guess what I am trying to get at is that for all it’s faults, Alli and Orlistat are admirable medications in the sense that they really try to get the dieter to change their eating habits by consuming less fat. For this, their popularity will never reach the expectations of the drug companies since our culture is one of wanting results yesterday… and as such, we are still looking for that magic pill when it comes to weight loss.
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