Alli...Ally...Friend?

Alli, an obvious play on the word ally, meaning friend, but is Alli a friend? We will take a look at what Alli is, what it isn't, how it works, side effects, and why someone would consider taking it. Alli is also known as orlistat and Xenical. Orlistat is the drug name, and it is marketed as prescription Xenical by Roche at 120mg and over-the-counter as Alli by GlaxoSmithKline at 60mg, half the dosage of prescription Xenical.

What Alli is not

Alli is not a miracle drug...there are no miracle drugs for weight loss. Keep in mind that if a weight loss method sounds too good to be true, you can bet your life that it is (and you very well may be betting your life)! The fact is, if there were an easy way to lose weight without putting work into it, there would be NO ONE overweight. With Alli the user must make lifestyle changes that include a healthy diet and exercise plan. The user must still do the work needed to lose weight, even without the use of Alli. The user must change the way he or she eats, incorporate exercise into his or her daily life, deal with the emotional causes of overeating, and develop healthier coping mechanisms.

How Alli works

First, a little nutrition lesson: 1 gram of fat contains more calories than 1 gram of carbohydrate or 1 gram of protein; fat has over twice the calories of carbohydrate and protein. What this means is if you eat a diet high in fat, most of your calories are going to derive from the fat.

Alli works by blocking approximately one quarter, or 25%, of the fat that you consume, which reduces the number of calories available for the body's use as either quick energy or stored energy (fat). Alli works in the digestive tract, preventing your body's enzymes from processing some of the fat you eat; the fat that is not absorbed in your body is then eliminated when you have a bowel movement. Alli works without ever entering the bloodstream, so the heart palpitations, insomnia, jitteriness, and other side effects of most diet medication are not experienced with Alli, or the dangerous side effects of some other weight loss drugs like ephedrine and Phen-Fen.

Alli claims to help you lose 50% more weight than you could without using Alli (with diet and exercise alone) for every 10 pounds you lose, Alli could help you lose 5 more pounds, for a total loss of 15 pounds. I have not seen any evidence to back up this claim, so I cannot speak to this claim's validity.

With Alli, you learn, fairly quickly, what foods you can eat, and, perhaps more importantly, what foods you should avoid. You learn how to control your emotional eating and how to make healthy food choices; in this aspect, Alli acts to modify behaviors. Sure you can still binge on pizza or other high fat food, if you don't mind the treatment effects that are guaranteed to follow. If you think that you can skip Alli for one meal in order to eat something high in fat, think again! You could still experience treatment effects!

Alli Support

Alli does not just give you the pills and say "here, have at it." What Alli does, is offer extensive support and instruction. Alli gives you a balanced, customized fat and calorie targets that are comparable to the USDA's Food Pyramid guide and will promote weight loss at a healthy rate. Alli gives you meal plans, menus, recipes, and shopping lists each week, that you can personalize to fit your tastes and lifestyle, that simultaneously fall within your recommended calorie and fat targets; using the meal plans takes out all the guess work, but you can eat your regular foods as well, as long as the fat and calories are within your targets. The meals provided by the Alli menu are both delicious and varied; you will not get bored by following the menu.

Alli has a food diary that details your calorie, fat, protein, and vitamin consumption for the day and it can be customized if you eat something other than what is preset by the menu. Alli has an exercise tracker that gives fairly accurate calorie counts for a variety of exercises based on your weight, not the average calories burnt by a 150 pound woman. Alli provides weekly coaching on managing hunger, dealing with emotional eating and setbacks, pre-planning meals, and making lifestyle changes.

Alli provides a private (only you can view) online journal. Alli has message boards so you can give and receive support from others using Alli, but the best part, in my opinion, about the message boards are the boards that enable you to ask specific questions to nutritionists or dieticians and physical trainers...and they actually answer!

Treatment effects

The treatment effects, the one thing everyone has heard of, and perhaps the one thing that keeps most people from giving Alli a try. After all, who wants an oil slick in your drawers? When your car is leaking oil, you take it to a mechanic to have the problem fixed, so why would someone purposefully take a pill that potentially could have embarrassing, if not humiliating, side effects or, as Alli refers to it, treatment effects?

What are the treatment effects? Treatment effects are significant changes in bowel patterns and are caused by eating too much fat in one meal, and they include, oily spotting, loose stools, more frequent stools, and difficulty controlling your bowels. If you stay within the target amount of fat per meal you will not experience these treatment effects.

Those are the official treatment effects; unofficially, I also experienced some abdominal pain, bloating, and gas which was, most of the time, tolerable. Not everyone will experience these treatment effects, and the most disgusting ones I only experienced once, after having two slices of pepperoni pizza. Would one slice of pepperoni pizza have had the same effects? I do not know, do not want to know, and am not about to find out!

What were the treatment effects that I experienced? For those who want to know about my experience, keep reading; for those who do not, skip the remainder of this paragraph and the next paragraph. Eight hours after eating the pizza (this unfortunately continued for several hours after) I went to use the bathroom and found an oil slick in my underwear that had soaked through to my pants. Conveniently, I was at home when this happened, so it was not a really big deal. Call me a control freak if you want, but I was not comfortable with the thought of oil leaking from my behind and not even being able to feel it happening. In addition to that indignity, the commode was full of yellowish-orange oil. Yes, I do mean oil, not unlike the oil that forms on the top of the pepperoni after it cools.

Prior to starting Alli, I could not imagine oil leaking from my behind and not being able to feel it, but that is exactly what happened. Yet, however gross and humiliating it was, I have to admit that I felt a certain gratification at knowing that all that fat was no longer in my body, and my body did not have a chance to make that oil into extra pounds to heap on the circumference of my waist and hips. The only other ignominy in this was the yellowish-orange oil clung to the sides of the toilet bowl and would not flush away without quite a bit of toilet bowl cleaner and brisk scrubbing. Makes you wonder what the inside of your intestines look like, doesn't it? I decided then and there to make sure I never made that mistake again! The next slice of pizza I eat will definitely not have any pepperoni! In this way, Alli can be effective behavior modification! One little tip, if someone happens to have this happen to them, the oil in your underwear and on your pants is OIL; to remove it, I discovered (insert EW) that Dawn dish soap really is best at removing oil.

The Other Side

For someone who has never struggled with a weight problem or fought the battle of the bulge, it may be difficult to understand why anyone would subject him/herself to the possibility of social mortification. Understand this, the average overweight or obese individual is desperate to be thin and healthy, to be able to move normally, to not need a belt extension on the airplane, to be able to enjoy the rides at amusement parks, to be able to cross their legs, to be able to walk up a flight of stairs without wheezing, to have people look them in the eyes and not turn away in disgust, and to have their child hug them and wrap their arms all the way around. What many of us take for granted everyday is what the overweight individual aspires to be/become; this desperation makes them a target for every 'quick fix,' quack, and often dangerous weight loss gimmick on the market today.

Caution!

Because Alli blocks fat, and some vitamins can only be absorbed with fat Alli recommends taking a multivitamin every night at bedtime. I stress being cautious because the fat soluble vitamins are: Vitamins A, D, E and K.

Vitamin A

Vitamin A, also known as retinol, plays many roles in the body such as eye sight, bone growth, tooth development, cell division, gene expression, reproduction, the skin, and mucous membranes in the throat, nose, mouth, and lungs. A deficiency in Vitamin A can cause blindness in children, night blindness, GI infections, loss of vision, diarrhea, and keratinization of the skin and eyes.

Vitamin D

Vitamin D helps the body use calcium and phosphorous, helps form and aid repair of bones, and promotes the hardening of bones and teeth. A deficiency in Vitamin D can cause rickets and osteomalacia, both serious conditions.

Vitamin E

Vitamin E works as an antioxidant to protect vitamins A and C, essential fatty acids, and red blood cells. A deficiency in Vitamin E can lead to anemia and low birth weights.

Vitamin K

Vitamin K is responsible for blood clotting and bone health. A deficiency in Vitamin K can cause excessive bleeding and all the hazards associated with that.

Even though Alli is available over the counter now, I still believe it a good idea to inform your doctor if you are or are thinking about taking Alli, so that he or she will know to be vigilant about watching for the signs and symptoms of a deficiency in these vitamins.

Summary

Alli is a tool, not unlike a hammer. A hammer works great to drive a nail in or remove one, but it is completely useless to tighten a bolt or change a light bulb. What do I mean by this? Alli is not a quick fix, but rather a way to assist the overweight individual in learning to live a healthy lifestyle. As Phen-Fen so clearly demonstrated, IF you are considering taking Alli, or any other weight loss drug, supplement, or surgery, it is in your best interest to make an informed decision. Educate yourself through research and interviews. I cannot stress enough how important it is to be an informed consumer! Carefully weigh your options, choices, the benefits, and risks prior to putting something into your body or permanently altering your body. Is Alli for everyone? No, but then nothing is ever truly "one size fits all."

References

www.Myalli.com

www.webmd.com