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The Skinny on Alli

For years, dieters across the nation have turned to drugstore aisles in search of a quick fix for their weight problems. Hundreds of bottles of supplements and diet pills line these aisles, and most use catchy advertisements and testimonials to make what many doctors say are unsubstantiated claims — fooling dieters into believing that a bottle of pills could help them lose 10 or 20 pounds in a matter of days or weeks.

For the first time, however, medical experts at the Food and Drug Administration have stamped their seal of approval on an over-the-counter weight-loss pill. The drug, Alli (pronounced AL-eye), which will be available in stores in June, lends a helping hand to dieters looking to gradually lose weight, according to manufacturer GlaxoSmithKline.

AN ALLY FOR OVERWEIGHT AMERICANS?

Alli can help overweight Americans shed extra pounds, but should not be considered a miracle drug, said Malesia Dunn, a GlaxoSmithKline spokesperson. Consumers will also have to follow a reduced-calorie diet and commit to regular exercise to see results, she said.

“Now, instead of [losing] 10 pounds, by including Alli in that program, you will potentially lose up to 15 pounds,” Dunn said. “And for a lot of people that becomes very meaningful.”

The drug’s active ingredient decreases the body’s absorption of fat by about 25 percent per meal — meaning that dieters do not absorb those fat calories. The undigested fat passes through the body and can cause unpleasant side effects, including gas, oily spotting and loose stools. The FDA recommends that users follow a low-fat diet to reduce these side effects.

“If you eat a lot of fattening, high-fat products, you’re still going to have a lot of that in your body,” Dunn said. “The product only blocks a percentage.”

Dunn said GlaxoSmithKline has spent a great deal of time and marketing to educate consumers about how Alli works. Even the drug’s website, www.myalli.com, tells potential customers that losing weight “won’t be easy — nothing worth it ever is — but greater weight loss is possible.”

“Alli’s just going to help you with that payoff,” Dunn said.

GlaxoSmithKline has also funded the production of a new book to educate overweight consumers about weight loss, according to an April 30 GlaxoSmithKline press release. The book, titled Are you Losing it? Losing Weight Without Losing Your Mind, provides dieters with weight-loss strategies, low-fat menu ideas and advice on how to make lifestyle and behavioral changes, according to the press release. The company’s website for Alli also includes a Body Mass Index calculator and “Alli readiness quiz” that helps potential consumers determine whether they should use the drug. Only people ages 18 and older who have BMI of 25 or higher should take Alli.

If taken three times per day, Alli will block about 100 to 200 calories daily, Dr. Caroline Apovian, a Boston University medical professor said. Apovian endorsed the drug on its website and contributed to GlaxoSmithKline’s weight-loss strategies book.

“I decided to endorse Alli because it is the safest and most effective FDA-approved weight-loss drug to go over the counter,” she said.

Although the FDA considers the drug to be a safe and effective weight-loss aid, some people said Alli’s intestinal side effects make the pill an unattractive option for weight loss.

“I just would never want to use it,” said Donna Devlin, an administrative secretary at BU’s Office of Career Services. “I wouldn’t want to have the side effects. It doesn’t seem worth it.”

ARE THERE CONSEQUENCES TO ACCESSIBLE AID?

Although Alli should only be used by overweight adults, there is no way to prevent normal or underweight adults from taking the drug because it will be available without a prescription. Apovian said the drug is safe, even when used by people who do not need to lose weight.

“If you are not overweight, there is really no added risk as long as you take a multivitamin in the evening, so that the Alli does not malabsorb those vitamins,” she said.

Dunn, the GlaxoSmithKline spokesperson, said the way Alli works does not cater to the behaviors of people with eating disorders, so it is unlikely they would abuse the drug.

“The product really only works if you take a certain amount of fat in your diet,” she said. “If you look at folks who are anorexic, if you will, those are people who are not eating enough fat or any fat in their diet. For people who might be bulimic, there’s not an issue. They are looking for a bit of a quick fix . . . this product really does not work that way.”

BU nutrition professor Joan Salge-Blake said she thinks people will try to abuse Alli, but said the drug’s own side effects will curb any misuse.

“If you have a high, high fat meal, the fat is going to be eliminated from your body, and you’re going to get some not-so-pleasant [intestinal] side effects,” she said. “Your body’s going to tell you, this is not going to work . . . in a way, its own side effects will help people to not misuse it.”

ONE PIECE OF THE PUZZLE

Ideally, people who have issues with their weight should meet with a registered dietician to see if certain behaviors, like eating when stressed or emotionally distressed, have contributed to weight gain or obesity, Salge-Blake said.

Then they can ask, “What are the habits that got us into this predicament? And let’s change them,” she said.

Still, Alli is a better alternative for people looking to lose weight than other, unregulated diet pills, Salge-Blake said.

“I think that there’s so much misinformation out there and products that don’t work, and people are spending a lot of money on them. So the public now has one thing that is FDA-approved, and does work,” she said. “For some people, it may help them get started.”

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