Weight Loss at What Cost

OTC drug comes with unflattering gastrointestinal side effects

By Daniel TrecrociDaniel Trecroci

"…I'm just one stomach flu away from my goal weight."

Emily (played by Emily Blunt) to Andy Sachs (played by Anne Hathaway) in the movie "The Devil Wears Prada," Copyright 2006.

It's only a funny line from a movie, but is it possible that a recently approved weight loss drug helps obese type 2s lose weight through a similar dynamic?

alli™ (orlistat 60-mg capsules) was granted FDA approval on February 7, 2007, making it the only over-the-counter, FDA-approved weight loss drug. Manufactured by GlaxoSmithKline Consumer Healthcare, alli™ (pronounced AL-eye) is half the dosage strength of Xenical™ (orlistat 120 mg capsules), which is made by Roche and is only available by prescription.

According to GlaxoSmithKline, alli™ helps people lose 50 percent more weight than with diet alone.

Unflattering Side Effects

But does that weight loss come at a cost? Since its FDA approval in 1999, orlistat has been notorious for its side effects, which include oily spotting, gas with discharge, fecal urgency, fatty/oily stools, and frequent bowel movements.

Anne Peters, MD, director of the USC Clinical Diabetes Programs, tells dLife that promoting weight loss and exercise is a great way to treat type 2 diabetes. However, alli™ users need to be aware of its side effects.

"Most of the patients I have tried on orlistat have not been able to tolerate the side effects and have not wanted to take it," says Peters. "The problem with drugs to reduce appetite is that eating is such a fundamental biological requirement that to mess with that system can cause unwanted side effects."

Francine Kaufman, MD, head of the Center for Endocrinology, Diabetes and Metabolism at Children's Hospital in Los Angeles, says alli™ is, "an important new way for patients to be more in the driver's seat for their own weight management." Kaufman adds, however, that alli™ is not necessarily that easy for most people to use due in part to its gastrointestinal side effects.

"So hopefully, they will stay connected with their medical teams for the optimal outcome…Perhaps together, with the support of the medical team and with increased access to [medications like alli]…we will start to see some impact on the obesity and diabetes epidemics."

Must Be Used in Conjunction with a Reduced-Calorie, Low-Fat Diet

Vidhu Bansal, PharmD, director of medical affairs for GlaxoSmithKline Consumer Healthcare does not agree that losing weight with alli™ is similar to losing weight with a stomach virus.

"alli™ works by blocking the absorption of about 25 percent of fat in the food a person eats," says Bansal. "[It only works] on the fat you eat. Because of the way it works, alli™ must be used in conjunction with a reduced-calorie, low-fat diet containing about 15 grams of fat per meal. Eating a meal with too much fat while taking alli™ can result in bowel changes."

To help consumers who choose to use this drug, alli comes with a comprehensive educational support program, which includes sample menus. This program helps the consumer understand how to utilize a reduced-calories, low-fat diet, which in turns helps minimize the potential side effects.

Bansal adds that alli™ has a better tolerability profile and a lower incidence of side effects than Xenical (its higher-dose counterpart). Their users, his company reports, have told them that the treatment effects served as a signal which helped them to adopt healthier eating patterns.

For more information about alli™, log on to www.myalli.com.

Read Daniel Trecroci's bio.

Read more of Daniel Trecroci's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.


Last Modified Date: May 20, 2013

All content on dLife.com is created and reviewed in compliance with our editorial policy.

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