Alli: Explained

There are many of “weight loss claimed products” on the market. One of the products is ALLI. The TV commercial caught my attention even “FDA approval”, “over the counter drug” and “fifty percent more reduction” congratulations to the ad creator. Let me explain to you what that means.What is ALLI?
ALLI is the weight loss plan, which includes a pill called “Orlistat” or trade name Xenical. Orlistat is one of the prescription drugs for the weight reduction. The prescription strength Orlistat is 120 mg three times a day. ALLI includes 60 mg of the Orlistat three times a day.How does it work?
There are several studies looking at the Orlistat (or ALLI for weight loss) as an inhibitor of fat digestion for weight reduction. Only one percent of the medication is absorbed into the blood stream and the rest works in the intestines. It blocks the digestive enzymes responsible to breakdown fat to make it suitable for digestion. The dietary fat is not absorbed into the system. Hence, reduced calorie consumption and reduced weight.Is it effective?
Let’s quantify the weight loss effect by using the Orlistat (or ALLI) The studies look at the effect of Orlistat in weight reduction phase and maintenance phase. In weight reduction phase, everyone who was on placebo or on Orlistat was put on lower calories diet. The studies were done over two years. First year is for the weight reduction and the second year is done for weight maintenance. During the study 2, the Orlistat 60mg (ALLI) three times a day was used for the maintenance phase where calorie restriction is omitted. The regain of the weight during maintenance in the Orlistat 120mg and 60 mg group was 3.2 and 4.2 kg respectively. The bottom line is: Orlistat 120 mg (three times a day) has shown to lose weight up to 4 kg (8.8 pound) than losing weight with diet alone. (10.1-6.9=3.2) **Weight loss in kilogram X 2.2= weight loss in poundsHow much weight loss is needed to get FDA approval for a weight loss drug?
There is no set number for it. But there is a term called “medically significant weight loss” and a product must have “medically significant weight loss” to get FDA approval.How much weight loss is “medically significant weight loss”?
Weight loss of about five percent of initial body weight can improve your general health and cardiac risk. That is why even five percent loss from the initial weight is considered medically significant. Ten to Fifteen percent loss is considered a success and more than fifteen percent weight loss is considered extremely successful.So how do you understand the TV ad for ALLI? Fifty percent weight loss!!
It sounds really good. (This TV ad caught my attention from the first time too). Do you understand the advertisement right? Refer back to table 2. The total weight loss by Orlistat (Xenical) and diet is about 10 kg. Weight loss from calorie restriction (dieting) is up to 7 kg. Fifty percent of the 7 kg is 3.5 kg. It is not fifty percent of your body weight. It is fifty percent more with ALLI than diet alone which is up to 4 kg (8.8 pounds)What are the side effects of the Orlistat? (or) What are the treatment effects of ALLI?
This is the main difference where the doctors and the product makers differ. As a physician, my first thought is what are the side effects. I guess that come from the rooted oath “first do no harm” from Hippocrates. So as a doctor, I would not polish that as treatment effects. It is side effects/ undesired effects. I want the consumers to understand that these effects are supposed to be weighted against the potential benefits. The listed side effects of the Orlistat are as follow:Intestinal borborygmi (rumbling of the stomach)
Abdominal cramps
Flatus
Fecal incontinence, oily spotting, and flatus with discharge
Potential Vitamin A, D, E, K deficiency because they need fat for their absorption.
The side effects occurrence is up to 30%. Does Orlistat have any other benefit as fat blocker? Yes, Orlistat can reduce cholesterol up to ten percent. But remember there are much more efficacious cholesterol lowering agents out there and it is not indicated to use solely for the cholesterol.