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February 21, 2007

The New Diet Pill: Is It for You?

Maybe you've heard that come summer, you'll be able to go into the drugstore and — without a prescription — walk out with an FDA-approved diet pill called alli. So, what's the catch?

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Maybe you've heard that come summer, you'll be able to go into the drugstore and — without a prescription — walk out with an FDA-approved diet pill called Alli. So, what's the catch? Not to be a downer, but the new drug isn't new — it's been around as the prescription drug Xenical (the generic name is orlistat) since 1999 — and it's probably not for you, especially if you're not overweight and are just looking to feel better in your bikini. Here's the deal:

  • You still have to diet. The stuff works by blocking the absorption of fat in your intestines. And if your intestines don't absorb fat, guess where it goes? And you risk what the company calls a "treatment effect" of flatulence, oily stools, and fecal incontinence (yes — as bad as it sounds). That's true especially when you eat more than the recommended 30% of calories from fat while taking the pill (about 15 grams per meal; the amount in one McChicken sandwich). That's incentive to keep your fat consumption down all right, but you can probably think of some other motivation that's way more date-friendly.

  • You don't lose that much. Taken three times a day, Alli can "safely help people achieve meaningful (5%) weight loss when used in conjunction with a reduced-calorie, low-fat diet." Pretty amazing...until you do the math. For a 200-pound person, a 5% weight loss is 10 pounds. True, that can make an important difference in your health. But it's probably not the kind of loss most people are hoping for from a pill (especially one that has that "treatment effect").

    The pill also "helps people lose 50% more weight than with diet alone," the company says. Here's the math: If you lost six pounds with diet and exercise, Alli would help you lose a whopping three more pounds (with the potential for fecal incontinence). In all fairness, though, if you lost 20 with diet and exercise, it could help you shed another 10, and 30 pounds isn't anything to sneeze at.

  • It might not help the people who need it most. The pills are projected to cost $1 to $2 per day (no insurance help here; remember, they're over-the-counter). Obesity is greatly affecting people with lower incomes...who aren't going to be able to spend that much for a couple of pounds of weight loss.

  • Okay, it's not total hype. If your weight is hurting your health — you have diabetes, prediabetes, are at risk for heart disease, and more — then Alli may be useful for you. Howard Eisenson, M.D., the director of the Duke University Diet and Fitness Center, puts it wisely like this: "It's a reasonable tool to have on the market if you reserve its use for people with medical reasons to lose weight." If you're just trying to get in shape and can't resist the idea of "bonus" weight loss just from popping a pill? "You can achieve every bit as much and more if you follow the simple prescription that everyone finds so difficult, which is to eat less and move more."

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