Alli is the first over-the-counter weight loss pill and has gone on sale in chemists across the UK this month. It’s actually not a new diet drug since the pill has been available here in the UK on prescription only for the last 10 years under the name “Xenical” (or Orlistat).

The over the counter Alli is half the strength of Xenical but manufactures claim the results are almost the same.

People need to be aware that they can’t just walk into a chemist and buy Alli off the shelf – pharmacists have a legal obligation to sell it correctly and therefore will want to assess you before you are allowed to buy the drug. You will be weighed and your height taken to work out your BMI – if your BMI is less than 28 the Pharmacist will not let you buy it. They will also want to have a chat to you about your current diet. You cannot buy Alli if you are under 18, pregnant or breast feeding.

One worry is that whenever a new “diet wonder pill” is launched there is a risk it will be abused by anorexics who want to speed up their weight loss. However Alli works on the food you eat (see below) so in theory there is no danger of this happening.

What is Alli and how does it work?
Alli is a weight loss aid suitable for adults with a BMI of 28 or more. The manufacturers claim that taking three Alli tablets a day with meals while following a low fat, low calorie diet and doing regular exercise will increase weight loss by up to 50% more than just willpower alone – so it shifts an extra pound for every two you manage to lose.

Alli costs £49.95 for a one month supply which works out at roughly £1.60 per day for the daily dose. You can also get a two week supply for £32.95. Each pack contains your capsules, an information leaflet and a container in which to keep your capsules. There is also a cook book you can buy for a further £14.99 which contains low fat, low calorie recipes.

Alli recommend that each person should take in roughly 1,400 calories per day and each meal should contain around 15 grams of fat. The manufacturers say you can take Alli for up to 6 months.

What is Vita Clinics’ view?
Xenical is a complex drug. The fat in the diet is broken down (digested) in the body into its simplest form so that it can be absorbed. The body does this with the help of enzymes called lipases. The excess fat or calories in the diet is thus absorbed by the body and stored as body fat. This results in weight gain.

When the previously prescribed dose of Orlistat has been taken with meals (120mg with each meal), it has been shown to attach itself to the lipases and block their action. This effect stops some of the fat in the diet from being digested (roughly 30% of the fat in the diet). The undigested fat cannot be absorbed and is excreted in the stool and therefore often causes significant diarrhoea. Significant weight loss does however not occur while patients have diarrhoea, as 70% of the fat ingested is still absorbed. Weight loss will be optimal if a patient reduces the fat in their food to the point where they stop having diarrhoea. This way the total number of calories consumed and absorbed will be reduced which results in weight loss.

We are not convinced that taking a half-strength dose will be effective. We suspect that people will still get the side effects without the weight loss! Clearly, further studies need to be independently carried out into the long term effects of this reduced dose.

We use weight loss drugs such as Xenical (at a ‘proper’ effective dose) as part of a medically supervised weight management programme. Patients need expert help from specialist Dieticians and Nurses to get the best effect from the drug by changing their diet and eating behaviour. Many patients will also need the support and help of a Bariatric Psychologist to explore why they over-eat and how to address the root causes in the long term. Without this, no diet pill, no matter how good, will work in the long term.

The weight loss journey is a slow and difficult process and Alli is not a wonder pill. If you want to lose weight and keep it off, you need expert help.

To find out how Vita Clinics can help, contact us on 0800 849 8050 and speak to a specialist Nurse or Dietician, or book a free consultation.

www.vitaclinics.co.uk