By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

OLD-FASHIONED DIET AND EXERCISE BETTER FOR MOST FOLKS THAN ALLI

Question: Recently, I’ve seen several TV ads for a new over-the-counter weight loss product called Alli. Then today, I was in the store and saw huge displays for this same product. The ads and displays make this sound like a new miracle drug that can insure that you’ll lose weight even if you’ve had trouble losing weight in the past. How does this work? Somehow I doubt it’s as good as the ads would indicate. But every now and then there is a new miracle product. Is this the miracle weight loss product we’ve been waiting for?

Answer: Well, the fact that you asked this question the way you did shows me that you have some degree of healthy skepticism about this new weight loss product. That’s a good start.

The ads that you mention are very slick. They promise weight loss if you “commit” to the product and a more healthy lifestyle. They’re upbeat and somewhat motivational. You’re left with the impression that Alli will somehow help you to become more fit. There’s some truth in these ads, but they don’t really tell the whole story.

First, Alli is not an appetite suppressant. It’s an over-the-counter version of the prescription drug Xenical. These drugs work by blocking absorption of fat in your digestive track.

The drug’s maker -- GlaxoSmithKline -- gives an accurate description on its web site of the way Alli works. The drug attaches to some of the natural enzymes in the digestive system. This prevents them from breaking down about a quarter of the fat you eat. The undigested fat cannot be absorbed and passes through the body naturally. They also point out that eating too much fat while taking Alli can cause what they euphemistically call “treatment effects.”

Well, what they call a “treatment effect” might more accurately be called a negative side effect. Specifically, eating a meal with too much fat will cause such symptoms as an urgent need to use the bathroom, loose stools, or gas with “oily spotting.” Potentially unpleasant to say the least. GlaxoSmithKline reasons that once you experience such a side effect you’ll be more cautious about eating that Big Mac and fries while taking Alli. In essence, this negative experience will help you stay on the “straight and narrow” during the rest of your treatment with Alli.

If you decide to try Alli, you can count on losing about 50 percent more weight -- over a period of several months -- than you would if you just followed a diet and exercise program. For some folks, perhaps, the “treatment effects” might provide the additional motivation that they need.

I’d recommend, however, that you first try to reduce your calorie and fat intake the “old-fashioned way.” Exercise regularly. Eat a diet with five servings of fruits and vegetables a day, only lean cuts of meat, reduced portion sizes, and no snacking between meals. If you stay on this program for the long term, you’ll lose as much or more weight than you would with Alli. And, as an added bonus, you won’t experience those wonderful treatment effects.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.