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Dr. Bill's Commentaries

Are you alli ready?   (June 13, 2007)

The press is having a field day (again!). This time it’s about a weight loss product described by the manufacturer as “An Innovative and Honest Approach to Weight Loss Combines a Safe and Effective Product With An Innovative Personalized Support Program.” The company's press releases describe FDA approval of orlistat in 60 mg capsules for over-the-counter (OTC) use in the United States; it will be sold starting in mid-June under the brand name alli™ (pronounced AL-eye).

As the company indicates, “Consumers spend billions of dollars each year on fad diets, unproven miracle pills, and potentially unsafe weight-loss supplements that may not work.” So, I’ll ask: might alli turn out to be another “potentially unsafe weight-loss supplements that may not work?” I’d think the answer for many people will be “yes.” After all, orlistat has been on the market for years as a prescription drug called Diabetes Monitor); alli is just a lower dose of Xenical.

What's the problem? The recent press release admits that “Consuming a meal with too much fat, while taking alli, can result in bowel changes such as having an urgent need to use the bathroom.” Let’s be a bit more blunt: the “bowel changes” side effects have also been described as “Gas with oily discharge, increased bowel movements, an urgent need to have them and an inability to control them, particularly after meals containing more fat than recommended. One person has even recommended an Alli-Oops bag (containing baby wipes, lotion, body spray, extra panties, extra pads, extra pants, and plastic bags)!

Now, the question for readers who are concerned about diabetes: Should folks with diabetes rush out to the drugstore and buy their orlistat OTC? My answer: Not without the full knowledge and agreement of their physicians. And not because of the bowel changes - but because the medication may have another effect: it causes lowering of BG - which has observed as early as after two weeks of treatment. Hence patients with diabetes who are treated with orlistat may need to reduce their daily doses of other antidiabetic medications, such as insulin, and metformin.

So, check with your physician before deciding whether to try orlistat. And plan to carry an Alli-Oops bag...

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Dr. Bill Quick began writing at HealthCentral's diabetes website in November, 2006. These essays are reproduced at D-is-for-Diabetes with the permission of HealthCentral.

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