Weight-Loss Drug Orlistat Approved for Purchase Without Prescription

The Food and Drug Administration (FDA) has just approved the over-the-counter (OTC) purchase of an orlistat pill. This product, with the brand name Alli, contains one-half the amount of orlistat present in the prescription product with the brand name Xenical.

Xenical has not proven a blockbuster drug for producing weight loss. In a series of trials, people taking Xenical for one year lost 6.4 lbs. more than did those taking a placebo during the same period. Not great, you would agree, but still better than the dozens of widely promoted weight-loss products for which no proof for any weight loss exists.

The other approved prescription drug for weight loss, sibutramine (Meridia), is somewhat more effective than Xenical. At the end of one year, those taking sibutramine lost 10 lbs. more than did those taking a placebo.

OTC Alli is taken three times daily, one with each major meal. The drug works by blocking the action of an intestinal enzyme required for the breakdown of the major dietary fats (triglycerides).

Undigested triglycerides cause the major side effects of orlistat - oily, liquid stools and frequent bowel movements. Weight loss is achieved for two reasons. First, a significant number of fat calories, which ordinarily account for about 30 percent of calories in the diet, are lost with the stools. In addition, people taking orlistat soon learn that they will have fewer intestinal symptoms if they reduce the amount of fat in their diet.

Fat-soluble vitamins - vitamins A, D, and E - are lost in the stools along with the undigested triglycerides. So, if you decide to try Alli, you should also add a multivitamin pill at bedtime.

The FDA warned that Alli should only be used by adults who are overweight or obese, and who have not had an organ transplant or intestinal problems associated with poor absorption of nutrients. The FDA notice also stated that anyone taking blood-thinning medications or who is being treated for diabetes or thyroid disorders should check with their doctor before taking orlistat.

It's not clear whether taking half the dose of Xenical will lead to even less weight loss than with Xenical itself, perhaps only three to four pounds by the end of a year. You should keep in mind the alternatives: In one year, you could lose five pounds by eliminating 50 calories a day, or 4.5 lbs. by walking one mile three times a week.

How can you eliminate 50 calories a day from your diet? One chocolate chip cookie, a 12-ounce beer, and an ounce of potato chips each contain about 150 calories. So all you have to do, for example, is to skip one of these every three days.