Newly Approved Alli Is No Weight-Loss Magic Pill

At nearly 84, my mother, a beautiful but pleasantly plump woman, called me excitedly. When could she start taking Alli, the new over-the-counter weight loss pill that has just been approved by the Food and Drug Administration?

Alli contains a medication called Orlistat that impairs absorption of fat from the bowel into the body. Alli is the same medication as Xenical, a prescription drug that contains twice the dose of Orlistat (120 mg versus 60 mg for the over-the-counter variety). Alli can be taken up to three times daily with a meal containing fat.

The first question my mother asked was whether Alli would cause weight loss if she continued living the way she currently does. She walks, but only from the bedroom to the front door and to the car. Regardless, she prefers to keep her walking to a minimum. She pointed out that although she consumes "plenty of fat," maybe "the fat would merely pass through me like a vacationer in transit rather than someone who planned to stay permanently" -- her words!

Sadly, my mother is not an ideal candidate for Alli. Without lifestyle changes, the benefits will be limited, and there are side effects. Many patients experience increased gas. Diarrhea is common. More importantly, Alli interferes with the absorption of the fat-soluble vitamins (A, D, E, K). Losing these crucial vitamins can lead to skin abnormalities (vitamin A), bone thinning and an increased risk of fracture (vitamin D) and the potential of bleeding (vitamin K). While vitamin E deficiency is not known to have any adverse effects, a healthy amount of vitamin E from dietary sources may protect against heart attack, stroke and Alzheimer's disease. If you take Alli, you will also have to take fat-soluble vitamin supplements that may not be as valuable as those received in the diet.

Alli will only work in combination with calorie restriction and an appropriate exercise program. For every five pounds lost by the diet, an additional two pounds may be lost because of the drug. But does it work in the long term? Experience with the prescription drug Xenical has not been encouraging. With or without medications, most diets fail. Diets -- the ones founded on simple restriction -- don't work. Only through major lifestyle changes can one effectively lose weight, keep it off and sustain a healthy life. Our traditional concept of "dieting" by clinging to the newest fad or celebrity prescription is doomed to failure.

Beyond the question of sustainability, prescribing Alli flies in the face of recent research that discredits very low-fat diets. A prudent amount of the right fats is important to your health. Monounsaturated fats found in olive and canola oil and omega-3 fatty acids found in fatty fish, nuts and avocados have been linked to a lower risk of heart attack, stroke and Alzheimer's disease. In addition, these fats help decrease risk of cancers, including colon, breast and prostate.

Furthermore, there is some evidence, in animal studies, that a high fat content in the colon, caused by Alli, may predispose patients to precancerous lesions. By preventing all fat absorption, Alli cannot discriminate between good fat and bad fat. Despite the additional weight loss, this may not be good for your health.

Alli is not recommended for anyone under the age of 18, and I would strongly urge that it not be attempted if you are over the age of 70. Older people are more prone to developing nutritional deficiencies that can cause serious problems. Never consider Alli if you have a major chronic disease such as heart, lung, kidney or endocrine disease, including diabetes. Additionally, by impairing fat absorption, Alli may interfere with prescription medications.

Lifestyle is everything. Eat right, avoid excessive starch, consume monounsaturated fats and omega-3 fatty acids in moderation, eat lean meat and fatty fish and consume all the fruits and vegetables you want. Exercise -- the more the better -- and you will never, ever need a pill as a crutch to weight loss.

Lifelong Health by Dr. David Lipschitz: is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz, and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at [www.creators.com]. More information is available at [www.drdavidhealth.com].