Among weight loss medications for the obese, the generic drug Orlistat, sold as “alli weight loss capsules” or “Xenical”, continues to be popular. It is available by prescription and also over the counter.
This article addresses four questions. Is Orlistat effective? How does it work? Is it safe? What are the next steps for someone interested in using Orlistat as a diet pill?
How Effective are Orlistat Weight Loss Capsules?
Several clinical trials and long-term studies have been performed using Xenical weight loss pills. These double-blind studies compared people who diet and take Orlistat with those who also diet but take an inactive placebo drug. (In a double-blind study, neither the test subject nor the tester knows whether the pill is the active drug or a placebo).
These studies have shown that people dieting with Orlistat do lose more weight than those who use a placebo instead. On average, adding Orlistat to the diet and exercise regimen doubled the weight loss.
These same studies have found that Orlistat treatment can also lead to better results in other areas. The diet plus Orlistat led to a greater reduction in “bad” LDL cholesterol. Their blood pressure was reduced more than in the control group. Fewer people in the Orlistat group developed early warning signs of type-II diabetes than those in the control group.
It is not clear whether the secondary benefits, such as lower LDL levels, are directly due to the weight loss drug or simply to experiencing greater weight loss than the dieters in the placebo groups.
The studies indicate that people in the control group did very well as dieters, despite using a placebo instead of Xenical. Anyone who maintains long-term weight loss is a “winner” compared to those whose weight rebounds after a diet. One might suspect that the study protocols were effective in keeping people on track with diet and exercise. The Xenical group did indeed do better, however.
How Does Orlistat Work?
This medication functions by inhibiting the intestine’s lipase chemicals. This means that about 30% of dietary fat is not absorbed as nutrition, but eliminated through bowel movements. This lowers the total intake of calories and shifts the balance toward carbohydrates and proteins, which are not affected by the drug.
Alli weight loss capsules are only part of the weight loss program, however. Diet and exercise are important physical components. The “myalli” web site also offers social and psychological tools to help the dieter in the quest for weight loss.
The main changes in diet are: to eat three equal and balanced meals per day; to keep the calories from fat below 30% of the total intake; to reduce overall calorie consumption. The diet is very similar to advice found in American, British or Canadian government health agency web sites.
Dieters using these weight loss capsules are also instructed to increase their exercise levels. Since Orlistat is aimed at the obese, the usual advice to “check with your physician before starting an exercise program” is doubly important. Orlistat users are more likely to have other health risk factors than the general population, so it is vital to have a doctor’s advice on the exercise component of the diet plan.
How Safe are Orlistat Weight Loss Tablets?
Perhaps the biggest concern for Orlistat is the risk of liver damage.
A number of other medical warnings are included in the referenced web sites. Pregnant women and nursing mothers should not use Orlistat. Allergic reactions include hives or rash, and possibly including difficult breathing. Gallbladder, kidney stone, thyroid and pancreatic problems, including bile blockage, are contraindications for using this medication.
Drug interactions are possible; particularly blood thinners (anticoagulants such as warfarin), blood pressure and diabetes medications. Orlistat reduces Cyclosporine absorption, so timing these medications is important.
The doctor will probably advise taking a supplement for fat-soluble vitamins A, beta-carotene, D, E and K.
Some people using Orlistat also reported some annoying side effects such as gas, oily stools, or an “urgent need” for a bowel movement.
The simplest and safest advice for the dieter is to discuss all current medications with the doctor, and to ask about all the current warnings. Drug safety is a constantly-evolving field: no one article can address all the issues.
What are the Dieters’ Next Steps?
Orlistat is a serious weight loss medication that should be discussed carefully with a doctor, even if a non-prescription form will be taken. Orlistat is not recommended for a variety of prior medical conditions, so the doctor should screen potential users.
Success depends on diet and exercise. Alli weight loss capsules certainly seem to increase the potential benefit of diet and exercise. A physician can help the dieter compare the drug risks of using Orlistat weight loss capsules against the problems of obesity.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
Genentech, ” (Xenical) Product Information “, copyright 2011, referenced Mar. 15, 2011.
GlaxoSmithKline, “how alli works“, referenced Mar. 15, 2011.