At 9:30 a.m. last Thursday, 12 boxes of Alli, the first FDA-sanctioned diet drug to be sold without a prescription, were placed on the top shelf of the diet section of a Walgreens in Santa Monica, Calif. Four hours later, all but one had been sold.
“I have never in my life experienced anything like this,” store manager Roe Love, a pharmacist for 20 years, said as she eyed the empty space next to the last box of 90 capsules selling for $59.99.
It was a similar situation at the Walgreens on 430 N. Michigan Ave., according to a store employee who spoke to RedEye on Tuesday.
“We have sold a lot,” said the employee, who asked that his name not be published because he didn’t have permission to speak to the media. He gestured toward the Alli packages behind two locked glass shelves a few feet away: “We just got it in about a week ago, and it’s been selling like crazy. People keep on asking about it all day.”
The diet pill has been rolled out across the country over the last several days by manufacturer GlaxoSmithKline and is intended for overweight people 18 and older. The company’s myalli.com Web site and literature describe the potential for a greater weight loss than dieting alone (if you do everything right) and a warning of extraordinarily unpleasant and embarrassing side effects (if you don’t).
The over-the-counter diet drug was introduced as the stronger, prescription-only Xenical several years ago. It works in the digestive system by blocking the absorption of about 25 percent of fat that is consumed. In a theoretical 3,000 calorie-a-day diet with about 100 grams of fat, the drug would eliminate about 225 calories. But it also can result in what the manufacturer describes as loose stools and gas with an oily discharge.
“It’s probably a smart idea to wear dark pants, and bring a change of clothes with you to work,” the drug’s official Web site says. (The drugmaker’s literature and Web site say side effects can be minimized with a low-fat, reduced-calorie diet.)
However, a Naperville-based registered dietitian told RedEye that those warnings are most applicable for someone abusing the product, such as using it as a chaser for a cheeseburger.
Christine Palumbo, a private practitioner with 30 years of nutrition experience, said if you limit your fat intake to 15 grams per meal, you should be fine.
“Everyone’s constitution or system is a bit different, so some may be able to get by with a few more grams of fat per meal, and some will have to get by with a bit less than what’s recommended,” Palumbo said, adding that she has fielded several calls from friends and clients about adding Alli to their weight-loss plans. “What I would suggest is not to try this out during the workweek, but on a weekend, and preferably not on a night you’re going out.”
But the women buying Alli in the California Walgreens a few days ago seemed unfazed by the warnings. At a San Fernando Valley Walgreens that had sold 10 boxes — with one man among the buyers — no one was asking the pharmacist about side effects.
“‘Will it work?’ That’s the only question they’re asking,” said the store’s pharmacy manager, who spoke on condition of anonymity.
“I’ve tried so many other things,” said Monique Brown — a secretary who says she’s been through Metabolife, CortiSlim and various products — at a Rite Aid drugstore in Santa Monica. She dreams of losing 30 pounds, she said.
“I’m just willing to give it a try. There are side effects to a lot of things. … I work in an office, and I sit all day. There’s a bathroom right there. We’ve all worked together a long time. If you have to go, you have to go.”
The manufacturer predicts that 5 million to 6 million Americans a year will buy the drug. About 130 million Americans are considered overweight.
The materials that accompany Alli emphasize that people should eat a low-fat, reduced-calorie diet. If dieters can stick to that discipline, they “can lose about 50 percent more weight than dieting alone,” according to the drug brochure, which many stores displayed.
“I like this medicine because the problem with most Chicagoans, or even most Americans, is that we want to lose weight without making any changes,” Palumbo said. “We want to take a pill, but that’s the only change we want to do. Alli could force people to cut back on their portions.”
Portion control can allay some of the side effects. And the manufacturer notes that awareness of possible side effects acts as a disincentive to overeat fatty foods.
Not everyone welcomes the product.
“We’re skeptical about something like this going over the counter,” said Dr. Rohini Ashok, a Kaiser Permanente-Santa Teresa, Calif., physician and a leader of the HMO’s new, doctor-supervised weight-loss program. “It’s not an unsafe drug, but it’s not benign. The side effects are pretty gross.”
Ashok says that while the drug may be helpful for a small group of people, such as patients with high cholesterol and poor diets, many patients who have taken the prescription version of Alli generally do not refill their first prescription because they can’t tolerate the side effects.
New York-based nutritionist Oz Garcia said: “There is no real advantage to using Alli unless you’re doing what you’re supposed to do — working out, eating a well-balanced diet, all the things you have to pay attention to.”
Garcia noted that a fat-blocking drug does no good for those gulping down cookies and pasta and other carbohydrates. “A lot of the weight gain that has occurred in the last decade is because people are already eating low-fat, but they’re eating high carbs,” Garcia said.
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Shedding pounds
Here’s what users of orlistat, the ingredient in Alli, can expect from the weight-loss drug, according to The Wall Street Journal:
– One in five will lose 10 percent or more of their body weight.
– Half will lose less than 5 percent of their body weight.
– Side effects include gas, oily discharge and loose stools.
