Image 1: alli 84s.

Next week will see the biggest European consumer healthcare launch of 2009. On Tuesday 21^st of April alli, the new weight loss drug, will be launched in the EU markets. As a lower dose version of the prescription only medicine Xenical, alli contains the same active ingredient orlistat, but at 60 mg it’s only half of its strength. alli will be made available from pharmacies for overweight adults (18 years and over) with a BMI of at least 28.

Orlistat 60 mg is a clinically proven weight loss treatment, which became available without a prescription in the US in June 2007. Since its launch in 1998 as a prescription only drug Xenical 120 mg, it has been used in over 30 million patients worldwide. Its safety and efficacy have been proven in over 100 clinical trials on more than 30000 patients. 60 mg dose was shown to have over 80% of the efficacy of 120 mg dose, with a more favourable adverse effect profile.

Orlistat works by binding to and inactivating lipases (enzymes needed for the breakdown of fats), which prevents the absorption of about 25% of consumed fat. This undigested fat is then passed out normally in the stool. It is designed to be used in combination with a reduced calorie, lower fat diet. When used in such combination it can increase weight loss by 50%. For every 2 lb lost through diet, alli will help you lose an additional 1 lb, however individual results may vary.

In the studies almost 50% of users lost at least 5% of their bodyweight over 6 months and 15% lost at least 10% of their bodyweight over 6 months. Other benefits of the 6 month treatment course were 2.4% and 3.5% reductions in total and LDL cholesterol respectively and a 4.5 cm reduction in waist circumference. Even a modest amount of weight loss (9-10 kg) can have a positive effect on health and well-being. A 10 kg reduction in weight can bring about a 20-25% drop in all cause mortality, 40-50% reduction in obesity related cancers, 30-40% fall in diabetes related deaths, more than halves the risk of developing diabetes, reduces blood pressure, reduces angina symptoms by 90%, reduces total cholesterol by 10%, while increasing good cholesterol by 8%, improves lung function, reduces back and joint pain and reduces breathlessness and sleep disturbance. There are also psychological benefits like feeling more attractive, optimistic, positive about life and proud.

The principle behind successful weight loss is the right balance of calorie intake (food and drink) and calorie expenditure (physical activity). It is also important to set realistic goals for weight loss at about 1-2 lb (0.5-1 kg) per week. This way you can stay motivated while gradually reducing calorie intake and developing a balanced diet and a healthy lifestyle that you can maintain long term.

To lose weight you need to create a calorie deficit. You can do that by reducing calorie intake, increasing calorie expenditure or ideally both. alli helps to reduce the calorie intake while exercise increases the calorie expenditure, creating a winning formula. To achieve calorie deficit, a healthy diet and about 45-60 minutes of moderate intensity physical activity (that leaves you slightly out of breath, but still able to talk) is recommended at least 5 days a week. For cardiovascular health 30 minutes of moderate physical activity 5 days a week is sufficient. Everyday activities such as walking, housework and gardening can be part of the exercise programme, provided they are performed at slightly higher intensities.

Because alli only works in combination with a lower fat, weight-reducing diet, alli users will receive a special guide with every pack. The information pack explains that alli is not just a weight loss pill, it’s a weight loss programme. You need to commit to a lower fat diet and increase your activity level before starting alli.

Less than 30% of total daily calories should come from fats, which equates to around 15 g of fat per meal (maximum three meals per day) for a 1400 kcal diet. This will differ for men and women and for different activity levels. Also included in the pack are meal plans, exercise suggestions, recipes and BMI guidance. An easy to use website with information, advice, tools and discussion forum will also be available at www.alli.ie.

The recommended dose for alli is one capsule, three times daily with main meals (immediately before, during or up to one hour after the meal). If a meal does not contain fat there is no need to take alli. Equally if you miss a meal you should not take alli. Eating higher than recommended amounts of fat may result in adverse effects like wind (flatulence) with or without oily spotting, sudden bowel movements (diarrhoea), fatty or oily stools and soft stools. Treatment with alli is limited to 6 months.

alli is not appropriate for under 18s, pregnant or breastfeeding women, people taking ciclosporin, acarbose, warfarin or other anticoagulants, people with chronic malabsorption syndrome, people with cholestasis (blocked bile flow from the liver) and people who may be allergic to any of the ingredients. If you’re taking diabetes, high blood pressure or high cholesterol medication or amiodarone you should consult a healthcare professional before taking alli. Women using oral contraceptive pill are advised to use additional contraceptive protection if they experience severe diarrhoea. alli may reduce the absorption of fat-soluble vitamins (A,D,E and K), therefore a multivitamin supplement should be taken at bedtime (when not taking alli) to ensure that vitamins are absorbed.

L.G.