Alli is out—Use at your own risk
Sunday, June 17th, 2007We felt glued to our seats. My wife and I were sitting in a small cafe in southern New Hampshire—the only diners in the place—and on the TV in the corner was Neil Cavuto on Fox TV conducting an interview (a debate, really) about the new over-the-counter weight-loss pill just approved by the Food and Drug Administration: Alli.
A fitness expert was trying valiantly to argue, in effect, that Alli was the work of the devil, pointing out its negative side effects and advocating a saner approach to weight loss that might involve, say, proper diet and exercise. But she was outgunned—outgunned by Cavuto himself and his MD interviewee, Fox’s own health commentator, Dr. Manny.
While watching this one-sided boxing match in which the underdog was throwing all the right punches and still couldn’t seem to score at round’s end, we had an epiphany: What’s most noticeable about all the publicity Alli is getting is that the medical community seems to be bending over backwards to remain neutral or to find positive things to say about the drug.
It may be they’re nonplussed by all the hubbub and by the fact that a prescription drug (Xenical) that had not been particularly popular has now obtained FDA approval for over-the-counter use at half the prescription dosage. In fact, such a move could indicate that manufacturers are trying to perform an end run around doctors themselves. (”Doctors don’t seem to be pushing it, so let’s try direct marketing to consumers ourselves.”) And the FDA has lent its imprimatur to the whole proceeding.
Or perhaps we’ve just not caught the right members of the medical community yet. (After all, drug companies do advertise on TV, which may explain the free-for-all we witnessed on Fox.)
But we’ll be happy to point out that there are negatives to a weight-loss program that depends upon not absorbing fats, which is what orlistat, Alli’s active ingredient, is all about. It works by preventing the pancreas from releasing an enzyme (lipase) that enables the breakdown and absorption of triglycerides by the gut. In simple terms, the fat you eat doesn’t get digested and absorbed by your body. It just passes through to be eliminated by the bowel.
Since triglycerides in the blood are one of those things—along with cholesterol—that your doctor is probably trying to get you to reduce, that’s a good thing, right? Well, not exactly. Actually, the high levels of serum triglycerides your doctor is worried about are caused by eating carbohydrates.
And fats, as it turns out, are an important part of the diet. Ever hear the phrase “essential fatty acids?” In case you haven’t, there are essential fatty acids (EFAs) and essential amino acids, neither of which can be produced by the body, which is what makes them essential in the first place. As T.S. Wiley and Bent Formby, authors of the book Lights Out point out, there is no such thing as an essential carbohydrate. So cutting carbohydrates to lose weight actually makes more sense.
What’s more, as these authors point out, fat-soluble vitamins such as A, K, D and E enter the body by hitching a ride with fatty acids in the gut. If you don’t absorb those fatty acids, you may have to do without those fat-soluble vitamins. The information supplied about Alli clearly states that users are urged to take a multivitamin as a part of the accompanying diet regimen. (Much has been made of the manufacturer’s forthrightness in presenting this warning.) What may not be so clear is that the multivitamin likely will have little effect in increasing the absorption of the fat-soluble vitamins if the body is busy not absorbing fats.
We’ve no doubt that Glaxo SmithKline has a winner with Alli. Since the entry cost to try it is around $50, the curiosity factor alone should account for blockbuster sales. But we won’t personally be tempted, given the pill’s health downside and potentially nasty side effects, which include incontinence and get worse from there. (Let’s just say there are worse ways you can be “glued” to your seat.)
We’ll try to cut back on the carbs and treat our bodies to some “burst” exercise. Anybody have a set of kettlebells they’d like to donate?
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