Alli is the brand name for Orlistat which is the generic name of the drug that causes altered fat digestion. The recommended dose is 2 capsules or 120mg three times daily. The over-the-counter recommendation is to take one pill three times daily.
The idea behind Orlistat is its property in causing increased fat fecal excretion. The fat, instead of being absorbed by the gut is blocked and comes out in the stool instead. This limits the amount of dietary fat from your diet that your responsible with.
The fat, when it comes out, proceeds in an oily matter that can be spotty. You'll know when its working. You are supposed to take it with a meal, one hour before a meal or one hour after a meal containing 15 grams of fat or less.
It is recommended for those people that are obese (Body Mass Index Above 30). The recommendation is legitimate given its excellent cardiovascular safety profile and beneficial effects on serum total and low-density lipoprotein (LDL) cholesterol concentrations. In other words, it makes your bad cholesterol and total cholesterol decrease when used as suggested.
In normal subjects eating a diet that contains 30 percent fat, orlistat causes a dose-dependent increase in fecal fat excretion that peaks when approximately 30 percent of the ingested fat is not digested. The more orlistat you take, the more fat is excreted but don't take more than 120 mgs three times daily.
You are to take a multivitamin everyday at night while on orlistat because it decreases the absorption of fat-soluble vitamins (A, D, E, K) and beta-carotene with vitamin D being the most altered. For patients taking warfarin, this can be a problem because less vitamin K may require a reduction in dose of warfarin to remain coagulated.
With the alli dietary supplement there have been meta-analysis of 12 different trials that included patients with and without diabetes. One group was assigned orlistat plus a behavioral intervention and another group received a sugar-pill (placebo) and behavioral intervention.
The group that took orlistat lost 5 to 10 kilograms or 11 to 22 pounds compared to 3 to 6 kilograms in the sugar-pill group. This weight loss occurred over a period of 12 months. In the orlistat treatment group, weight loss remained with up to 24 to 36 months of orlistat treatment.
In one very long and large trial, 3304 overweight patients, with 21 percent of whom had impaired glucose tolerance, received orlistat or a sugar-pill (placebo). Weight loss after the first year was greater in the orlistat-treated group (11 percent vs. 6 percent below starting weight). The trial lasted another 3 years in which there was some regain of weight in the orlistat group such that at the end of the 4 years, the orlistat group was 6.9% below starting weight vs the placebo patients that were only 4.1% below their starting weight.
In patients that have high blood pressure, orlistat reduces blood pressure. Orlistat also improves serum cholesterol values beyond that which is seen with weight loss alone. Others have reported a reduction in the rise of triglycerides associated with a meal.
Alli or orlistat has gastrointestinal effects that includes cramps, flatus, fecal incontinence, oily spotting, and flatus with discharge (people have reported losing control of their bowl temporarily). The problems can be avoided and are avoided by patients that don't eat high fat diets and sticking to the recommended intake of no more than 30 percent fat in the diet.
Out of an estimated 40 million people worldwide that used orlistat over a 10 year period there were 13 reports of severe liver injury, 12 that occurred outside the US. That's an occurrence rate of 0.000000325%. But for this reason, people that use orlistat should contact their health care provider if they experience itching, jaundice (yellowing of the eyes), pale color stools, or anorexia develop.
Personally, my results with orlistat have been positive; however, I have not stayed on it long term. It does indeed cause spotting. I notice that when I use orlistat I eat a lot healthier and then I don't see any spotting so I think I'm wasting my money unless I'm eating something fattening. I hope that makes sense, don't get me wrong, I'll remain on it if I eat healthy but for some reason I have never needed it long-term.