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Backlash slim on diet pill

Good sales reported despite messy side effects, cost

BY LOUIS MEDINA, Californian staff writer
e-mail: lmedina@bakersfield.com | Monday, Jun 18 2007 9:20 PM

Last Updated: Monday, Jun 18 2007 9:26 PM

Alli, the first FDA-approved nonprescription weight loss pill, went on the market late last week and already is ringing up hefty sales in Bakersfield -- despite its high prices and messy, gassy side effects.

"We got it in on the 14th and on the weekend we were all sold out," said Eva Flynn, a pharmacist at the Wal-Mart on Rosedale Highway. "I was hoping we'd have it today in overnight delivery," she said Monday.

"I came in at one o'clock and I've sold three," said Herinder Aujla at 3 p.m. Monday. She is a pharmaceutical technician at Walgreens on Ming Avenue and Stine Road.

Elizabeth Park, a pharmacy technician at Rite Aid on 23rd and H streets, said her store's sales of the GlaxoSmithKline drug since Friday have been only "so-so" due to a late shipment. But there have been plenty of inquiries from interested customers and she herself has sold two packages to women who "looked to be in their 20s," she said.

The capsule, available in starter kits of 60 and 90 units, and in refill packs of 120 units, promises to help people 18 and older lose weight faster, provided that they also eat leaner and exercise more to squeeze into that longed-for smaller size.

But when you squeeze a body that is made up mostly of liquid, something is bound to ooze out, hence alli's nasty side effects, which include leaky stools and flatulence with oily discharge, especially when you take it with a fatty meal.

"That's why I was surprised that so many people were wanting it," Flynn said. However, she is not aware of users buying more feminine hygiene pads or adult disposable diapers to wear since the diet supplement's debut.

"But maybe they will in the future when people find out they need that kind of thing," Flynn said.

Pronounced "ally," (as in your ally in the fight against fat) the drug is for both men and women but is marketed aggressively to appeal to the latter: The Web site, myalli.com is full of images of beautifully cooked and served healthy dishes in balanced portions, and of almost only women smiling, practicing yoga, weighing themselves and taking charge of their weight.

What is alli?

According to pharmacists and pharmaceutical techs around town, alli is the lower-strength version of the prescription drug Xenical, which has been on the market for several years.

"That's not been a very popular medication here at the pharmacy because of the side effects," said Nicole Sprague, a pharmacist at El Tejon Drugs on Brundage Lane, as she laughed about the unpleasant side effects.

But she also -- seriously -- offered some hope: "If people actually cut down on the amount of fat that they eat in their meals, the side effects won't be as bad," she said.

The drug blocks only about a quarter of fat consumed, Flynn said. The manufacturer recommends that it be taken three times a day, with every meal, but Flynn recommends using it only once, with the fattiest meal of the day.

"But I'm afraid people might think, 'I don't have to diet, I'm taking alli,'" she said. "They're going to get a false idea that the fat is going to be blocked by the pill so they don't have to diet," which is quite a messy proposition.

The active ingredient in both Xenical and alli is Orlistat. Flynn said alli capsules, at 60 milligrams, are half the strength of Xenical, which is much more expensive: a 90-capsule pack of alli retails at Wal-Mart for $49.63, plus tax, and a like pack of Xenical retails for $245.36, she said.

These are Wal-Mart prices, however, and the same alli pack sells at Longs, Rite Aid and Walgreens for $59.99 and at El Tejon Drugs for $77.29.

Still, Dave Marcus, store manager at the Walgreens at Ming and Stine, said he sold his entire allocation of 20 boxes on Thursday. He sold 12 the following day and since then it's been sporadic.

"I think it kind of peaked right away and it's gone down a ways," he said.

But people continue to purchase alli despite the various product warnings highlighted on the box in a cautionary shade of yellow.

Serious side effects

"Organ transplant alert," the warning label on the alli box says: "Do not use if you have had an organ transplant. Orlistat interferes with the medicines used to prevent transplant rejection."

In the worst case scenario, Flynn said, the body of an organ recipient using alli could form antibodies against the organ and the person would need to have another transplant.

"Hopefully it wouldn't happen," she said, "but it's possible."

Flynn said Orlistat also interferes with Coumadin, an anti-clotting drug often prescribed to people who have had strokes or who have blood clots in their legs. But she said Coumadin users know there are many drugs that interact with that medication.

Orlistat also blocks absorption of fat-soluble vitamins, especially vitamins A, D, E and K, which are important for cell function, healing and blood coagulation, and are standard components of multivitamins, she said.

The alli warning label tells users to take a multivitamin supplement once a day at bedtime. This is to keep from taking vitamins and alli at the same time, Sprague said.

Flynn said she does not like to recommend diet pills of any kind to her customers.

Sprague, however, said, she does recommend weight loss aids to people who want help with weight control, but with a caveat: "They do really need to be dedicated to changing their diet and exercising at the same time. There is value to the supplements, but they need to be used correctly."

In this, Flynn agrees with her: "You have to be willing to change your lifestyle," she said. "Eat healthy and exercise in a regular way."