Alli and Xenical as Weight Loss Drug Options

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Following the recent withdrawal of sibutramine (Reductil) in Europe, orlistat is the only approved diet pill for obesity treatment available. In addition, many patients in the USA may not be suitable for using Meridia, following recent FDA resctrictions imposed on the weight loss drug.
Orlistat diet pill is available in prescription form as Xenical, and over-the-counter (OTC) as Alli. The purpose of this article is to inform patients of this alternative weight loss drug option.

What is Diet Pill Orlistat (Xenical,Alli)?
Orlistat is a lipase inhibitor, which means it acts to block the enzymes that break down fat in the gastrointestinal tract. As such, the diet pill induces weight loss by blocking fat absorption by the body. However, orlistat does not block all fat in the diet from being absorbed, and about 75% of the fat taken in still gets digested by the body.

As such, clinical studies have shown greater than 100% more weight loss when patients are treated with Xenical in combination with diet, compared to just diet alone. The efficacy of Alli for inducing weight loss, however, is around half of this.

Orlistat Side Effects

Unlike sibutramine and phentermine, there is minimal absorption of orlistat into the bloodstream and the weight loss drug is therefore not associated with the systemic side effects that plight these appetite suppressants. However, because of orlistat’s mode of action, the weight loss drug is associated side effects that include flatulence, diarrhoea, oily spotting and loose oily stools.

How is Orlistat (Xenical,Alli) Used for Weight Loss or Obesity Treatment?

Orlistat is available in prescription form as Xenical, and over-the-counter as Alli. Xenical has been available as a weight loss drug in both the USA and Europe for over a decade now; however, the switch to the OTC version of Alli occurred only in the last few years.

Both weight loss drug options are approved as obesity treatments in patients with a body mass index (BMI) greater or equal to 30kg/m², or for weight loss in overweight patients (BMI > 28kg/m² in Europe or BMI > 27kg/m2 in USA) with associated risk factors, such as type 2 diabetes or dyslipidaemia, when used in conjunction with a reduced-calorie diet.

Although OTC Alli is half the dose of Xenical, each weight loss drug is to still be taken as one capsule three times daily.

What are the Main Differences Between Xenical and OTC diet pill Alli?

There are several differences to be noted between Xenical and Alli, which are as follows:

Xenical is the prescription version of orlistat, while Alli is available as an OTC diet pill.
While Xenical is manufactured by Roche, GSK owns the rights to and markets the OTC version.
Alli contains 60mg of orlistat, while Xenical contains 120mg orlistat,
Although OTC Alli has been shown to be clinically effective for weight loss when used in conjunction with diet in both overweight and obese patients,Xenical has superior efficacy for weight loss than Alli
Due to the lower dose for OTC Alli, this weight loss drug has milder side effects than Xenical.
Xenical has the advantage of having been shown to reduce the onset of diabetes in obese patients

The Problem Patients Face When Taking Orlistat, Obesity Treatment and Weight Loss Drug

For weight loss to occur with either weight loss drug, patients much take either Xenical or Alli in combination with a reduced calorie diet. It is suggested that the patient’s diet should contain no more than 30% of calories from fat. Patients must remember to stick to this diet, as the more fat that is ingested, the more likely orlistat side effects will occur.

If patients become worried or disenchanted because of the unpleasant effects of orlistat treatment, they should remember that these side effects will generally occur at the beginning of treatment and should become less frequent and go away with time.

Both Alli and Xenical are contraindicated in some patients, therefore if considering the switch to either weight loss drug, overweight and obese patients should consult their pharmacist or doctor to find out whether they are suitable candidates for such options.