Lose weight! Feel great! Well, maybe not

A new weight loss drug hits the shelves -- but is taking it worth the side effects?

Published June 19, 2007 8:35PM (EDT)

Here's a question: Would you take a medicine whose possible side effects included making you poop in your pants? I'd guess that it'd have to be a pretty important pill to make it worth the risk (treating a mild headache wouldn't cut it). And I'd also think that such a med wouldn't fly off the drugstore shelves.

But I'd be wrong. Last Thursday, the first over-the-counter diet drug approved by the Food and Drug Administration hit drugstores -- and customers (mostly women) couldn't get enough of it. According to the Los Angeles Times, even a price of nearly $60 (for a one-month supply) didn't keep the drug, known as alli, on the shelves. "I've never seen anything like this," one store manager was quoted as saying.

How does this magic pill work? A lower-potency version of the prescription drug Xenical, it blocks your body from absorbing about 25 percent of the fat that you eat. (In a diet of 3,000 calories and 100 grams of fat, this would knock out about 225 calories.)

If that sounds too easy, it's because it is. First of all, it does nothing to calories that come from carbohydrates and protein. Second, if you check out alli's Web site, you'll find an entire section devoted to potential "bowel changes," which the site euphemistically calls "treatment effects," and it's quite clear that the human body is not designed to expel a quarter of the fat it eats.

What sort of treatment effects? Well, you may get "gas with oily spotting," "loose stools" or "more frequent stools that may be hard to control," the page says, before likening the undigested fat -- which will show up in the toilet -- to "the oil on top of a pizza." How do you prevent these side effects? Simple. Just limit yourself to no more than 15 grams of fat per meal. Yes, you heard that right -- in order to get the benefit of alli, you're supposed to eat a low-fat diet. Correct me if I'm missing something, but if you're already eating a low-fat diet, why would you need alli?

Putting it a different way, if alli prevents you from absorbing a quarter of the fat you eat, that means that for a meal with 15 grams of fat in it (at nine calories per gram), it'd be saving you approximately 36 calories. Not to get all philosophical, but if someone were to ask me how many calories it would take to get me to risk shitting myself in public, it'd be a hell of a lot more than 36.

Before I get even more worked up, let me point out that I understand that in cases of extreme obesity (or conditions where, for whatever reason, medication is necessary to reduce weight), alli might be a reasonable choice. But according to the pharmacists interviewed by the Los Angeles Times, most of the women (and yes, they were women) who grabbed alli weren't obese or overweight. They bought it because, as anyone in tune with pop culture knows, the "perfect" body is still -- for most people -- an unnaturally thin one.

None of this is surprising, but I still find it depressing that we live in a society where women are so obsessed with thinness that they are willing to sacrifice control of their bowels to avoid a handful of calories a day. Here's another quote from the "treatment effects" page of the Web site: "Until you have a sense of any treatment effects, it's probably a smart idea to wear dark pants, and bring a change of clothes with you to work." Sure, most people wouldn't mind losing five pounds, but in such a case, is it really worth it?

By Catherine Price

Catherine Price is an award-winning journalist and author of Vitamania: How Vitamins Revolutionized the Way We Think About Food. Her written and multimedia work has appeared in publications including The Best American Science Writing, The New York Times, Popular Science, O: The Oprah Magazine, the Los Angeles Times, The San Francisco Chronicle, The Washington Post Magazine, Salon, Slate, Men’s Journal, Mother Jones, PARADE, Health Magazine, and Outside. Price lives in Philadelphia.

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