Orlistat: should you stand by your rice cake?

There is no quick and painless way to lose weight. Deep down inside, every woman knows the truth of this unfortunate and often depressing fact of life, but a large successful industry has nevertheless been built on selling the myth that there just might be. And this industry survives because we’re all desperate to believe in the myth. It would just make life so much easier. I certainly wouldn’t be about to eat polystyrene discs masquerading as rice cakes for lunch for the 16th day in a row, if it were true, and I probably wouldn’t have dragged myself out for a painful 4 kilometre run last night either. It’s so easy to fall prey to the marketing of the weight-loss industry, the fad diets, the quick fixes and, of course, the innumerable “diet pills”.
So how does a diet pill work? I’ve always been healthily sceptical of the idea that there is anything I can swallow that will somehow magically erase the slice of cake I just ate. The most prominent pill of the moment is orlistat, marketed as Alli®, which you can see advertised in all good, and probably bad, chemists, and each time I walk past an advert I have a moment of “oh, could that really help me?” and I wonder how it works.
Orlistat works by stopping your body from absorbing some of the fat that you eat. It blocks the action of enzymes in your intestines that usually break down fat so that it can be absorbed into the bloodstream. These enzymes are known as lipases. So at first glance what orlistat does is to prevent up to 30% of the fat that you eat ever going anywhere near your hips or bum. Sounds good to me, where did I put that cake?
Unfortunately, but unsurprisingly, this is too good to be true. Orlistat does have some side effects; the most notable being that if your body doesn’t absorb the fat you eat, it must leave your body unprocessed. So if you aren’t careful to make sure that you monitor your fat intake, you end up with what is essentially fatty, oily diarrhoea. Sadly, then, Alli® doesn’t mean you can have your cake and eat it too, not unless you also want to spend a good long time on the loo.
Still, the fact remains that Alli® does work; it reduces the fat that your body absorbs admirably. There’s no doubt that it has been proven to do so. And in fact the marketing department for this product have even managed, impressively, to turn the unpleasant side effects of the pill into an additional bonus, cunningly pointing out that if you have to spend hours on the loo every time you overdo the fat, you’ll probably stop wanting to eat so much fat pretty quickly! I can’t argue with that, although I must say that personally I’d probably opt to flush the pills down the loo and take my chances with the rice cakes. But then I’m not medically at risk from my weight, so I have that choice.
Another minor side effect of Alli® is that it also inhibits the uptake of fat-soluble vitamins. Fat-soluble vitamins, which include vitamins A, D, E, and K, are transported along with fatty micelles into the blood through the cells of the intestine. When the amount of fat being absorbed is reduced, the uptake of fat-soluble vitamins is also reduced. It is therefore important to take vitamin supplements with Alli®, and it’s recommended that you take them 2 hours before or after you take the diet pill, to make sure that they get absorbed while they can.  
Ultimately, the basic answer to my question is yes, Alli® does work. If you are struggling to lose weight on a calorie and fat-controlled diet then the addition of Alli® could give your weight loss a helpful boost. Whether or not that help is worth the side effects is for you to decide. Either way, it certainly isn’t a quick and painless way to lose weight. I stand by my statement that there is no such thing. And therefore, I stand with resignation by my rice cakes.


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