Big splash is expected for diet pill

Proper use of the new diet aid is urged

Mainland pharmacies are predicting long lines when a heavily promoted over-the-counter diet pill hits the shelves.

Alli (AL-eye) is the first diet pill approved by the Food and Drug Administration for sale without a prescription. But isle health experts say it's no substitute for a healthy lifestyle.

Officials for Times Super Markets in Hawaii say they hoped to have Alli at the front checkout counters today.

Longs Drug Stores in Hawaii will have the new pill for sale in the next week or two, said a Longs spokeswoman, with a price of about $50 for 60 pills.

A heavily promoted over-the-counter diet pill is being launched across the country this week, but it's no substitute for a healthy lifestyle, say isle health experts.

"It's a possible adjunct to a full-on lifestyle program," said Dr. Stephen Bradley, a bariatric medicine specialist who has lifestyle programs at the Waianae Coast Comprehensive Health Center and Kapiolani Women's Center.

"You never get away from lifestyle changes," he said. "There is no magic bullet and for the foreseeable future. There probably won't be."

Mainland pharmacies are predicting long lines when the pill known as Alli (AL-eye) hits the shelves. It's the first diet pill approved by the Food and Drug Administration for sale without a prescription.

It's a reduced-strength version of orlistat, marketed by GlaxoSmithKline as the prescription drug Xenical.

Longs Drug Stores in Hawaii will have the pill for sale in the next week or two, said Farra Levin, spokeswoman for the chain in Walnut Creek, Calif. She said it will sell for about $50 for 60 pills.

Dean Takahashi, nonfoods buyer for the 12 Times Super Markets in Hawaii, said they hoped to have it at the front checkout counters today.

The Pillbox Pharmacy in Kaimuki will offer Alli when it's available, said pharmacist Stuart McElhaney.

But, he stressed, "There is no wonder pill that's gonna make everybody skinny."

He said the only purpose of the diet pill is to block fat absorption. "It's effective, but people are not going to be very happy with the side effects, and they are predictable when you don't absorb fat with your meal," he said. "It goes right through you."

The prescription drug Xenical "has really not been an enormous success. ... I've watched activity dwindle," he said. "It works for some; for others, they don't like the side effects."

The best solution to weight loss is regular physical activity combined with well-balanced eating, said Alison Bright, Kapiolani Medical Center registered dietitian.

"We promote a healthy lifestyle, eating a lot of fruits and vegetables and whole grains, cutting back on fats and watching portion sizes," she said. "We tell people to look out for things that promise quick fixes."

The diet pill works by blocking absorption of about 25 percent of the fat in food a person eats at mealtime, Bradley explained.

"One gram of fat is nine calories," he said. "A gram is about the weight of a small paper clip. So the theory is a quarter of fat you eat passes through without being absorbed. It's that many calories less you're taking in every day and you're starting to lower daily calories.

"It's also educational," he added. "If you eat too much fat in your diet, you tend to get loose stools and urgency to use the bathroom immediately. Your body is basically informing you your diet is too high in fat if you don't realize it."

Another potential problem is that vitamins A, D, E and K are bound to fat, so some may be washed out with the fat, Bradley said, recommending multiple vitamins when taking Alli.

Some of his patients wanted to be put on Xenical, but it cost about $200 a month, which was "a big impediment," he said.

He said he will recommend the less costly over-the-counter pills to patients he feels would benefit in his lifestyle programs. "But I will be very careful to educate them that this is not a panacea. It would be effective only in the framework of a true lifestyle-change plan."