Why You Should Think Twice Before Using Alli or Other Weight Loss Aids

Reports of liver injury have been linked to Alli and Xenical, but every pill has its price.

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When it comes to losing weight, we'd all love that quick fix: a pill, shake, heck, even surgery to ease our efforts. Unfortunately, weight-loss aids—even when approved by the Food and Drug Administration—come with risks as well as benefits. Yesterday, the FDA announced an investigation into reports of liver problems thought to be related to an over-the-counter weight loss pill, Alli, and the prescription version, Xenical. This came after the agency received information on 32 cases of serious liver injury, including six cases of liver failure, in those using either product, which contain different doses of the drug orlistat. (The reports spanned 10 years.)

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A woman weighs herself at G W Allan chemists, where the Alli slimming pill is stocked on April 23, 2009 in Edinburgh, Scotland.

The FDA hasn't determined yet whether these liver problems are related to orlistat since overweight individuals—who are most likely to use these drugs—tend to have a higher risk of developing liver failure because of a condition called nonalcoholic fatty liver disease. The agency is not putting a warning label on these drugs and hasn't advised doctors to change their prescribing practices. Still, the FDA is telling folks to see a doctor if they're experiencing signs of liver problems like jaundice (yellowing of the skin or whites of the eyes), brown urine, weakness, or abdominal pain.

I think, though, that the real take-home message is that we can't assume that any weight-loss medication is risk free. Those who are severely overweight might find that the weight-loss benefits of orlistat are greater than its risks, but those with just a few pounds to lose may want to think twice, given what may be a small possibility of liver damage. (Alli and Xenical already have some nasty side effects like diarrhea and fecal incontinence if used incorrectly.) And unapproved drugs or weight-loss supplements should definitely be avoided altogether; those herbal weight-loss concoctions sold on the Internet may have harmful prescription drugs hidden in them. As tempting as these products may seem, they're certainly not worth the price of good health. One New York doctor whom I interviewed recently told me that he frequently gets calls from female celebrities trying to get him to prescribe thyroid hormone pills that are meant for those with a slow-functioning thyroid. In healthy users, they boost metabolism and burn calories at a faster rate, but at the price of heart palpitations and bulging eyes, mimicking an autoimmune condition called Graves' disease. While this doctor refuses to write such prescriptions, I have no doubt these actresses and models are finding other doctors who will.

On the flip side, I recently saw a photo in the September issue of Glamour depicting a full-figured model posed in a state of artful undress with her tummy sagging prominently. She looked radiant and beautiful even with this figure flaw, and Glamour was rewarded with letters from women thanking them for depicting beauty that real women could aspire to. If you're already at a healthy weight but are looking to shed a few pounds with the help of drugs, take a moment to check out this photo. Perhaps plain old healthful eating and exercise—plus an acceptance of those small figure flaws—are really the fix you need.