(WOMENSENEWS)--Who would trust a diet pill that has no proven health benefits and requires you to keep an extra pair of pants handy in case of uncontrollable diarrhea and oily discharge?
GlaxoSmithKline is betting that a lot of people will. The international pharmaceutical giant, with consumer products headquarters in Pittsburgh, has launched a $150 million marketing campaign for its new diet pill. It anticipates annual sales in the billions.
Alli (pronounced AL-eye) is the first over-the-counter diet pill to be approved by the Food and Drug Administration.
It went on the market June 15, at a cost of about $50 for a 60-capsule kit or $60 for 90 capsules. Recommended use is one to three pills daily, in combination with a low-fat, reduced-calorie diet and exercise plan. (A higher dose of the same drug--orlistat--has been sold in the U.S. as a prescription drug under the brand name Xenical since 1999 and will continue to be available.)
GlaxoSmithKline boasts that people taking alli lose 50 percent more weight than they would with diet and exercise alone. Sounds good, right? But this actually translates into losing an average of only about two and a half to five extra pounds. And maintaining this weight reduction is tough; most people regain what they have lost, even if they continue to take the pill.
The orlistat in alli blocks the absorption of about one-quarter of the fat a person consumes. That fat passes right through the body, which causes negative gastrointestinal effects (such as gas and oily leakage that soils clothes) in about half of the people who took alli in clinical trials. Those negative effects may be an excellent motivator to stick to a low-fat diet, but people may compensate by eating more sugar, which isn't healthy.
A Real Problem
To be sure, weight is a major health concern in the United States today. Two-thirds of Americans are considered overweight, and half of those are obese; the numbers are higher among people who are poor and among African American women and Latinas when compared to white women.
How much you weigh (in relation to your height), your waist size and how much weight you gain after your mid-20s are associated with your chances of having or dying from a heart attack, stroke or other type of cardiovascular disease; developing diabetes and several types of cancer; and experiencing other health problems, including infertility and asthma.
But alli is not part of the solution, as its marketers claim. Its high cost and negative effects are not worth the minimal "benefit" of a small increase in short-term weight loss, and it has no proven health benefit. In fact, it decreases the absorption of fat-soluble vitamins A, D and E and beta-carotene. The FDA recommends that anyone taking alli also take a daily multivitamin.
Public Citizen, a nonprofit consumer advocacy group based in Washington, D.C., has argued that alli causes precancerous changes in the colon, although the FDA responds that available evidence doesn't prove a cause-and-effect relationship.
In addition, promoting the use of such a drug without a prescription opens the door to abuse by people with eating disorders and those under 18 (the cutoff age for the FDA approval). The potential for such abuse, along with other health concerns, inspired Prescription Access Litigation to give GlaxoSmithKline the "With Allies Like This, Who Needs Enemas?" award recently. (Prescription Access Litigation is a national consumer advocacy coalition based in Boston, of which Our Bodies, Ourselves is a member.)
Avoiding Diets, Encouraging Health
Alli is just the latest in a long string of weight-loss strategies that aim to boost corporate profits more than to increase health. Rather than suggesting that overweight individuals pop more pills or adopt yet another dieting scheme, we need to encourage lifelong healthy eating and regular physical activity. We also need to address negative social and environmental forces that contribute to our rapidly expanding national waistline.
For individuals, health at any size is a much better goal than thinness. People of all shapes and sizes can improve health by eating a variety of healthy foods, practicing attuned eating (eating when hungry and stopping when full), being physically active, and accepting and celebrating their bodies as they are. Whether a person's weight goes down or not, these practices can help boost mood, energy and fitness.
As a society, we need to stop judging individuals and focus more on the social causes of the rise in obesity in adults and children since the 1980s. These include super-size portions; a more sedentary lifestyle; and heavy marketing of sugary sodas and other cheap, convenient foods full of trans or hydrogenated fats, sugar and salt.
Unhealthy junk foods and fast foods are often cheaper than fresh fruits and vegetables, thanks in part to U.S. government subsidies. Television and computers can contribute to the problem by both increasing the amounts of time that people spend being inactive and exposing viewers to more advertising of unhealthy products.
What to Do
To combat these trends, we can:
- Collaborate with our local PTAs, employers and community groups to replace sodas and unhealthy snacks in school, workplace and community vending machines with healthier options such as water, fruit, nuts and seeds
- Increase the amount of physical education and recess time in schools
- Get fresh, local, healthy food into cafeterias in businesses, schools and universities
- Design communities to encourage bicycling and walking rather than reliance on cars
- Advocate for regulation of marketing of unhealthy foods, especially ads aimed at children, and use our purchasing power to support magazines and other media that don't rely on revenue from ads promoting unhealthy choices
- Learn about how the government subsidizes low-quality foods such as corn and wheat but does not subsidize healthier items such as fruits, vegetables, beans and nuts
- Become food activists. Join groups such as the Organic Consumers Association that keep members informed about food policies that will make a positive difference as well as petitions and other campaigns to help make healthy foods more widely available, cheaper and more convenient than junk foods.
- Combining a focus on individual fitness rather than weight and a public health campaign to increase activity and reduce unhealthy eating is more complicated than simply pinning our hopes on yet another pill. But it will do more to improve our health, without any of the nasty side effects.
Judy Norsigian is the executive director of Our Bodies Ourselves, a nonprofit women's health advocacy organization. Heather Stephenson is the editor of "Our Bodies, Ourselves: A New Edition for A New Era" (Simon and Schuster, 2005), "Our Bodies, Ourselves: Menopause" (Simon and Schuster, 2006) and "Our Bodies, Ourselves: Pregnancy and Birth" (Simon and Schuster, forthcoming in 2008).
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For more information:
Bitter Pill Awards, by Prescription Access Litigation:
American Medical Women's Association,
"Health at Any Size: The Size-Acceptance Nondiet Movement":
Organic Consumers Association:
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