I wonder if asking my doc for Xenical would be cheaper for me than buying the Alli. I'll have to see next time I go to the doc.

Can't help you with that question Nicole as I live in the UK where prescriptions are charged at a flat rate, irrespective of the drug, so I only pay £6.85 a month (about $14).

Kitty

Hi, I'm brand new to this forum. I have been taking four Alli up to five times a day for the last six months. "Treatment effects" have been tolerable; but unfortunately, I'm not losing any weight. I'm trying to eat a healthy diet of fruits, vegetables, non-fat yogurt, Lean Cuisine meals and raw nuts and seeds, but I haven't been limiting my portions of nuts and seeds and I am actually gaining weight. Obviously the four Alli I take every time I eat a handful of nuts or a Lean Cuisine meal either aren't blocking all the fat or I am ingesting way too many carbs. I guess I will need to go on a very low carb diet and up my greasy fat intake for the Alli to have an effect on my weight.

I think you have a misunderstanding of how orlistat works. It doesn't actually 'block' fat it lessens the production of fat metabolising enzymes that are produced in the gut. I don't think taking more of it than is recommended enhances the effect in any significant way.

In order to lose weight on it you are going to have to limit your portions (read calories) in conjuction with the low fat diet. I can very easily overeat on healthy food, particularly nuts and seeds, as I found out when I did a low GI diet. My biggest problem with my weight was not poor food choices, as I eat fairly healthily, but portion control. You need to determine some way of measuring how much you are consuming remembering about a third of your calories from fat will not be absorbed. This may not be as great as you think as, for example, if you have 45g fat per day and one third of that is not absorbed (15g) its only 135 calories (15x9) per day. Without lowering your calories intake below what you expend its going to take a long time to lose weight relying on the orlistat alone.

However a lower calorie diet in conjunction with the orlistat does produce better results than is achieved by diet on its own. Its not a magic bullet that is going to help people lose weight without modifying their diet.

Kitty

Yes, I see that I am. There obviously is no such thing as a "magic pill" that will cause me to lose weight without modifying my diet and lifestyle. I just hate being hungry all the time but that is the only thing that has worked for me in the past and it looks like I will have to be hungry for the rest of my life in order to achieve and maintain a healthy weight.

Well if taking a double dose of Alli will not help then why have a 120 dose of Orlistat? They are fundamentally the same product are they not?

I have heard that many thin people say this. That they are hungry much of the time, but its the only way that they can maintain their weight

You are correct that Xenical is a double dose but the information leaflet still says it only stops absorption of around 30% of fat. Maybe it is more effective at the higher dose (plus possibly more likely to cause side-effect?) but I don't think doubling the dose doubles the fat 'blocking' effect.

Kitty

I wasn't suggesting that it necessarily "doubles" it (nor any other quantification), but yes more effective. It really doesn't "double" the treatment effect to take two Alli. This I know from experience. Whether that is the case with Xenical I don't know and am really not concerned over.

The point I was trying to make is that it is most likely more effective. If it weren't, then why even make it?

Here in the UK only Xenical is available and only on prescription from a doctor. The prescription version was around some years before the OTC 'half dose' version Alli was licenced. I think the reason they make the two different doses was, I'm guessing, the only way Roche could get it licensed as an OTC medication and of course the $$$ that can be made from selling it.

Kitty