Alli, a slimming pill without a prescription

In the title role, the slimming molecule Orlistat , prescribed for ten years by doctors under the name of Xenical (120 mg per capsule, not reimbursed). After losing weight at 60 mg, changing the lab and finding a new name, here is Alli, which can be bought without a prescription. However, it is sufficient to swallow two capsules (2 x 60 mg) to take the dose of a capsule sold on prescription (120 mg) ...

Disconcerting. Because if the original version requires the sesame of a doctor , to identify contraindications and avoid drug interactions, is there any danger in letting consumers self-medicate and tinker with their dosage? Or should we deduce that the relative effectiveness of the molecule makes it harmless?

In addition, if Alli is intended exclusively for obese or overweight people whose Body Mass Index (BMI) * is 28 or above - for example, 77 kg for 1.65 m - what risks are there for those who will inevitably divert it, because of its free sale, to take advantage of it to make binge without rounding off or to unload some extra pounds before the summer?

The French Agency for Health Safety of Health Products (Afssaps) does not hide its embarrassment. It is responsible for managing its placing on the market after the green light of the European Agency for the Evaluation of Medicines - a decision voted by a narrow majority, twelve countries, including France, voting against. "We are obliged to apply European decisions, but the free sale of this drug raises questions, recognizes Anne Castot, responsible for the coordination of vigilance at Afssaps. Currently, we are thinking and evaluating how to frame it. "

In the end, Alli should arrive in pharmacies in May or next June, at a price of 50 to 60 € per month of treatment . The approach in this page is not to advertise but inform our readers, who will inevitably hear about it. It's up to them to decide.

(*) To calculate your BMI, divide your weight by your height squared (example: 60 / 1,632 = 22.5).

Normal weight : up to 25; overweight : 25 to 30; obesity : from 30.

Slimming Pill: Its mode of action to lose weight

Alli / Orlistat acts on the digestive system: it blocks locally, for a few hours, the intestinal lipases, enzymes necessary for the digestion and assimilation of fats. Nearly 25% are thus evacuated by natural means.

Against the slimming pill Alli

The opinion of nutritionist Jean-Michel Cohen , author of "Lose, the big lie" (Flammarion ed).

"It's a business product. It can be seen as a dietary supplement that will not help much. Clearly, the pharmaceutical industry has not succeeded with the Xenical , which fails to lose weight obese - and that doctors no longer prescribe - we try to roll consumers with this version of slimming pill Alli, whose dosage is divided by two. This is pure scandal, but what a manna! About twenty million French are overweight : if five million of them buy a box, it is 250 million euros of gains! Of course, patients get rid of some of the swallowed fat through unpleasant side effects - diarrhea that is untimely and uncontrollable - but that is not enough. Losing weight is more complex. "

The risks? "They exist. First, deficiencies of vitamins A, D, E and K, which result from malabsorption of fat because these vitamins sit in lipids. Two examples: Vitamin E has a crucial role for cell membranes, and vitamin D is at the heart of research to prevent certain cancers (colon, breast, prostate) as well as in the treatment of obesity . In fact, on the one hand, the vitamin D feed is enriched and, on the other hand, a product which decreases its absorption is authorized. We walk on the head! Then there are losses of minerals (magnesium, potassium ...). Warning to major users of laxatives, such as anorexics, especially deficient in potassium, because when the rate is too low, the heart flanks ... "

In case of overdose ... "No danger of drug overdose . But many medications, like the contraceptive pill, which require fat to be absorbed into the body before passing into the bloodstream, will be less effective. "

The diversion of the drug? "Only their wallets are thin. For gourmands wishing to erase 4 kg rebels, fat stool and illusion. But above all, it will undermine their quota of vitamins and minerals. "

For the slimming pill Alli

The opinion of nutritionist Pierre Azam.

"It is an additional tool in the management of overweight and obesity diets for the 80% of people concerned who, in any case, do not consult already. Alli improves the performance of a diet: we lose 6 kg, instead of 4 with the diet alone . And this allows especially to empower people and establish a nutritional pedagogy: it is imperative to adopt low-fat and balanced meals, and to play sports , because the molecule does not act alone. Without reforming one's diet , one does not lose weight. The digestive side effects are warning signs to become aware that we are eating meals that are still too fat, that the "light" quiche is not, or that we swallow hidden fats. Weight loss is reasonable and rational, there is no miracle. "

The risks? "The molecule offers perfect safety. To make up for vitamin and mineral leakage, it is enough to make meals that are coherent and properly balanced in fruits , vegetables, fish and meat; the contributions are then largely covered and compensated. "

In case of overdose ... "The side effects will be stronger, that's all. As for the anorexics , without fat absorption the drug will not act. "

The diversion of the drug? "It will be ephemeral and risk free: those who use Alli to keep the line while enjoying ice cream or foie gras will quickly let it down, because they will have only the side effects, without losing weight. The lipids weigh 900 Cal / 100 g: with Alli, one absorbs 675 Cal, because only 25% of the fats are eliminated. "

Potential contraindications? "The pharmacist should take the precaution of asking if the woman is not pregnant, if the person is of age, has no digestive diseases, etc. He may also advise to consult if he deems it necessary, knowing that the risks are in any case minor: Orlistat is not an atomic bomb! Patients who suffer from liver or kidney disease, or who are on anticoagulants, are sufficiently responsible and concerned about their health. "

Other slimming pills for weight loss

Sibutral (Sibutramine molecule) It increases satiety and suppresses appetite, which actually decreases the volume of meals , by acting on serotonin and norepinephrine, two chemical messengers of the brain through which neurons communicate with each other. On prescription, because its use is very framed.

Acomplia (Rimonabant molecule) It has been banned in Europe since October 2008 , after causing suicides and severe depression in patients who have never had a psychiatric history. It works by blocking certain receptors in the brain, liver and fat cells.