Alli and Appisat Approved For Over-the-Counter Sale in UK

Two diet drugs, Alli and Appisat, will go on sale in chemists for the first time in the UK this week. Previously, both drugs have been prescription-only.

But are they likely to help hopeful dieters - or just add to the credit crunch strain on wallets?

Alli

Alli (orlistat) was made available over-the-counter in the US in 2007. The drug works by reducing the body's ability to absorb fat. The unabsorbed fat is passed out ... often with unpleasant side effects: from GlaxoSmithKlein's approved treatment program:

alli™ works by preventing the absorption of some of the fat you eat. The fat passes out of your body, so you may have bowel changes, known as treatment effects. You may get:

• gas with oily spotting
• loose stools
• more frequent stools that may be hard to control

(If you want a full, and funny, "translation" of what the official wording probably means, I found Jeff Kay's Alli Side Effects In Layman's terms handy.)

So does Alli work? In clinical trials, it has been shown to have a beneficial effect on total weight loss. But experts have cautioned that the impact on most users is likely to be smaller. Gareth Williams, a professor of medicine at Bristol University, carried out his own trial of Alli and wrote in an editorial in the British Medical Journal:

Dieters in these trials are highly motivated and under medical supervision. People tempted to try Alli might be advised that taking it without medical supervision may achieve an average daily energy deficit of only 100kcal - equivalent to leaving a few French fries on a plate, eating an apple instead of ice cream, or (depending on enthusiasm and fitness) having 10 to 20 minutes of sex.

(Reported on by The Guardian, £1-a-day diet drug promises weight loss.)

If you're tempted to take Alli, consider spending that £1 per day on fresh fruit and veggies instead. A 100 calorie deficit really isn't much ... and the side effects (reported on by Alli users on various forums around the internet) aren't worth it. And studies have suggested that people who take Alli use it as an excuse to continue eating unhealthily.

Appesat

The other approved drug is Appesat, which does not enter the bloodstream (you still risk an upset stomach) but helps create a feeling of fullness in the stomach. Is it effective, though? The Guardian points out that some consultants to Appesat, such as Dr Jason Halford, are cautious about praising the drug. He said:

The cure for obesity and being overweight will never be found in a pill, packet or a wonder drug ... Drugs don't necessarily deal with reasons why people become obese, which are largely psychological. Drugs that increase feelings of satiety and control hunger will not help these people.

Diet drugs are expensive, have side-effects, and only work if you're following a healthy diet. (You might even put on weight while using Alli.) And most people don't stick with them for long enough to make a difference - probably because of the side effects.

Why not skip the drugs, save your money, and just adopt a healthier diet?