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Posted Oct 17 2008 12:00am

PillsPart 1 of a 2 Part Series

In a world where the numbers of overweight and obese people only continue to climb, many people are desperate for any help they can get with weight loss. Sure, most people can lose weight following a low carb, or conversely, a low calorie, low fat diet for a little while anyway. But long-term compliance continues to elude many people. Wouldn’t it be nice if you could eat all the carbs or all the fat you wanted and not gain weight?

That’s the allure of a category of newer dietary supplements called starch blockers, and the over-the-counter fat blocker called Alli. The idea is, “Go ahead and eat the foods you like, just keep them from breaking down and make them pass right through, so you don’t absorb the calories.”

First, just to give you a little background… Starch blockers are substances that stop the digestion of starches by blocking one of the enzymes that break them down. For example, a prescription drug for diabetics called acarbose (Precose) blocks the enzyme called alpha-glucosidase.

A newer over-the-counter starch blocker called Phase 2 is extracted from white beans and is an ingredient in many different starch-blocking weight loss products that go by different names. It blocks alpha-amylase, another carb-digesting enzyme.

Xenical (orlistat) is the higher-dose prescription version of Alli. It blocks the fat-digesting enzyme called lipase. Many users don’t know that it was almost taken off the market by the FDA due to the severe side effects.

Do these products help with weight loss? Somewhat. For starch blockers, there aren’t many studies to look at, but one that was done by the manufacturer of Phase 2 showed people lost an average of a half a pound a week compared to controls who only lost .21 pound per week.1

One study of orlistat showed that subjects who took the drug and followed a low calorie diet lost about 15 pounds in 2 years compared to those on placebo who lost about 8 pounds.2 The Alli full program is supposed to include exercise, in which case, weight loss could be, and according to testimonials on the web site, often is greater. Some experts have noted that the drug doesn’t work unless you have a certain amount of fat in your diet.3

However, it is really important to note these products block only a small percentage of the calories from fats or starches, so it is still necessary to practice portion control and to exercise, or they aren’t effective. That’s why Alli provides a whole online support program teaching people how to reduce their calories further using portion control, and encouraging exercise.

Blogs and online discussion forums show starch blocker users reporting the same thing you still can’t eat whatever you want or you don’t lose weight. The bottom line is, you still have to do the hard work of dieting and exercising.

Despite that, and the side effects of gas and loose oily stools, one study found that Alli users report very high satisfaction with the product.4 But would they be as willing to use it if they knew that a health research group has questioned whether it may potentially cause colon cancer? 5

Next time I’ll discuss the side effects and safety concerns of fat and starch blockers and provide a few helpful pointers for sticking to a low carb diet.


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