Active substances: Orlistat
Firstly, it is unlikely that many users will see significant health benefits.
Clinical trials inevitably show antiobesity drugs at their best, because the participants are relatively motivated and are supported by dedicated staff who reinforce lifestyle advice.
We do not know how well Alli would perform without such support. Moreover, the benefit of orlistat over placebo in clinical trials is small—typically 2-5 kg after one year, 1 3 and declining to 2. As one online provider of diet pills.
The net health gain of taking Alli without medical supervision is therefore probably minimal. Even though orlistat seems to be innocuous, selling it over the counter could cause insidious collateral damage.
Obesity is a life sentence. Some remission can be earned by good behaviour, but this requires affected people to fight against strong societal and commercial forces and change their lifestyle radically.
Globally, obesity is spiralling out of control and will only be reined in by public health campaigns that somehow persuade people to eat less and exercise more.
Selling antiobesity drugs over the counter will perpetuate the myth that obesity can be fixed simply by popping a pill and could further undermine the efforts to promote healthy living, which is the only long term escape from obesity.
The only real beneficiary will be GSK. We will never know whether Alli is useful, as there will be no proper follow-up.
Viewed commercially, proof of efficacy is irrelevant—money will roll in for as long as the obesity pandemic continues to yield enough people prepared to pay for a quick fix solution to their unhappiness.
On the basis of criteria that include value, customer feedback, reorder rates, safety, and packaging, Alli is currently ranked only 57 th out of 200 by ConsumerPrice-Watch.
Nevertheless, Alli will probably generate income for GSK.
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