On April 8, 2024, “Alli,” Japan’s first drug aimed at reducing visceral fat, was released. Visceral fat is known to increase the risk of lifestyle-related diseases and has been a challenging issue for those who could not reduce it through exercise or dietary measures alone. “Alli” has been eagerly awaited as a solution.
However, many questions arise: Is “Alli” truly effective? What are the side effects? Who can take it? Let’s dive deep into the details of “Alli.”
What is Alli?
Overview of Alli
Alli, developed and sold by Taisho Pharmaceutical, is a medication designed to reduce visceral fat. Its active ingredient, Orlistat, blocks the absorption of fats, thus reducing visceral fat, waist circumference, and body weight.
Orlistat is approved in over 100 countries globally and is established for its safety and efficacy. Although previously available only as a prescription drug in Japan, it has now been released as an over-the-counter medication for the first time.
Effects of Alli
Alli can block about 25-30% of fat absorption from your diet. The expected benefits include:
- Reduction in visceral fat
- Decrease in waist circumference
- Weight loss
- Improvement in cholesterol levels
- Better blood sugar control
In clinical trials, those taking Alli lost on average more than twice as much weight compared to those who took a placebo. Specifically, the placebo group lost an average of 2.3 kg after one year, whereas the Alli group lost an average of 4.8 kg, demonstrating its effectiveness in improving obesity.
The weight reduction is anticipated to start within about six months of starting the medication, with an expected weight loss of approximately 2.1 kg in half a year and about 4 kg in a year.
Side Effects of Alli
While Alli is generally considered safe, some reported side effects include:
- Potential leakage of stools with gas
- Unnoticed oil leakage from the anus
- Oily stools
- Increased bowel movements
- Inability to control bowel movements
- Abdominal bloating
- Diarrhea
- Abdominal pain
These side effects are mostly due to Alli’s fat-blocking action, particularly when consuming a fat-rich diet. Other effects, such as vitamin deficiency and worsening skin condition, have also been noted.
About 20% of those taking Alli report the side effects of stool leakage with gas and unnoticed anal oil leakage. It might be advisable for those concerned about these side effects or during the initial stages of treatment to consider using adult diapers.
Where to Buy Alli
Alli is available at pharmacies and drugstores but requires a face-to-face sale by a pharmacist as it is categorized as a “pharmacist-guided medication.” No prescription is necessary, but buyers must meet certain conditions, including being over 18 years old and having a waist circumference above 85 cm for men and 90 cm for women (the Japanese standards for metabolic syndrome). Additionally, potential users should have been actively attempting to improve their lifestyle, such as diet and exercise, for at least three months before taking Alli.
Price of Alli
- 18 capsules (6-day supply): ¥2,530
- 90 capsules (30-day supply): ¥8,800
Reaction on Social Media to Alli’s Launch
The release of Alli has garnered a lot of interest on social media, with various reactions:
Positive Reactions
- “Incredible to have a medication that reduces visceral fat!”
- “I’ve tried many diets before, but maybe this will finally be the one that works?”
- “I’m concerned about side effects, but I want to try it first.”
- “I plan to consult with my doctor to see if it’s right for me.”
Negative Reactions
- “Losing weight through medication seems unhealthy.”
- “I think it’s more important to improve basic lifestyle habits.”
- “The medication is too expensive for me to just try it.”
- “I’m still not convinced of its effectiveness.”
About the Active Ingredient Orlistat
How Orlistat Works
Orlistat targets the enzyme lipase, which breaks down fats (triglycerides) into glycerol and fatty acids for absorption. By inhibiting lipase, Orlistat prevents the absorption of fats from the diet, leading to reduced calorie intake and weight loss. This mechanism makes Orlistat a valuable drug for obesity treatment, aiding in weight management.
Meta-analysis: Effectiveness and Safety of Orlistat
A study titled “Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis,” compares five FDA-approved drugs, including Orlistat. It found all five to be more effective than placebo in weight loss, though they also showed a higher incidence of side effects. Orlistat’s participants had a 44% probability of achieving at least a 5% weight loss over 52 weeks, the lowest efficacy among the drugs, yet it had the lowest risk of discontinuation due to side effects at 22%. This establishes Orlistat as a moderately effective yet safe medication.
Efficacy and Safety of Orlistat in Japanese Individuals
The paper “Efficacy and Safety of Lipase Inhibitor Orlistat in Japanese with Excessive Visceral Fat Accumulation: 24-Week, Double-Blind, Randomized, Placebo-Controlled Study” indicates that Orlistat effectively reduces visceral fat area, waist circumference, and weight more than placebo. Side effects were primarily mild and related to the gastrointestinal system, confirming its safety among Japanese adults.
Difference from Other Obesity Medications: Direct Fat Absorption Inhibition
Unlike many other obesity treatments available in Japan, Alli (Orlistat) uniquely inhibits fat absorption directly. Other medications and support drugs differ in how they reduce energy absorption.
How Calorie Limit Works
Calorie Limit’s components, including Phagomin, Chitosan, and Tea Saponin, block the absorption of carbohydrates and fats, aiding weight management. Its clinical trials show it can suppress postprandial blood sugar and triglyceride levels. Despite minimal side effects, its digestive suppression activity may disrupt gut microbiota and cause loose stools.
Mechanism of Naishiitol
Naishiitol, containing the traditional Chinese medicine Boiogito, helps in managing obesity by expelling excess fluid and waste, improving blood flow. However, its effectiveness varies among individuals, with some studies showing no significant weight difference from placebo.
Majindol’s Function
Majindol (Mazindol) acts on the central nervous system to suppress appetite, thus reducing calorie intake and assisting weight management. It’s approved for medical use in Japan and has shown significant weight loss in local trials.
Salacia’s Action
Salacia retards the breakdown of carbohydrates by inhibiting alpha-glucosidase, thus controlling post-meal blood sugar spikes. It also may enhance gut health.
Indigestible Dextrin
As a dietary fiber, indigestible dextrin slows sugar absorption and stabilizes blood sugar levels. It also improves gut health and helps prevent obesity.
Global and Japanese Obesity Trends
As of February 29, 2024, over one billion people worldwide are classified as obese, according to a Lancet publication. This rapid increase is seen more in low- and middle-income countries transitioning from malnutrition to obesity faster than expected.
In Japan, over 30 million people are considered obese, comprising 33.0% of men and 22.3% of women. The launch of Alli, developed by Taisho Pharmaceutical, represents a major advancement in treating obesity. Priced from 2,530 JPY for six days, Alli is sold in pharmacies as a required face-to-face sale drug.
Conclusion
Alli, the first visceral fat reduction drug launched in Japan, contains Orlistat which blocks about 25-30% of fat absorption from food. Clinical trials show significant weight reduction compared to placebo. However, its intake may cause gastrointestinal-related side effects like oily stools and frequent bowel movements. The release of Alli brings a new option for obesity treatment, providing a direct mechanism of action unlike other obesity drugs.