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Fat Americans eating more pills

USERS of Alli, the first weight-loss drug approved for sale over the counter in the United States, are finding what they likely suspected all along: pills are no magic substitute for diet and exercise.

Yet the market for diet aids is expected to remain firm as Americans engage in the New Year's tradition of resolving to shed pounds ?? even as the economy is mired in recession.

Americans - two-thirds of whomare overweight or obese - spend US$30billion a year on weight-loss products and services.

GlaxoSmithKline's Alli, a weaker version of Roche's prescription-only Xenical, created a stir when it was approved 18 months ago.

Since then, it has become known for its unpleasant side effects, including incontinence, diarrhea and flatulence with "oily spotting."

"It works to inhibit absorption of fat from our diet," said Shirley TerMolen, a Chicago internist. "Therefore the fat comes out in the stool, causing diarrhea, which patients don't like much."

Because the side effects result from eating too much fat, TerMolen noted that some of her colleagues use the drug to help patients modify their behavior.

TerMolen said she has prescribed the drug but has not seen a lot of success. "For most people, they're just looking for a shortcut instead of just eating better and exercising," she said.

Donald Hensrud, a weight management specialist at Mayo Clinic, called the gastrointestinal side effects overstated - as is the intended effect.

"People who took the drug lost only four more pounds (1.8 kilograms) than the placebo group after a year," Hensrud said. "People have to ask themselves whether the expense of this medicine is worth a few extra pounds."

A 30-day supply of Alli costs US$60.


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