The BetsyG-Spot

Last week, I started a three-part series on the Alli weight-loss program. In Part I, I talked about how I got heavy and a little bit about my history as an eater and dieter. This week, I’ll talk about the Alli program, and next week I’ll discuss the weight loss that happened after I stopped taking the Alli pill that I credit Alli with anyhow.

By Betsy G

Alli is the only FDA-approved over-the-counter pill for weight loss. It was formerly available only by prescription, as Orlistat. Last year it was released in non-prescription form under the Alli name (pronounced ally, i.e., friend).

When I purchased my Alli starter pack, I was serious about losing at least 20 pounds. I had decided to take a running start before I actually shelled out the money, just to make sure I was ready to diet. Alli is expensive ($60 of so for about a month’s worth) and I didn’t want to waste my money if I was going to blow it. But once I was sure I was on the path, I took a trip to CVS.

The starter pack
At the store, I was faced with a variety of packages, and the starter pack was the most expensive. I asked the pharmacist what was in the starter pack and she didn’t know, but she thought it might prescribe a gradual increase in dosage. Wrong.

The starter pack has all the literature, including the calorie counter and meal plans. If you can get that stuff from someone else, there’s no reason to buy the starter pack; the pills are the same.

Do read the literature
Whether you buy the starter pack or borrow the booklets from someone else, I can’t recommend strongly enough that you read all the literature that comes with the product.

I had done some amount of research before I purchased the pills, and already knew a couple of key points:

• Alli is not a diet pill; you don’t lose weight simply by taking the pill. You use it in conjunction with a weight-loss meal plan (also known as a diet). It can help you increase your weight loss by up to 50%. So if you would have lost 10 pounds by dieting, you might instead lose 15 pounds with Alli.
• Alli works by preventing your digestive system from absorbing fat. If you eat more fat than you’re allowed, there’s a nasty side effect (what Alli calls “treatment effects”) that can be embarrassing. (On a related note, if you eat a very low fat diet, Alli won’t do much of anything for you.)

As soon as I got home with my kit, I sat down in the chaise on my deck and started reading. I have never read a diet book in my life, but I spent an hour reading the Alli materials. I was impressed. I’m a technical writer, so I could see the effort they’d gone through to make everything as clear and unambiguous to as wide an audience as possible.

From the literature I disovered that Alli recommended the “running start” I’d given myself on my own. Lucky me. I was ready.

A word about treatment effects
The thing you may hear of most about Alli is the “treatment effects,” which is basically that you risk leaking oily stool if you eat too much fat.

I think the Alli plan is very generous with its fat allowance, particularly if you’re used to eating relatively low fat, as I am. At 15–19 grams per meal, it would take eating a large steak to go over. In the four months I was on Alli, I never experienced treatment effects. If you don’t cheat with fat, you won’t experience treatment effects. Period. (If you’re clever, you can cheat with non-fat candies like Skittles without having a problem. Not that I would recommend such a thing. Put that bag down, right now.)

Alli web site
After I read the literature, I registered on the web site. The web site is the real ally in this plan. I found the support offered there very helpful. The Alli people really understand the mentality of the failed dieter and speak to that on their beautifully written web site.

(By the way, I recommend that you visit their web site for details on the plan. They do a much better job at describing the plan than I ever could. I’m just writing about my experience, not providing a tutorial on using Alli. It is probably the best web site I have ever used. Do the work if you want to use this plan. Read everything.)

After you supply vitals that confirm that you are sufficiently overweight for Alli, they ask for your target weight. I was at about 170 and wanted to get down to 145. The web site explained that this was too great a goal; I was apt to give up if I didn’t see myself progressing toward it quickly enough. Absolutely right. I instead put an initial goal of something like 162. That was the first change in my dieting mentality.

As with other dieting sites, you can enter your weight after your weekly weigh-in and enter nutrition info about your meals. When you don’t make your goals, they offer helpful advice and encouragement. Even when you do meet your goals they offer helpful advice.

One bit of encouragement that really resonated with me was to forgive myself if I made a mistake. In the past, if I had a loss of diet composure in the evening, I would atone the next day by skipping breakfast and eating a teeny lunch. This would start the bad cycle that resulted in the late-day pig-out, a skipped breakfast the next day, and so on. On Alli, if I had a bad night, I started the next day as I knew I should, with my full, healthy breakfast.

One of the best pieces of advice they gave was about refined sugars. I had never really worried about eating whole grains, though I did eat wheat bread over white. What did it really matter? I never understood what the big deal was about processed sugars. I thought it was a fiber issue.

But the Alli web site said the thing that got my attention: when you eat refined sugars—basically any carb that is white—you get hungry faster. You know, a nutritionist could explain the difference between a white potato and a sweet potato to me all day long, and nothing would have as much as an impact as that one statement from Alli: I’ll be hungry sooner on white carbs, stay full longer on good carbs. White carbs=hungry. Wow. That was the most profound moment of my dieting life.

From that point on, I viewed white carbs as something I was essentially allergic to.

Great meal plans
One of the reasons I think I had such success with Alli was that I liked their meal plans. They offered two different sets of menus. I think one was a bit more exotic and one more basic. While I didn’t follow the meal plans exactly, I followed the gist of them each meal, substituting out what I didn’t like, staying in line as best I could with the distribution of fats, proteins, and carbs.

The one thing I didn’t agree with was the number of calories per day they said I was entitled to. At my weight and with my goal, they said I could eat 1800 calories a day. I know my metabolism well enough to know that I would gain weight if I ate that much. I bucked the advice of the plan for only this, and set my caloric intake at 1200–1400 calories a day.

One of the most important parts about following the plan is portion size. Again, Alli got it right by describing portion size in simple terms: 4 ounces of chicken is about the size of a deck of cards. You have to get the portion size right or you’ll eat too much fat. And if you eat too big a serving of rice or pasta, you’ll exceed your calorie limit. Don’t delude yourself on portion size. If you follow the plan but your portions are too big, it’s all for naught.

Why Alli worked for me
I stayed on the plan and charted my progress on the web site, setting a new goal once I reached the first one. By the time I’d been on the plan for four months, I’d lost 15 pounds. It was a slow and steady weight loss, and I didn’t feel I had done anything fruity to get there. Did the Alli add to the weight loss? I have no idea. But I was back under 160, at about 156, when I decided that the Alli pill had lost its effectiveness for me (this tends to happen by the time you’ve taken it for six months).

So why do I thnk it worked? For several reasons:

• The “Anabuse-effect.” As my friend Angie pointed out, and the Alli web site now uses as a selling point, Alli is a powerful motivator for not cheating. Just as Anabuse makes alcoholics horribly ill when they drink alchohol, Alli has the potential for a highly embarrassing problem if you “fall off the wagon,” to continue the metaphor.
• Great meal plans. I have never eaten as well as I did on the Alli plan. The meals are interesting without being complicated to prepare, and the plan introduced me to food products I hadn’t tried before. On Alli, I never felt deprived, never felt like I was eating rabbit food, so I had every motivation to stay on the diet.
• Expense. Maybe $60 or $70 for a 30–40-day supply isn’t much to some people, but I have never spent that much money to lose weight. As long as I was shelling out that money, I was going to stick with the plan.
• Exercise. You didn’t think you could get away without exercising, did you? While Alli encourages gradually building up exercise and doesn’t put you on a guilt trip if you’re not at the gym five times a week, I know my body, and I know I won’t lose anything without exercise. Right around when I started the plan, I started running again (I had always been doing my stairmaster and also did Dance Dance Revolution regularly). I had to change my mentality on exercise; it now took priority over getting in an extra hour’s work/pay. This is something I have to remind myself several times a week. Exercise takes priority. No arguing.

And that’s my somewhat less-than-succinct explanation fo my experience on the Alli plan. Next week, I’ll talk about how the next 15 pounds dropped off, and talk a bit more about the Alli meal plans and how they have permanently changed how I eat.