While the media and many bloggers have focused much of their attention on alli's potential treatment effects, consumers who are actually using the product take a different view.

They say that treatment effects act as a deterrent or a reminder NOT to eat fatty foods. We know this anecdotally from alliFirst Team members as well as from a new study presented at the recent annual meeting of NAASO (aka The Obesity Society). Download PDF of study poster.

The study found that fewer than five percent of users stopped taking alli because of treatment effects and that, in fact, potential side effects were viewed by many as a positive feedback tool.

Caryn Eyring, the alliFirst member featured in People Magazine (after losing 21 pounds), attended The Obesity Society Annual meeting in New Orleans. She said in an interview:

“I had a treatment effect once when I ate too much fat at a meal. I just got right back on the diet. There is no way that a little treatment effect was going to stop me from doing what’s working for me. alli is like a little reminder, sitting on my shoulder, telling me to stick to the plan.”

- Quote from Caryn Eyring, an alliFirst Team member from New York who has now lost 30 pounds.

In the interest of full disclosure (you knew we'd say this)... Caryn's weight loss results and experiences may not be typical of all users.

Back in June I wrote about the alli first team, the first 400 or so consumers who tried alli. A few of the first team members who appeared in the news, most notably Caryn Eyring, who was featured in People Magazine on July 9, 2007. She told People she'd had only one "alli oops" episode and that alli was forcing her to "eat healthier." (This is a repeated theme, BTW, from alli users.) 

Now you can see Laura, a real alli user (i.e. not a professional actress although she has great stage presence) on TV in a new :30 second spot. It's posted to alli's YouTube channel. For updates from other alli users (including John and Laurie) visit real alli stories on myalli.com. Oh, and you can submit your own alli story here, and chances are, you'll see it on myalli.com.

Odds are, if you are reading this, you probably know what a treatment effect (TE) is and why they can happen. And yes, we have been very open about TEs in our marketing of alli. USA Today even writes about our sense of scatalogical humor.

But is there really a benefit to using a product that could result in treatment effects? Many cynics say no, but new users of alli disagree. Some people have even been rethinking treatment effects. Not because they're unpleasant, but because TEs are keeping them honest. The USA Today article makes that point too.

What do you think? Can treatment effects increase motivation for people really committed to losing weight?

Welcome! alli is the only FDA-approved OTC (over the counter) weight loss product available for overweight adults. You've probably seen our advertising (check out our TV ads on YouTube). The goal of this blog is to have a two-way conversation about weight loss issues. We are going to challenge many people's notions about weight loss. And, we want you to challenge us in return. I encourage you to leave a comment below or on any other entry.

My oops experience...

I hope you'll stick with me - and our other contributing authors - and give us time to find our stride in the blogosphere.

alliFirst Team member Caryn Eyring (left) told People Magazine she's lost 21 pounds since she started taking alli in April, along with "cutting fat [and] doing yoga."

She's quoted in the July 9, 2007 issue of People (page 77) with a post-jail Paris Hilton on the cover. Caryn had one  "alli-oops" episode after eating a chicken with crispy noodles appetizer, according to People. alli, she says in the article, "is forcing me to eat healthier."

Yup, alli will punish cheaters if you don't stick to a low-fat diet. But isn't that the whole point... to encourage a healthier way of eating? As another alliFirst member, Paula Miguel, told People: "If I stopped taking alli today, I would still keep those new habits."

Oh and just a reminder that coverage of the alli program by People Magazine is not an endorsement. 

It's no surprise that there are videos on YouTube (see here) that make fun of alli's potential treatment effects (TEs as they're being called). We loved toilet jokes in kindergarten. And apparently a lot of folks still like them now.

Mainstream media is also fixated on alli's possible side effects. See Google news search results on "glaxosmithkline alli." I find it interesting that this is the "news hook" dominating coverage of alli. For in fact...

1. The folks who are actually using alli seem to have a positive attitude about TEs; i.e. they know they can control them.

2. Treatment effects are avoidable if you watch your diet and limit your fat to 15 grams per meal.

Anecdotal reports from the alliFirst Team members say that run-to-the-toilet episodes are manageable and rather rare. The 400 alliFirst members were recruited in April to try alli so they've been using the product for several months now. Their experience should be a useful guide for others.

(Full disclosure: I'm not currently using alli as I'm not overweight.)

Still don't believe me on TEs? Watch Stand-Up Doctor (who is not affiliated in any way with GlaxoSmithKline). He describes himself as a family physician and weight loss doctor by day and a stand-up comedian at night. He has previously prescribed Xenical, the prescription version of alli (it's twice the dose or 120 mg of Orlistat). He says on the video:

"Even at the prescription dosage although people seemed to get a little gassy and sometimes bloated and even occasionally had diarrhea, I never had a (patient) tell me they had an accident or that they couldn't make it to the bathroom... "

Note: The comments on this blog from the alliFirst Team are uniformly - unnervingly - passionate and positive about using the product. See here and here and here. Yup, I was a bit suspicious as you might be too. But the folks at GSK assure me the alliFirst members have not been coached on what to say. 

They're getting a good deal: a six-month supply of alli (worth about $300) as well as access to private online support communities.

Along with the chance to get up close and personal with the alli brand team. For anyone trying to lose weight, who wouldn't want to join the alliFirst Team?

I was curious how GSK chose the lucky 411 who got to try alli before it became available to the public this week. (You should be able to find alli on shelves tomorrow.)

The inside story on the alliFirst Team

Here's what I found out:

GSK asked Communispace, which runs private online communities (discussion groups), to send out email invitations to become an alliFirst member. A total of about 2000 email invites were sent out.   

463 people qualified to be alliFirst members (i.e. they were at least 15 pounds overweight and willing to commit to a low-fat diet and to an exercise program).

411 of those were selected to join the alliFirst team.

The pool of email invite recipients came from three sources:

- those who had visited QuestionEverything.com and indicated they were interested in learning more about alli

- those who answered the "are you ready?" questions affirmatively on myalli.com

- past members of Partners in Weight Loss (a GSK community for overweight women) who also said they were interested in trying alli when it became available

Typical profile of an alliFirst Team member

A typical member, the GSK folks tell me, is a white woman ages 30 - 39 who wants to lose 16 to 50 pounds. She has attended two to four years of college and her household income is between $50,000 and $100,000.

She has tried other weight loss programs in the past, is highly motivated and has agreed to the alli readiness questions.

Namely, she is willing to do the "hard work" to lose weight gradually, is committed to following a reduced-calorie, low-fat diet with an average of 15 grams of fat per meal AND...

understands that if she takes alli with a meal containing too much fat she may get treatment effects (that's GSK term for side effects) such as gas with oily spotting, loose stools and more frequent stools that may be hard to control.

Yup, these 411 alliFirst members appear to be a hardy group as well as super enthusiastic. Seems like a great marketing move on GSK's part.

Here's my oops story... Consider it a cautionary tale. But also take heart. It wasn't that big a deal. And it only happened once. (I've even talked about it on CNBC.)

Treatment effects are common if you eat meals with too much fat. They aren't a safety concern - they won't hurt you. But they could be embarrassing if you aren't prepared to deal with them.

The rule of thumb is to limit your calories from fat to about 30% per meal, or about 15 grams of fat per meal. 

I learned this the hard way when I ate a fish sandwich and french fries from a fast food drive-through WITH TARTAR SAUCE, and a soda.  Really smart, huh? 

Good thing I was close to home so I could change my clothes.*  But you know what?  It hasn't happened since. 

Yes, I still see occasionally undigested fat floating in the toilet. But I'd rather have the fat flushed away when I go to the bathroom than have it wrap around my waist or clog my arteries. 

Studies show that about one out of every two alli users in a real world setting (real world, meaning you're on your own, versus being part of a "controlled clinical trial" where you get lots of instruction and advice) don't even get treatment effects.  Those that do should expect to experience a "signal" that alli is working to block excess fat- but very few people (something like 5%) stop using the program because of how the product works.

Over time (I've lost 60 pounds and kept it off for about three years) I've learned to make changes in the way I eat. I still enjoy steak and potatoes - but I pick filet or strips versus rib eyes, and pass on the butter.

* My oops experience happened surprisingly quickly. That's not typical. The delay between eating a high fat meal and experiencing treatment effects varies from person to person but is generally 12 hours.

I'm frequently asked "Hey, Mr. Marketing Guy, why are you being so cutesy and calling uncontrolled bowel movements 'Treatment Effects.' Can't you just be real and call them side effects?"

Well, we could, but calling them side effects is actually misleading.

Side effects vs. treatment effects

Side effects are generally unrelated to what a drug is trying to fix and often are harmful. 

For example, I take a calcium channel blocker to lower my blood pressure.  It also makes me dizzy.  But I don't take the channel blocker to get dizzy. If I wanted to get dizzy, I could chase around my 4 kids and 2 dogs. 

I take my calcium channel blocker to reduce my blood pressure and to get out of any hard work that requires me to operate heavy machinery (which my drug's label suggests I avoid).

How alli works

When you take alli, the blocked fat goes out the only exit available.  If you eat too much fat, the fat excretion is ugly.  That's how the drug works!  The exiting fat isn't a side effect, it's the actual treatment of the drug. Hence, "treatment effects." By the way, they are not harmful in any way.  You are not losing electrolytes, just fat.  You didn't need the fat anyway.

And while you are on alli, you can operate heavy machinery.  Just thought you'd like to know.

You may have heard about the book are you losing it? and wondered what it was all about.  If you've seen it, odds are you found it in places you wouldn’t expect... like your local pharmacy counter or on the shelf in the weight loss product aisle (while supplies last).

This is not a money-maker for GSK. We've pledged all of the profits from the book to help prevent childhood  obesity through programs offered by Shaping American’s Health and NAASO, the Obesity Society.

If you want to learn more about the book, go to areyoulosingit.myalli.com.  Keep in mind that the book isn’t just about alli - only 21 of the 150+ pages talk about the alli program.  But, one of the pages does include information about the alli treatment effects (page 69), as mentioned by CNBC's Mike Huckman.