Inconsistent Demand for Dieter's Little Helper

As Alli, the first over-the-counter diet drug approved by the U.S. Food and Drug Administration begins to arrive in drugstores and pharmacies around the country, retailers are reporting uneven demand for the product.

An article in today's Los Angeles Times reported that the GlaxoSmithKline product sparked a "feeding frenzy" in stores from Santa Monica to the San Fernando Valley.

But while some pharmacists around the country reported high demand for the product -- in some cases before it reached their stores -- others reported that boxes were sitting on shelves untouched.

"We have had requests; we don't have a product yet," said Bill Prather, owner of the Blue Ridge Pharmacy in Blue Ridge, Ga.

He said questions from eager consumers about Alli, which blocks the absorption of some of the fat consumed by those taking it, began coming in as soon as the FDA approved the drug back in February.

Other stores had the opposite situation.

"We actually just got it in today. We haven't had many questions on it yet, though," said Jay Levine, who runs Hampton Roads Bon Secours Atrium Pharmacy in Norfolk, Va.

He reported that not a single box had been sold, although the pharmacy had advised some of its customers that the pills had arrived.

Levine attributed the slow sales to the conservative nature of the area surrounding his pharmacy, as well as the ineffectiveness of Alli's prescription predecessor, Xenical.

Heavy Debate

Levine said he has doubts about Alli's effectiveness because of the steps consumers will need to take when they use the drug.

GlaxoSmithKline informs consumers in materials accompanying the drug that they will need to reduce fat and calorie intake to avoid Alli's unpleasant side effects, which include loose stools and an oily discharge.

"When things get over-the-counter, they tend to be taken regardless of changing habits," said Levine. "And it definitely won't work that way."

Just under 100 miles away from Levine, in Richmond, Leonard Edloe sees the drug differently.

"If you're healthy and overweight, it's ideal," he said. "Most people need a little encouragement in order to lose weight."

Edloe emphasized that patients hoping to benefit from Alli need to be healthy, talk about the drug with their physician, and strictly follow the manufacturer's recommendations.

He commended GlaxoSmithKline for materials sent out with the drug, which he said gives pharmacists good guidelines for explaining necessary lifestyle changes that accompany Alli to patients.

"It's just not a magic pill," Edloe said.

For people willing to take those steps, Edloe said Alli provides the extra edge they may need to shed pounds.

"We have a tendency in our country to look at drugs as an answer to everything," he said.

Because of that mind-set, Edloe sees Alli as giving a dieters more incentive.

"[Some dieters] need [Alli] for a psychological lift. It will give a boost to somebody who was actually looking to use all the tricks of the trade being offered with this product," he said.

Some Pharmacists Just Say No

Other pharmacists see little good coming out of Alli.

"I'm not a big fan of the product," said Ed Snell of Ed Snell Pharmacy Shop in Pocatello, Idaho.

Snell said he has had a few inquiries but does not expect the product to sell well in his pharmacy because "if somebody asks me about it … I'll probably talk them out of it."

He said he does not feel that anyone who can adjust their lifestyle as the manufacturer recommends needs the drug to lose weight, and suspects that some users will end up worse off.

"I can see where some people will get fatter," said Snell, who expects many users will take the pills and then eat Big Macs guilt-free.

"It's going to give them a license to go ahead and do the things they shouldn't be doing," he said.

Variations in Demand

Demand for the product appears just as varied as pharmacists' opinions. Pharmacies contacted for this article in Alabama, Illinois, Arizona and North Carolina reported no questions about Alli. Others were flooded.

"I would say in the last week or so we've gotten 20 or 30 phone calls from people who want it," said Barry Walton of Mac's Medicine Mart in Kingsport, Tenn., which expects its first shipment of Alli to arrive Saturday.

Walton is among a number of pharmacists who expect the drug to have heavy demand at first but then level off.

"I expect it's probably going to be a pretty big seller for a little while, but then it will probably level off. I'm not sure people will appreciate the side effects as far as seepage out of the rectum," he said.

More Than Just Fat Loss

One concern shared by many pharmacists is that Alli's fat-blocking properties will also block the absorption of fat-soluble vitamins in the body, leading to vitamin deficiencies.

"I'm pretty big on vitamins, and that is a concern," said Walton.

Despite his support for the drug, Edloe shares the vitamin concerns and said that is a reason why only healthy people should use Alli.

But all the pharmacists agreed that people should not take Alli without first doing what they should do before beginning any diet: talk to their doctor.

"If people are going to consider purchasing that, they really ought to talk to their pharmacist or physician first," said Walton.

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