The Alli diet involves taking the weight-loss drug orlistat in combination with a reduced-calorie and low-fat diet, as well as an exercise program. Alli is an over-the-counter version of the prescription drug Xenical; Alli contains 60 mg of orlistat, but Xenical contains 120 mg. Orlistat works by preventing absorption of some of the fat you eat. You generally take Alli three times a day, once with each main meal that contains fat. Following specific diet guidelines is important to prevent adverse effects when taking Alli.
Digestive Effects
Orlistat is classified as a lipase inhibitor, according to MedlinePlus. It works in the intestines to block absorption of some dietary fat, which then leaves the body through bowel movements. Because of this effect, the most likely problems associated with Alli are disagreeable changes in bowel movements. Some people only experience this for the first few weeks of treatment, but others continue to have trouble.
When taking Alli, you might develop gas with oily spotting, more urgency and frequency of bowel movements, difficulty controlling bowel movements, loose stools, diarrhea, oily or fatty stools, rectal pain or discomfort and abdominal pain. These effects are common, according to eMedTV, with 10 percent to 20 percent of participants in pre-approval clinical trials with orlistat experiencing some degree of gastrointestinal issues. The occurrence increases with a higher intake of fat in the diet.
Vitamin and Medication Concerns
Because Alli blocks absorption of fat, it also blocks absorption of fat-soluble vitamins, explains MedlinePlus. To prevent deficiency when using Alli, take a multivitamin containing vitamins A, D, E and K. Take the multivitamin once daily, at least two hours before or after taking Alli. Because Alli affects absorption of vitamin K, consult with your doctor if you take the medication warfarin, because vitamin K levels in the body affect warfarin and you might need a dosage adjustment. Additionally, Alli decreases the absorption of certain medications, so talk with your doctor about any drugs you take before beginning a diet with Alli.
Liver Damage
The U.S. Food and Drug Administration approved labeling changes for Alli and Xenical in 2010 because of rare cases of liver damage liked to orlistat use. The agency received 32 reports between 1999 and October 2008 of serious liver injury in orlistat users, including six reports of liver failure. Because the cases are so rare compared to the number of people who have taken orlistat without these problems, the FDA did not determine a definite link between orlistat and liver damage. Signs of liver injury include itching, jaundice, dark urine, light-colored stools and loss of appetite, according to eMedTV.
Issues with Other Organs
Orlistat might cause or worsen gallbladder problems, according to eMedTV, and it also can cause pancreatitis. Symptoms of pancreatitis include severe stomach pain that spreads to the back, along with nausea, vomiting and a rapid heartbeat. Orlistat use increases the risk of kidney stones, so people with a history of kidney stones should talk with a doctor before taking Alli. Some people have developed low thyroid function, or hypothyroidism, while taking Alli along with a thyroid medication.
Allergic Reaction
A serious allergic reaction to Alli is possible, according to Drugs.com. Signs include a rash, hives, difficulty breathing, and facial, throat or mouth swelling. These signs call for immediate medical attention, as allergic reactions to medication can lead to anaphylaxis, which can be life-threatening.
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