Losing Weight With Alli (Orlistat), Without Yellow Orange Goo

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December 18th, 2009 Leave a comment Go to comments

I’m a typical middle aged American guy with a weight problem. I’d like to share some of the useful experiences I’ve had without blushing, and also want to share some of my personal medical data with readers, too. So I’m writing this under the pseudonym “Lester Waite” because one of my goals, and I’m sure that of many others, is “less weight.”

Human health is complicated and there can be many different causes behind similar symptoms. It would be nice if there was a “magic bullet” fix for weight gain that will work for everyone, but from my experiences and reading I don’t believe this is likely to ever happen. Having tried a lot of recommendations that worked for others that didn’t work for me, I’ve seen firsthand how weight loss ideas seem very hit-or-miss and for me, unfortunately, mostly miss.

I did, however, finally discover the means to lose some significant weight. But it has some big “gotchas” that really need to be addressed to make it workable for more people. In this article, I’ll explain what I found that has worked for me as it might work for you, too.

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Want to Lose Weight?

I wanted to lose weight. Over the years, I tried lots of ideas, ranging from reducing portions to increasing exercise to various weight loss supplements designed to crank up the metabolism. Nothing worked much. Even when I found supplements that helped reduced my appetite and food intake, the weight didn’t come off.

In 2008, I learned about Irvingia in the article More Weight Loss than Any Other Discovery in Supplement History and gave a couple of forms of it a try. It reduced my appetite and I ate less. That seemed like a good sign. Disappointingly, I gained more weight anyway!

While there have been rave reviews of Irvingia for weight loss based upon controlled studies, it is clear that it by itself plus reduced food intake didn’t work for me. Given how Irvingia is believed to work by reducing leptin resistance, it makes sense that it may not be effective for everybody as not everybody suffers from leptin resistance.

In mid-2009, I read a Life Extension article The Nine Pillars of Successful Weight Loss and noticed that although I had tried most of the ideas already, including the Irvingia supplements. The two main ones I hadn’t tried were balancing my hormones to a more youthful level and assisting fat loss by using an over-the-counter drug called Alli that reduces fat absorption in the digestive system.

I gave these ideas a try. It turns out they work for me and I finally started losing some weight. However, I ran in to some difficult problems with using Alli that took some time and embarrassment to work out. Explaining these problems and the solutions needed to make Alli work comfortably is the main point of this article.

I strongly believe that hormone balancing has helped me, too. I’ll write about that in a future article as my personal experience with it is primarily applicable to men whereas studies show Alli works well for both men and women.

The Nine Pillars of Successful Weight Loss also mentioned carbohydrate-blockers included in a new formulation of Life Extension’s Irvingia supplements. I had tried the previous two versions and they helped reduce my appetite, but did nothing for me in regards to losing weight. This third version has also helped with my weight loss, so I’ll be writing about this in the future, too. I believe that for some people, Irvingia can be effective on its own, but for others like me the body may compensate by lowering metabolism and thus balancing hormones and reducing fat absorption are also necessary to achieve some meaningful weight loss.

What is Alli?

Alli is the over-the-counter version of a weight loss drug called orlistat. It and its prescription equivalent Xenical are effective means to help lose weight. They work by blocking the action of some of the fat-digesting lipase enzymes in your digestive tract. The net effect is that somewhere around 1/4 to 1/3 of the fat you eat just flows through your body undigested. The plus side is that this helps reduce your calorie intake significantly and will likely help you lose weight and lower undesirable LDL cholesterol and trigylceride levels. It does all of this without leaving you with jitters, heart palpitations, elevated anxiety, and/or difficulty sleeping that a lot of other diet alternatives cause because of their heavy use of caffeine and/or other chemicals in an attempt to speed up your metabolism.

Alli’s Worst Side Effect: Undigested “Fat Flows”

If you haven’t used Alli before but would like to lose weight or improve your blood lipids, surely you’re wondering “But what’s the downside?” The biggest downside for most people who have used this diet aid is the subject of this article. It’s the yellow/orange goo composed of undigested fats that flows through your guts and out the end. For a lot of people, it can be such a problem that Alli is almost unworkable even though they find it is helping them lose weight and improve blood lipid test results.

If you’re of the squeamish sort, prepare for a bit of grossness as I bluntly state what happened to me and how I solved the problem. What I have to say could help you make effective use of Alli when it might otherwise work poorly for you, so please forgive my graphic descriptions as necessary to convey the information.

My Initial Alli Experience

About five months ago, I started taking Alli for my biggest meal of the day. Initially I tried taking two of the little blue 60mg capsules per meal, the maximum dosage recommended and the same amount of active ingredient as the 120mg capsules of Xenical.

Unfortunately, I readily got what I’d describe as “yellow/orange fat oil runs” from that. This is the big bad nasty side-effect of Alli. When it blocks the action of the fat digestive enzyme lipase in your digestive tract, the resulting undigested fat flows out as an almost fluorescent yellow and orange oily goo. Often it looks like little oil droplets sitting on the water in the toilet. Your used toilet paper looks sort of like somebody painted it orange and yellow. This in itself isn’t so big a problem. The problems comes from how Alli’s effect on your fat digestion makes you run to the bathroom in a panic at times. Worse, the yellow/orange oily goo doesn’t just come out when you intentionally sit down to defecate.

The worst part about this oily goo is that you can find yourself with your underwear and pants soaked through all the way through to the furniture on which you are sitting, yet all you thought you did was let out a quiet fart. It’s truly disgusting and also very embarrassing. Furthermore, the oily stain is very difficult to get out of clothes. Even with stain removers and laundry detergents with enzymes, you may still find your underwear with embarrassing yellow and orange streaks. Light-colored pants, shorts, skirts, and dresses could also be similarly stained, perhaps badly enough that you won’t want to wear them again. That could be costly.

Such problems made me think about stopping my use of Alli entirely. But after years of trying to reduce my weight mostly with no success, I was finally loosing some weight! I was motivated to find a way to solve the problems caused by Alli without impeding its effect.

At the same time, my LDL cholesterol and triglyceride levels plummeted dramatically. I’ve had problems with those being high for as long as I’ve been tested for them and along with my weight was never able to get them to budge significantly despite years of attempts by lowering food intake, increasing exercise, and using various dietary supplements. My liver function tests (AST and ALT) also improved, too, possibly indicating that my fat loss is helping to reduce my fatty liver disease.

While I don’t believe that Alli is the sole reason for my weight loss, waist size reduction, and improved blood lipids, I think it has helped a lot. So I really didn’t want to stop using it, despite the bad digestive side effects.

Alli’s Digestive Side Effects are Common

I’m not the only one to have these digestive problems cause by Alli. They are very common, but vary tremendously based upon the individual, how much Alli you take (taking two capsules causes more trouble than one), and how much fat is in your meals. On this thread on a weight loss forum, one writer mentions:

(from Alli the worst side effects — liquid, oily, orange)

The orange poop oil (sometimes called anal leakage) is annoying because it’s very viscous and seems to penetrate clothes immediately — sometimes all the way to the bottom of the chair. If you are wearing something light, like white pants, it can be very embarrassing when you are in public places. It sure makes a mess! You can’t hide the evidence either because as soon as you get up the chair will have the dreaded spot of poopy oil.

Sometimes you will get enough warning to rush to the bathroom but other times you won’t know about it unless someone asks you what is on your butt, or you see it on the chair. Unfortunately the poop oil can seep out without giving you a sensation that there is leakage so you won’t even know unless you get a warm wet feeling — and by then it’s way too late. By the time you feel it your pants are going to be soaked — unless you are lucky enough to be very close to a wad of toilet paper.

The oil can range in color from a light yellow [/b]to a dark red. Usually it’s a bright orange color, and for some reason it shows on all clothes.

You should really read the whole thread to understand the range of experiences and thoughts on Alli.

Side Effects Are “Helpful Encouragement”

One of the common spin jobs on the nasty digestive side effects is that they will help encourage you to eat less fat. By this reasoning, Alli is supposed to help train you to lower your fat intake by making the eating of fatty meals unpleasant. It’s advised that you eat meals with 15 grams of fat or less when using Alli. If you eat lots of fat, you get lots of unpleasant digestive effects. If you eat less fat, then there will be less undigested fat flowing through your guts causing unpleasant bodily outputs.

Realistically, there times that you simply can’t eat 15 grams or less fat without wholesale avoidance of tasty-looking food because you don’t know what ingredients are in the food. Other times, it is easy to cut out a lot of fat. Easy steps would be to not eat the fatty skin on chicken, cut off the fatty portions of a steak, and avoid fried fatty foods like donuts.

You could also simply avoid taking Alli with really fatty meals. But this defeats its purpose.

If you like to cook or have a partner or roommate who does, one of the best solutions to reducing the fat in your diet is finding appropriate recipes that you like. Vegetarian cookbooks are a good choice as they often have low-fat dishes that are souped up with spices to make them tasty. There’s also an Alli cookbook available that may help you find some favorite low-fat recipes:

Straightforward, TASTY recipes; many more than you get in the basic book
By “AmazonComWoman” (Dayton OH)
February 21, 2008

I was very surprised to see the other review for this book, but then I saw the line about the person NOT owning it. I preordered this book, and like the other reviewer, felt that the recipes would be the same…however, I forgot to cancel the preorder, so lo and behold, it arrived at my house in mid-December. This has become my FAVORITE diet cookbook! Unlike the South Beach Diet cookbooks, which contained laundry lists of ingredients and yielded usually unflavorful dishes, the Alli Cookbook contains (1) many, many more recipes than are found in the main book–250 pages of recipe text alone, (2) food for a large variety of tastes including vegetarian, (3) carefully thought out and easy to prepare dishes, (4) creative and interestingly seasoned dishes, and (5) dishes you would never think you would find in a diet cookbook. I am somewhat of a picky eater when it comes to “healthy foods” and I was still able to find dozens of recipes to suit my tastes. The bottom line is that this cookbook has helped me succeed on the Alli plan by adding needed variety and easy-to-cook dishes to my meal plan — so much so, that even when I get busy and forget to take the pills for several days, I still lose weight and almost never feel deprived. I don’t think I would be at the point in the diet with the recipes in the Alli Diet Plan book alone, and I credit this cookbook. (Since starting the diet in mid-November, I’ve lost 15 pounds, even with some cheating around the holidays, and I’m within 10 pounds of my overall goal.) If you want to enhance your chance for success on the Alli plan and want to enjoy some really flavorful dishes, you need to add this book to your Alli toolkit!

Solving the Nasty Yellow/Orange Runs Problem from Alli

I tried to reduce my fat intake. Although it wasn’t all that high most of the time in the first place, I still had unpleasant side effects when taking 120mg per meal. The further reduction I accomplished didn’t help much. My next step in reducing the nasty digestive effects was to take just one capsule of Alli per meal. According to the literature, this reduces its effectiveness from blocking about 1/3 of fat from digestion to about 1/4. There was certainly a reduction in yellow/orange goo, but it didn’t fix the problem entirely. So instead of having big messes every day or two, it was once or twice per week. This was still an unacceptable level.

I thought about what was happening to make the undigested fat run through my guts and make such a big mess. If there was a way to absorb it and let it out slowly, along with regular poop, that would help a lot. Rather than just letting the undigested fat run through my guts and out the end as yellow/orange oil, having it “captured” as something more similar to regular digestive tract output would greatly reduce the worst of the side effects. Fiber supplements are the answer that came to mind. They can do exactly what is needed to prevent out of control fat flows.

Unfortunately, fiber supplements have their own side effects. Some people find that particular kinds of fiber leave them feeling bloated or gassy. Thus the answer seems to come down to finding a combination of fiber products that work comfortably for you. Some people can’t take certain kinds of fiber. Psyllium husk, for instance, has a reputation of causing digestive discomfort more often than many other forms of fiber.

I added in fiber before and after dinner. I take a mixture of fiber supplements including chitosan, oat bran, gymnema sylvestre, grapefruit pectin, and a colon cleanser before dinner. This adds up to about 3 to 4 grams of extra fiber. After taking these and before eating dinner, I take a 60mg capsule of Alli and a phytosterol (plant-based) cholesterol blocker. I also take Life Extension’s Enhanced Calorie Control Complex which includes both Irvingia (which among other effects helps reduce hunger) and components that block complex carbohydrate absorption, thus tending to cut out some of the calories from starch and also reducing the postprandial (after-meal) sugar spike from jacking up my appetite excessively. After that, I eat dinner. Then I take a little more fiber, generally more chitosan and oat bran, about another 1 to 2 grams of fiber.

Since I’ve started using the fiber in this way, I haven’t had more “yellow oil runs” in months. It sops up the yellow/orange oil left behind by the Alli very effectively. I’m still more gassy than I used to be without taking any of these supplements, but that’s a far less troublesome problem than yellow/orange goo seeping out all over my underwear and pants.

As an added bonus, additional fiber helps absorb and bind up some of the fat before any lipase not affected by the Alli gets a chance to start digesting it. That should help improve weight loss a little more.

So in brief, it appears that combining Alli with a few grams of added fiber can get you a bunch of benefits:

  1. It sops up the yellow/orange oil, keeping it from running through your guts uncontrollably.
  2. The odds of an embarrassing and messy “fat flow” through your clothes is greatly reduced.
  3. Fiber helps clean out your digestive tract and absorb other nasties from the foods you eat.
  4. Fiber also helps soak up fats and oils that might otherwise be digested.
  5. Fiber supplements are often less expensive than Alli, so if they allow you to use one 60mg capsule rather than two 60mg capsules to get a similar weight loss, it could save you a lot of money.

Fiber alone also helps in some of these areas, plus it helps reduce postprandial (after-meal) sugar spikes, too.

Even if you decide to not try Alli or stop it, you should really consider using fiber supplements for their health benefits.

(from Obesity: Strategies to Fight a Rising Epidemic)

When it comes to weight loss, fiber has not received the attention it deserves. The recent focus on carbohydrates has led some people to reduce their intake of whole fruits and some vegetables because these foods contain carbohydrates. By doing this, those dieters deprive themselves of the many benefits of a naturally fiber-rich food source. According to the American Heart Association (AHA) and the National Cancer Institute (NCI), Americans should consume about 30 g or more of fiber every day. The actual average consumption, however, is between 12 and 17 g (AHA 2005; NCI 2005).

Consumed before a meal, soluble fiber has multiple benefits. First, it is filling and causes people to eat less because they are satiated sooner. Anecdotally, LE has received reports that some people can actually cut the size of their meals in half by consuming a glass of soluble fiber mix before eating.

Equally important, consuming fiber before meals can reduce the rapid absorption of simple carbohydrates (such as refined sugar) and modulate blood sugar levels (Anderson et al 1993). A review of clinical studies of fiber shows that it has numerous weight-loss benefits, including the following:

  • Soluble fiber-rich bread improved glycemic control, reduced blood pressure, and decreased cholesterol and triglyceride levels (Nizami et al 2004).
  • Consumption of an additional 14 g of fiber per day for more than two days was associated with a 10 percent decrease in calorie intake and body weight loss of 1.9 kgover 3.8 months (Howarth et al 2001).
  • A prospective cohort study showed that weight gain is slowed with higher intake of high-fiber, whole-grain foods, whereas study subjects put on more weight when consuming refined-grain foods (Liu et al 2003).
  • A prospective, randomized, double-blind study showed that soluble fiber supplements can increase post-meal satisfaction (satiety) significantly (Heini et al 1998).
  • A randomized controlled clinical trial demonstrated that soluble fiber can lower lipids and plasma glucose levels (Aller et al 2004).
  • A clinical trial suggested that a diet rich in fiber may lower blood pressure moderately (He et al 2004).
  • A highly regarded study in the New England Journal of Medicine showed that a high-fiber diet (50 g fiber, including 25 g soluble and 25 g insoluble) lowered 24-hour plasma glucose and insulin concentrations (Chandalia et al 2000).

Soluble fiber is found in oat bran, barley, vegetables, fruits, and other foods. However, for weight-management purposes, it is important to have soluble fiber before every meal. Therefore, soluble fiber supplements (such as powders or capsules) should be kept where meals are consumed, such as the kitchen or the office.

Some people shy away from fiber because they experience lower bowel disturbances if too much fiber is consumed at first. This can be avoided by beginning with a low dose of fiber before each meal and gradually increasing doses over a two- to three-week period. Once the body adjusts to increased fiber intake, gastrointestinal side effects usually disappear.

Reducing Gas

I’m fairly certain the increased gassiness I am sometimes experiencing is not related to the Alli itself. That’s because it sometimes happens when I haven’t taken any Alli at all. Although I’ve experimented with variations in my supplements, I haven’t been able to determine the exact supplements tied to the extra gas yet. My top suspect is the combination of the added fiber interacting with the carb-blockers in Life Extension’s Enhanced Calorie Control Complex that reduce the effectiveness of the alpha-amylase enzyme at breaking complex carbohydrates down into forms that can be absorbed by the body. The combination seems to result in extra gas that doesn’t happen with either fiber or Enhanced Calorie Control Complex alone. The result seems to be that digestive tract bacteria get more complex carbohydrates because the body doesn’t absorb them and as a result produce more methane, thus resulting in extra gas.

Some of the carb-blockers in Life Extension’s Enhanced Calorie Control Complex are derived from white kidney beans. As you may recall, there’s a ditty “beans, beans, the musical fruit, the more you eat, the more you toot” referring to their gassy effect on many people. I used to think that might be from the fiber as fiber has a reputation of causing such effects. However, some meals I’ve had a considerable quantity of beans and skipped my nutritional supplements and didn’t toot. I’ve also tried another white kidney bean derived carb-blocker apart from Alli and noticed a similar “enhanced tooting” effect. Wikipedia claims that the cause is oligosaccharides in the digestive tract being consumed by bacteria that release hydrogen and carbon dioxide. However, I think there’s more to it than this.

I’ve been experimenting to determine how to reduce the gassiness, but haven’t arrived at a solution using my normal diet and set of nutritional supplements. If I figure out a solution, I’ll write about it on this website and link this article to it so you might want to check back in the future. However, at the moment I’m not optimistic there will be a trivial solution for this without significantly reducing carbohydrate intake, abandoning the use of carb-blockers, or significantly increasing the monthly cost.

The Wikipedia article on flatulence points out that undigested carbs that make their way to the large intestine are one of the results of low alpha-amylase (caused by carb-blockers in this case) and normal bacterial activity. The only two “solutions” they mentioned that seem to be compatible with carb-blockers are “activated charcoal underwear” (invented in 1998) or an “internal deodorant” called bismuth subgallate that is primarily used by people who have had severe gastrointestinal disorders and/or surgery. I found that bismuth subgallate is sold for about $13.00 for a bottle of 100 tablets as a product called Devrom from JRS Medical. So far, this problem isn’t so severe that I’m willing to give it a try.

Nutritional and Timing Considerations for Alli and Fiber

As you may know, many important nutrients are fat-soluble. Vitamins A, D, E, and K are all fat-soluble. Omega-3 fatty acids such as those found in fish oil supplements are, too. So are many other nutritional supplements. If you were to take Alli for every meal and always take your nutritional supplements with meals, you’d likely be contributing to your own malnourishment and vastly reducing the effectiveness of the nutritional supplements because you’d interfere with their absorption. There are three significantly helpful steps you can take to keep the fat-digestion busting effects from Alli from interfering with your nutrition.

Take Fat-Soluble Vitamins Far Apart From Alli

The first step is to time your use of Alli at least a couple of hours apart from any fat-soluble supplements. Switch all your fat-soluble nutritional supplements away from the meals with which you take Alli. Alli blocks the fat-digesting enzyme lipase for about two hours.

Like most people, my biggest meal is dinner. I only take Alli with dinner or other large meals. So I try to take most of my supplements for the day by an hour or two before dinner. This gives them time to move far enough along in the digestive tract that the Alli and fiber won’t significantly interfere with my body’s ability to absorb all those helpful fat-soluble nutrients.

For the supplements I take after dinner, I make sure to allow at least a couple of hours after taking Alli before I’d take a fat-soluble supplement.

Add Vitamin A, D, E, and K Supplements To Your Diet

The second major step to prevent malnutrition while using Alli is to ensure you get enough vitamin A, D, E, and K by using supplements. At a minimum, I’d recommend daily consumption of a good quality multivitamin with at least 5000 IU of mixed vitamin A forms, a separate vitamin D supplement with at least 2000 IU, and the Life Extension Super Booster with Advanced K2 Complex product that includes significant dosages of multiple forms of vitamin E and vitamin K along with other helpful nutrients including lycopene and selenium.

Don’t overdo it with retinol forms of vitamin A. They can interfere with vitamin D and hurt your bone health severely, especially if you are not taking a lot of vitamin D. Try to get most of your vitamin A intake from beta carotene and limiting your vitamin A retinol form intake to 4000 IU or less per day. If you have a reasonably healthy liver, your body can convert beta carotene into the active retinol form of vitamin A as needed. I personally consume most of my vitamin A via inexpensive 25,000 IU beta carotene supplements.

Take at least 2000 IU per day of vitamin D for adults. You probably need a lot more than this, even 5000 IU per day is not enough for many adults, especially if they are overweight. See our article Higher Vitamin D Levels Improve Weight Loss and Health for more information on how inadequate vitamin D intake makes it more likely you will suffer from excessive weight and weight-related illnesses such as diabetes. Our article and Adjusting Your Vitamin D Intake to Optimal Levels can help you understand how to quickly boost your vitamin D levels and then fine-tune your vitamin D intake to achieve optimal levels.

Super Booster with Advanced K2 Complex includes the highly beneficial vitamin K2 variants MK-4 (menaquinone-4) and MK-7 (menaquinone-7) that are far better utilized by the body than common vitamin K which is usually the K1 (phytonadione) form. These forms typically cost more to get via separate vitamin K2 supplements than the Super Booster product itself costs even though it includes many other important nutrients in addition to similar or larger dosages of MK-4 and MK-7. Life Extension products sometimes appear to be premium-priced, but Super Booster is arguably one of the best bargains versus even discount-priced brands. You’ll see this if you research what it would cost to replicate its content via other supplements. A simple discount-brand 100mg vitamin K2 MK-7 supplement can cost almost as much as Super Booster. Yet it also includes all four forms of vitamin E tocopherols (alpha, beta, gamma, delta), including the important gamma tocopherol form that is not common in multivitamins or many separate vitamin E supplements such as those you commonly find at Costco and your local grocery and pharmacy.

This last comment probably bears some explaining for many readers. Most cheap vitamin E supplements include only the alpha tocopherol form of vitamin E which is just one of eight possible forms, four of which are called tocopherols and four which are called tocotrienols. Supplementing this form alone, without gamma tocopherol, can actually hurt your health because it displaces gamma tocopherol from insides your cells and thereby hurts their ability to protect cell interiors from oxidative damage. As Life Extension explains it:

If one consumes only alpha-tocopherol, the critically important gamma tocopherol is displaced from cells within the body.70 While alpha-tocopherol vitamin E suppresses lipid peroxidation, the gamma-tocopherol form quenches the dangerous peroxynitrite free radical. It is especially important for those who take vitamin E supplements to make sure they consume at least 200 mg gamma-tocopherol daily.

You can read more about the different forms of vitamin E and why gamma tocopherol is important in the article What Makes Gamma Tocopherol Superior to Alpha Tocopherol.

Another consideration is that cheap vitamin E products often use mixed D and L forms which are only 50% effective as the D form. So if you’re using the really common 400 IU vitamin E capsule composed of DL alpha tocopherol, you’re really only getting about 200 IU of the D alpha tocopherol form and it’s possibly hurting your health by removing gamma tocopherol from your cells.

For example, look at the Costco Kirkland Signature™ Vitamin E 400 IU product. At the time of this writing, you get 500 softgels of 400 IU each for $13.99. That sounds like a pretty good deal until you read the fine print regarding ingredients and discover that it uses DL alpha tocopherol and doesn’t include any gamma tocopherol. A product like that might hurt your health, not help it. Costco should really reformulate that product to include gamma tocopherol and use the D form of the tocopherols rather than the mixed D and L forms they use now.

One note of caution, if you have any kind of bleeding or clotting disorders, you should discuss the use of vitamins E and K with your doctor or spend some time learning about them to make educated choices. Vitamin K counteracts the effect of Coumadin (warfarin) which is a very common medicine used to prevent blood clots. Vitamin E tends to increase clotting time and increase bleeding risk somewhat. But don’t take this as a blanket warning not to use vitamin E and K if you are taking anticoagulation medicines, rather as a caution that you need to do some reading and discuss the matter with your doctor or pharmacist managing your Coumadin (warfarin) therapy. There’s evidence that Coumadin (warfarin) therapy works more consistently when used with vitamin E and K. Other evidence shows that such anticoagulation therapy over long periods of time can really hurt your body by depleting your bones of calcium and depositing that calcium as plaque on the inside of your arteries and veins. If you think this may apply to you, read the articles Vitamin K & Warfarin: Stabilizing Anticoagulant Therapy—While Protecting Cardiovascular and Bone Health and Protection Against Arterial Calcification, Bone Loss, Cancer, and Aging! for more information.

Selectively Using Digestive Enzymes

The third step may not be necessary for a lot of people, but you should consider it especially as you past 50 years of age and your body may be slowing down on the production of digestive enzymes. What you can do is to take a digestive enzyme supplement containing lipase along with any fat-soluble supplements you take within several hours after a meal with which you consumed Alli.

For Alli to work well, you want to give your meal time to move through the digestive tract for a couple of hours or more before you do anything to boost your lipase levels with a digestive enzyme supplement.

Let’s consider a couple of examples.

First, let’s say you use Alli with both lunch and dinner because you tend to eat big lunches. With breakfast at 8am, you could take many of your fat-soluble supplements. Take Alli with lunch at noon and with dinner at 7pm. If you take more fat-soluble supplements or medicines, take a digestive enzyme capsule with lipase along with them shortly before you go to bed at 11pm. This gives plenty of time for most of the undigested fat from the meals to move along in your digestive tract before you introduce the lipase and fat-soluble supplements.

As a second example, you could take all your fat-soluble supplements with breakfast. To be sure your body absorbs these well, you could take a digestive enzyme product containing lipase along with breakfast and be sure to consume at least a few grams of fat to allow the larger quantity of fat-soluble supplements to be absorbed well. If you don’t each much fat for breakfast, you could add in fish oil, lecithin, or other beneficial fatty supplements to your meal to help ensure there’s enough fat to absorb the fat-soluble supplements well.

Results: Fat Loss, Muscle Gain, and Waist Shrinkage

I’ve transformed some of my fat into muscle. The most obvious way I can tell this is probably what has happened is that all of my pants are more loose and some of the pants I “outgrew” from fat gain many years ago actually fit again even though I still weigh more than I did then. This is certainly a good thing, but I have more fat to lose as I’m still overweight for my height. My total weight loss so far has been about 16 or 17 pounds in 5 months. My waist size has dropped considerably, too. Belts that were on the verge of being too tight are now too loose. I probably need to buy some new clothes, but hesitate to do so because I suspect my body improvements may continue for a while longer.

My weight loss has not been astronomical or rapid, but that’s OK with me as rapid weight loss actually is not a good thing. Losing about a pound per week is a safe rate for most people. Lose more than two pounds per week and you may actually be harming your health. Sure enough, I was losing about one pound per week for the first couple of months and then the weight loss slowed down. This is a healthy rate, the kind of weight loss you should be aiming to achieve as I’ll explain next.

Fatty Liver Disease Worsened by Rapid Weight Loss

Many people have a common medical condition known as fatty liver disease but don’t even know it. I’m one of them. I didn’t find out about it until having an ultrasound of my abdomen for something completely unrelated. The ultrasound technician noticed fat accumulations in my liver. In the US, fatty liver disease could affect as much as 40% of the population. That’s based upon how fatty liver disease or more advanced forms of related liver degeneration occur in about 10% to 24% of the general population and 75% of the obese population (BMI or body mass index of over 30) and how about 1/4 of Americans are obese. It’s a major problem and it is likely affecting many people you know who have been significantly overweight for years but they probably don’t even know it.

In case you don’t know your body mass index (BMI), you can calculate your BMI easily. The link provides both English and metric units. For your information, when I started my weight loss, my BMI was 30.9, meaning I was considered obese. Now with a BMI of 28.3, I’m merely overweight. I have about another 22 pounds (10kg) to lose before I’m on the high end of normal weight which is defined as BMI from 18.5 to 24.9.

(from Obesity Can Lead to Fatty Liver…a Silent Killer)

Alarming statistics about nonalcoholic fatty liver disease

As expected, nonalcoholic fatty liver disease is observed principally in developed countries. In these societies, a sedentary lifestyle and high calorie, sugar, and fat intake lead to a high prevalence of obesity, insulin resistance, and diabetes.

Nonalcoholic fatty liver disease is currently the most common liver disease in the U.S. and worldwide, affecting estimated 10-24% of the world’s population. In the U.S., the Centers for Disease Control reports that currently, approximately one half of the U.S. adult population is overweight (BMI>25) and one quarter of the U.S. adult population is obese (BMI>30). That means upwards of 29 million Americans have nonalcoholic fatty liver disease, while 6.4 million of these persons have nonalcoholic steatohepatitis (NASH). Even more alarming than these statistics, nonalcoholic fatty liver disease is occurring among children in the U.S.

In most patients nonalcoholic fatty liver disease causes no symptoms. Nonalcoholic fatty liver disease often is discovered when routine blood tests show slightly elevated levels of liver enzymes (ALT and AST) in the blood. (For more, please read the Liver Blood Tests article.) Another way in which nonalcoholic fatty liver disease is discovered is when ultrasound examination of the abdomen is done for other purposes, say for looking for gallstones, and fat is found in the liver. In the late stages of non alcoholic fatty liver disease, the development of cirrhosis can lead to failure of the liver, swelling of the legs (edema), accumulation of fluid in the abdomen (ascites), bleeding from veins in the esophagus (varices), and mental confusion (hepatic encephalopathy). Patients with cirrhosis caused by Nonalcoholic fatty liver disease also may be at risk of developing liver cancer (hepatocellular carcinoma, HCC).

People with one of the variants of fatty liver disease usually need to lose weight, but must also be cautious not to lose it too quickly. Those who lose more than about one to two pounds per week are at much higher risk for permanently damaging their livers.


Overweight or obese people with NAFLD can usually normalize the elevations in liver enzymes, decrease some of the enlargement of their livers, and diminish the amount of fat in their livers merely through weight reduction. A weight loss of approximately 10 percent can significantly correct these abnormalities. If weight reduction is achieved early in the disease, progression to scarring and cirrhosis can possibly be prevented altogether. In fact, in one study, weight reduction actually reversed some scarring (fibrosis, not cirrhosis).

Three points need to be emphasized concerning weight reduction. First, weight loss must be sustained, or the disease will recur. Second, weight reduction must be achieved through reasonable methods, and it must occur at a slow pace. This means that people should aim for a 1-2 pound weight loss per week. Excessively rapid weight reduction or starvation techniques can actually worsen or even precipitate progression to cirrhosis and liver failure. Obviously, this is at odds with the purpose of the weight reduction. Furthermore, rapid weight loss has been shown to put people at risk for gallstone disease. In addition, it can adversely affect a person’s overall health. Finally, an exercise routine must be incorporated into any weight-reduction routine.

Next Steps

Shortly I’ll be writing about a few other nutritional supplements that can help you lose weight. In my case, I think that the reason I’ve been finally able to lose weight is because I’ve combined several approaches and that no one approach would be enough to achieve significant weight loss on its own. I suspect that many other people who have tried for years to lose weight may have similar obstacles.

Go read the article The Nine Pillars of Successful Weight Loss and then check back here. I’ll add the links to additional articles in this series below when they’re ready for you to read.

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Supplements Mentioned

This is a 90 capsule package that comes with a small usage information booklet and a pill carrying case. It’s sold as the “starter pack” for people who value the extras, but isn’t as good of a deal as the refill packs in terms of the cost per capsule.
This package is a “refill pack” meaning that it doesn’t come with the little pill carrying case and usage manual. It contains 120 capsules of Alli. Using Alli is pretty simple, so I personally think this is a better value. The price on this varies, sometimes it is a better deal than the larger refill packages.

Compare the number of capsules vs. price of this to the 170 and 360 capsule refill packages below. Sometimes this smaller package is actually a better deal.

This refill pack comes with 170 capsules and is a better value than the smaller packages. I don’t recommend starting with this as you might find Alli’s side effects are too intolerable, but once you’ve figured out it is working for you and get the side effects under control, this is a good choice for continuing to use it long-term.

Compare the number of capsules vs. price of this to the 120 capsule refill package above as that product is sometimes less expensive.

This refill pack comes with 360 capsules, making it one of the best values. I don’t recommend starting with this as you might find Alli’s side effects are too intolerable, but once you’ve figured out it is working for you and get the side effects under control, this is a good choice for continuing to use it long-term.

Compare the number of capsules vs. price of this to the 120 capsule refill package above as that product is sometimes less expensive.

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Further Reading

Obesity: Strategies to Fight a Rising Epidemic

New Findings on Fiber: Research Confirms Benefits of Fiber for Weight Loss, Lower Cholesterol, and Reduced Blood Glucose.

Why Aging People Fail to Lose Weight

Turn Off Your Fat Switch: Understanding the Risks of Leptin Resistance

More Weight Loss than Any Other Discovery in Supplement History

Obesity Can Lead to Fatty Liver…a Silent Killer

Calculate Your Body Mass Index

What Makes Gamma Tocopherol Superior to Alpha Tocopherol

Vitamin K & Warfarin: Stabilizing Anticoagulant Therapy—While Protecting Cardiovascular and Bone Health

Protection Against Arterial Calcification, Bone Loss, Cancer, and Aging!

These statements have not been evaluated by the Food and Drug Administration. The products mentioned in this post are not intended to diagnose, treat, cure or prevent any disease.

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  1. Heather
    August 20th, 2015 at 03:48 | #1

    Thank you for the article!! I recently began taking 120 orlistat twice a day with meals. I’m having your uh “issue” you had, as well hehe :/ Is it for SURE that the orlistat will still work if I take fiber? You said it binds up the goo, is it a for SURE that it won’t cause me to re absorb that fat?

  2. Anon
    August 5th, 2016 at 20:54 | #2

    It literally says on the packaging of fiber supplements to not take them within 30 minutes before or after taking medication. The “side effects” have lessened because the fiber has absorbed a part of the medication, not the oil in your digestive track. I’m not trying to be mean to you or anything, but consult a pharmacist. I’m going to be correct on this one.

  3. Claudia
    January 18th, 2017 at 14:32 | #3

    I´ve been taking all for two months, been eating the same but now I don´t get oily stools at all…Does this mean it´s not working?

  4. sTTu
    February 11th, 2017 at 12:32 | #4

    So no results with diets until taking the fat blocker in your diet, then the weight loss starts.

    Hmmm, in other words some of the food you had consumed was not being digested, just as if you hadn’t actually eaten it.

    Here’s a thought then – how about just not eating the pies in the first place and save pounds on the Orlistat!!

    I lost half my body weight with just sensible diet and exercise, no magic pills required.

  5. Kez
    March 21st, 2017 at 00:24 | #5

    Some people myself included have weight problems due to medical issues mine being epilepsy I go to the gym 4 to 5 times a week eat a sensible diet and am still considered obese. Orlistat in some cases is a last resort and to assume people just sit about and eat up all the pies just shows your small mindedness. Congratulations on losing your weight now around of applause to you!

  6. Lorrie
    May 8th, 2017 at 05:08 | #6

    I’m very overweight. I started a dieting as best as I could a year ago last May (2016). By last Nov (2016) I had lost a whopping 16 pounds. Then came the holidays. I gained back 6 of the 16 I had lost. I have lost 4 of those 6 pounds. I have rarely had consitpation issues in my life but for whatever reason, 20-30 years ago I started taking psyllium fiber. (I don’t remember why I started taking them now.) My friend who does have constipation issues, told me she uses Alli to help her when she gets very stopped up. I decided to give it a try because my weight loss has been so slow. I have not finished my 1st bottle of Alli yet. I found out quickly about the undesirable side affects. I had stopped my normal daily handfuls of psyllium because I was afraid it would reduce the effectiveness of Alli. I have rarely ever been hungry in the morning. Dad would say I couldn’t go to school without something to eat & he would give me a piece of toast. I fed it to the dog in the porch on my way out to catch the bus. I have rarely ever been hungry during the day but I eat a “never ending” supper. I was very happy to find this article. Going back to my normal daytime handfuls of fiber will make me very happy. And now I can avoid the nasty side effects of Alli. I’ve been searching the internet to see if my fiber would interfere with Alli’s effectiveness. This was the 1st article I’ve found relating the two (Alli and fiber). Thank you.

  7. Mike Hunt
    March 10th, 2018 at 08:01 | #7

    You hold your right with your 4 fingers straight out (side by side) and your thumb straight up so it’s 90degrees to your fingers. You wrap/loop toilet paper around the 4 fingers 3 or 4 loops or more. Slide this wad in between your butt cheeks. This is your 1st defence against farting/oozing the orange slime. Replace as needed.

  8. Joe
    May 27th, 2018 at 00:50 | #8

    I suspect the fiber + orlistat combo is one good solution for the “orange goo” problem.

    I came across this page after passing the orange goo for the first time after taking orlistat regularly for several months with successful weight loss. I wanted to know why it suddenly started. I usually eat a very high fiber diet, 40 grams a day or so. The goo occurred while I was on a long vacation and was eating low fiber processed food.

    One comment suggested the fiber effect was because it soaked up the medication. I do not believe that is the case as I experienced weight loss with the medication while on a high fiber diet and observed a change in the caliber and color of my stool after taking the medication. Not the nicest thing to think about, but it lends credence to the idea the fiber soaks up the fat droplets.

    It is important not to make diet adherence and obesity a question of morality or having a strong will, sTTu. Millions of people struggle with weight problems. Our brains and bodies are not wired to live in modern environments. Any durable, safe solution should be welcomed.

    I ea

  9. Former Alli User
    August 7th, 2018 at 18:44 | #9

    The Alli / Orlistat is NOT absorbed in the first place. It is not a medication that is designed or intended to be absorbed into the bloodstream. The maker of it wants it to bind to fat so that neither can not be absorbed.

    So you should not want the Alli / Orlistat to be absorbed into the bloodstream.

    Therefore what is the problem with the fiber?

    I would suggest only taking this Alli / Orlistat apart from nutritious meals, such as when eating junk like a donut or pizza. Certainly do not take it with fat soluble vitamins as you will just waste those vitamins. Then work at phasing out the junk and eventually getting off the Alli / Orlistat.

    Be sure to take some fat soluble vitamin supplements away from Alli / Orlistat with some healthy fats such as coconut oil, grass fed butter, extra virgin olive oil on a salad, etc. Otherwise you may be depriving yourself of vitamins such as A, D, E, K, and even minerals that need fat to be absorbed.

  1. January 1st, 2011 at 05:21 | #1
  2. April 12th, 2011 at 01:21 | #2

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