From time to time, I actually read posts and see what kind of responses are generated for a bit before I make any set of formal assessment. The reason is this; I am curious what kind of response might be generated. Make no mistake, I have likely seen your question but am waiting patiently to make comment at the appropriate time.
This particular agent reminds me of any fad - in particular the dietary supplement derived from shellfish used many moons ago known as chitosan - which had about 20 supportive studies behind it that stretched from 1994-2002ish and since it has lost favor. Chitosan blocked fat much like fiber does from being absorbed.
Along come the pharmaceutical alternatives Xenical (orlistat) and Alli (the OTC version), which work distinctly different. They attach to and partially disable lipase, an enzyme that breaks down fat for digestion, so about 30% less fat is digested and the undigested fat is excreted. Hell, that's what fecal matter is - undigested material.
Even though both work distinctly different - there is a common bond.
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Let's take something that blocks carbohydrates...in the supplement world, we know of various
[1] starch blockers (White kidney bean, Wheat, and/or Hibiscus are used supplementally)
-or-
[2] sugar blockers (L-arabinose)
So - what happened? They worked and worked as well as the fat blockers above (including Alli). Its like dieting eras and it just depends on which macronutrient we are trying to bastardize at the time (though macronutrient manipulation does have its place, its oftentimes not for the mainstream due to how tightly regulated it should be).
So - whether its fat being the enemy or Carbs being the enemy, the end result is less calories consumed and subsequently less weight gain or more weight lost.
The inherent problem? Well, there's NOTHING essential about eating a carbohydrate!!! Make no mistake about this. There is something VERY essential about fats (essential fatty acids) and proteins (essential amino acids) that you could become VERY sick without. In the fat department, you could even impede absorption of some micronutrients (fat-soluble vitamins), plus your hormones will be completely thrown off without fats as well. So while all diets will work to varying levels, so will all types of artificially-induced diets (i.e. - these agents that work to create a low-carb or low-fat environment). There is a less of two evils and it would be elimination of the carbohydrates no matter how much mainstream medicine doesn't want to hear it. Blocking fat is downright dangerous on so many levels.
Personally, I wouldn't prescribe a fat-blocker to a patient because I don't think its in the best interest of the patient from both a long-term weight loss perspective but also a health perspective. That said, Alli is a complete waste of medical funding on things that would better serve patient care. And I really harbor little care for how much the silly patent extension that dictates its continued production would suffer. Its downright terrible medicine and even more imporantly downright unhealthy.
Sorry for the stream-of-conscious rant after all that. I get excited every so often discussing many of these topics.
D_
