Three studies out of Australia have shown a lower dose of orlistat, along with a reduced-calorie diet, may result in not only weight loss but improved lipid levels and blood pressure. The plan is to market a 60-mg dose of orlistat as Alli, which would be a low-dose version of Xenical (120 mg orlistat).

The studies included 1729 overweight people who either followed a reducedcalorie diet alone or followed the diet in addition to receiving 60 mg/day of orlistat. At 6 months, almost 50% of the orlistat group lost at least 5% of their body fat, compared with 26% of the diet-only group. At one year, 45% of the orlistat group lost at least 5% of their body weight, compared with 29% of the dietonly group. Other side effects of orlistat included a reduction in low-density lipoprotein cholesterol (6% compared with 1.5%) and blood pressures (a 4% decrease in systolic and diastolic pressure vs a 1.5% decrease in systolic and a slight increase in diastolic pressure). The studies also showed that the lower dose of orlistat is tolerated better than the 120-mg dose.

According to researchers, gastrointestinal-related side effects caused 3% of patients to discontinue the 60-mg dose, compared with 5.4% of patients taking the 120-mg dose. According to Vidhu Bansal, PharmD, of GlaxoSmith- Kline Consumer Healthcare, the drug's manufacturer, orlistat blocks absorption of approximately 25% of fat and would make "an excellent candidate for over-the-counter use for weight loss."

Ms. Farley is a freelance medical writer based in Wakefield, RI.