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Will Americans buy it? The answer appears to be yes. After a huge marketing blitz, GlaxoSmithKline says the drug racked up $49 million in sales in its first three months -- 26% higher than the company had forecast. Allī now accounts for more than half of all sales of over-the-counter diet pills, according to research cited by

GlaxoSmithKline hopes to work out reimbursement plans with insurers. But most Allī users are paying for the pills themselves -- $50 to $60 for a 30-day supply.

Sometimes lost in the hype is the fact that Allī isn't new. It's a half-dose of Roche's prescription drug Xenical, with about 20% fewer side effects than Xenical.

Those side effects can be a bummer. Allī works by blocking digestion of fat, so fats you eat pass right through your bowel. If you eat more than 15 grams of fat at any meal (a hamburger and small order of fries has 38 fat grams), that extra fat means loose stools and gas with an oily discharge.

GlaxoSmithKline isn't downplaying the side effects. In fact, the company suggests that the side effects are a sign that you're still eating too much fat.

So does Allī really work? It's clearly a benefit for some people. Yet it offers only "modest" weight loss, according to a 2007 analysis of studies of Xenical (the prescription-dose version of Allī), Meridia, and Acomplia (approved overseas but, as Zimulti, not in the U.S.).

"People tend to be disappointed with the degree of weight loss they achieve with these drugs, even when they know that modest weight loss will improve their health," University of Alberta researcher Raj Padwal, MD, tells WebMD. "People who are desperate to lose weight are usually willing to try drugs, but if they don't see the results they want in two or three months they don't tend to stay on them."

Over studies lasting a year or more, Padwal and colleagues found that Xenical users lost an average of 6 pounds.

So what's the bottom line? Kathleen Zelman, MPH, RD, director of nutrition for WebMD, says diet drugs can help some people, but only in the context of a balanced, restricted-calorie diet and regular exercise.

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