As Alli, the first FDA-approved diet drug cleared for over-the-counter sale, arrived Friday in drugstores across the US, doctors and nutritionists were gearing up to counter the hoopla .

They are warning consumers that the drugs high cost and limited effectiveness may not be worth its notably unpleasant side effects.

Alli (pronounced "ally"), sold by GlaxoSmithKline, is a half-dose of the prescription drug orlistat. The drug has been marketed in prescription form by Roche Holding AG under the brand name Xenical since 1999, but it never turned out to be a blockbuster.

GlaxoSmithKline, however, expects Alli ultimately to rake in at least $1.5billion in annual sales, and the company is expected to spend $150million on marketing the drug in its first year.

Television and magazine ads are running. E-tailers Amazon.com and Drugstore.com report that the drug, which has been pre-sold, already is a top seller even at a cost of $50 to $60 for a month's supply. Alli blocks enzymes that digest fat, preventing the body from absorbing about a quarter of the fat eaten. The undigested fat is then excreted. One study of Alli showed that dieters who took the drug along with diet and exercise over a year lost about three pounds more than people who only dieted and exercised.

The company's message is that the pills are not a "magic bullet," and officials urge users to use Alli only along with exercise and a reduced-calorie, low-fat diet.

But because Alli can interfere with vitamin absorption, it can affect how medications act in the body. The drug is not recommended for children under 18, people with kidney disease, patients on blood thinners and certain other medications, and pregnant or breast-feeding women.

Then there are the side effects, which can include oily discharge, diarrhea and uncontrollable bowel movements significant enough for the company to recommend carrying an extra pair of pants until u
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