Sure it does. Just like Antabuse works for alcoholics. You drink, you vomit. With Alli, you eat fat, you crap yourself. If you knew you wouldn't crap yourself, you might eat a lot more. So sure, it "works." Should people be able to, knowing that, limit themselves to the small amounts of fat that would keep them safe and NOT take the Alli? Sure. But that's just not the way people work, Bert.  The makes of Alli are making large sums of money off of a pill that basically threatens its users...and the threat of unpleasant effects helps users feel some sense of dietary control. I feel the same way about my RNY. I am not sure I even HAD an RNY. I don't eat enough to dump or vomit. Maybe I had some placebo surgery and by my dietary changes alone am having the effects of an RNY. In the end, it was free and I stick to the plan, so it really doesn't matter to me: the results justify the means, or at least I hope they will. People are largely perceptual beings. Empirical facts and realities are not all that we are made of. Take "Homeland Security" as an example. After 9/11, I now must produce 6 forms of ID to get a driver's license in NJ. Now, any terrorist worth his salt can produce his own bogus driver's license, right? Of course. The program doesn't produce any *real* safety, probably, but by forcing each of us to forgo a civil liberty or two, we feel we surely must be safer. Right? The fact is safety really doesn't exist. Safety is something our minds like to think we can have, but all the best laid plans in the world won't stop terrorists or gravity or cancer cells from doing what they do. All we can do is prepare or set our minds to a space that helps us feel in some form of control. Alli does that for its users. So yes, it "works."