Alli (pronounced AL-eye) is an over-the-counter drug meant for overweight adults struggling to shed excess pounds. With its easy access and weight-loss promises, is Alli your answer for losing weight? Alli is a 60-milligram, over-the-counter version of orlistat (Xenical), a 120-milligram prescription drug. Both Alli and Xenical are meant to be used as part of a weight-loss plan that includes a low-calorie, low-fat diet and regular physical activity. Alli is approved for use in adults 18 and older who have a body mass index (BMI) of 25 or more. Xenical is approved for use in adults with a BMI of 30 or more (obese), and those with a BMI of 27 to 29 (overweight) who have other health risk factors such as high blood pressure or diabetes. The Food and Drug Administration (FDA) published a safety review of orlistat in 2010 because of rare reports of serious liver injury in people using it. 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