I've read the reviews, and have some first hand experience with Alli.  I've been on these pills for three days now and have already noticed a difference.  My neighbor has lost 25 pounds since Christmas with some modifications to her diet (she does NOT count calories).  The key is to stick with the low fat diet.  What the pill bottle doesn't tell you is that you should keep your fat grams to a minimum of 15 per meal or less.  Now, I've been keeping them at half that if at all possible. 

I've been on Weight Watchers, Your Image, LA Weight Loss, Atkins, Low Fat, The Three Day Diet, etc., and have lost weight with all of them because of stick-to-it-iveness.  There are NO magic pills, but this one seems to aid tremendously in getting the weight off quicker.  Thank goodness, because my clothes are TIGHT!  My weight problems stem from genetics and having babies, by the way.  And I'm almost 40. 

Tips from someone who knows:  don't diet to lose a certain amount of weight; diet for a certain length of time and see how it works for you.  And schedule in a "cheat" meal once every two weeks and you'll be less likely to backslide for extended periods.

In a nutshell, Alli will work for those who are willing to change their eating habits to something more healthy.  Going from eating everything I wanted to low fat isn't easy but something's gotta give!  By the way, the pill seems to have decreased my appetite as well.  And I've not experienced the "squirts" like others may have, and it may be because of keeping the fat grams to a minimum.

Hope this helps!