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Based on reading some of the websites it seems that their hypothesis is that because ALC is involved in the Krebs cycle in the mitochondria, which gets energy from fatty acids, that means ALC helps burn fat. There is not much in the scientific literature on this topic, but I did come across an article that found no difference in metabolic parameters in study participants taking L-carnitine versus controls (not exactly the same things as acetyl-L-carnitine, but they are used somewhat similarly in the body, there just isnt the extra acetyl group in the L-carnitine)

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When safety is methodically integrated into trial protocols, studies tend to experience lower participant drop-out rates, enhanced data reliability, and increased overall trial success

Anaphylaxis has been reported