Lose weight with Orlistat in a healthy and safe way

Orlistat (generic Xenical) is a weight-loss medication commonly prescribed to patients struggling with obesity. Alongside a healthy, low-fat diet and exercise programme, it can help you lose weight.

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which a doctor will review to determine if a prescription is appropriate.

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What is Orlistat?

Orlistat (Xenical) is a type of weight-loss medication that is prescribed to patients struggling with obesity. If taken in combination with a healthy, low-fat diet and exercise programme, it can help you to lose weight effectively and safely.

How does Orlistat work?

Orlistat is not absorbed into the bloodstream, but works locally in the stomach and small intestine by preventing an enzyme (lipase) from digesting fat. Approximately a third of the fat in your diet will be expelled in the body in your stools rather than being absorbed. This will help you to avoid gaining weight, but will only work is combined with a healthy diet and regular exercise.

How long does it take for Orlistat to work?

When taken correctly, Orlistat can help you start losing weight within 2 weeks and continue to do so for up to 12 months. However, if you have not lost at least 5% of your weight within the first 3 months of treatment, your doctor is likely to discontinue your prescription and discuss alternative weight-loss methods with you.

How will I know if Orlistat has stated working?

It is hard to tell if Orlistat is working, as it will only help you to lose weight if accompanied by a low-fat diet and exercise programme which should help you lose weight in themselves. Orlistat only works in the presence of dietary fat in your body, so if you cut fat out of your diet altogether, this treatment will have no effect. Eating a balanced, healthy diet, as recommended by a doctor or dietitian, is the safest and most effective way of losing weight.

How effective is Orlistat?

The effectiveness of Orlistat differs from patient to patient and is reliant on dietary changes and whether the patient is following an exercise programme. It is the only weight-loss medication proven to be safe and effective for use in the UK.

What to do if someone has an eating disorder and is taking Orlistat

Orlistat is prescribed to patients who are struggling with obesity and have failed to lose weight via other methods. It should never be used by someone who is of a healthy weight or underweight and is trying to lose more weight. If you suspect that someone you known is struggling with an eating disorder, try letting them know that you are worried about them and suggest that they speak to a GP. This can be difficult, as people suffering from eating disorders may not be willing to accept help. Visit the NHS website for advice on how to help if someone you know has an eating disorder.


Active ingredients

The active ingredient in Orlistat is orlistat.

Inactive ingredients

The inactive ingredients in Orlistat are cellulose microcrystalline PH 112,sodium starch glycolate (type A), silica, colloidal anhydrous, sodium laurilsulfate, gelatine, titanium dioxide (E171) and indigo carmine (E132).


How to take Orlistat

Always take Orlistat as instructed by your doctor. It should be taken in combination with a well-balanced and calorie-controlled diet that contains plenty of fruits and vegetables and contains roughly 30% calories from fat. You should also try to distribute your daily intake of fat, carbohydrate and protein evenly across your three daily meals. Swallow one capsules with water immediately before, during or within an hour of each meal. For best results, avoid eating fat-containing foods between meals, such as biscuits, chocolate and crips. 

If you miss a meal, or know for a fact that a meal did not contain fat, you do not need to take an Orlistat capsule. If you forget to take a capsule, try and remember to take it within an hour of our last meal. If an hour has already passed, just skip the dose and take your next one as planned with your next meal. Never take a double dose to make up for a missed one.

Orlistat dosage

Your doctor or pharmacist will decide the dosage of Orlistat that is right for you. The usual dosage is 1 x 120 mg capsule taken with each of the three main meals per day.

When can I stop taking Orlistat?

Orlistat should be taken for the duration prescribed by your doctor, and can be taken for up to 4 years.

How to stop taking Orlistat

After stopping treatment with Orlistat, you should stick to a healthy, balanced diet and exercise regularly to avoid putting weight back on. If you have not lost at least 5% of your body fat within 12 weeks, your doctor will discontinue treatment. 

Do I need to change my diet when taking Orlistat?

Before taking Orlistat, your doctor will recommend a healthy diet that is low in fat. You should begin this diet prior to treatment, for the duration and after you finish taking Orlistat.

Side Effects

Orlistat side effects

Like all medicines, Orlistat can cause side effects in some patients. If you feel unwell while taking this medication, tell your doctor or pharmacist as soon as possible.

The following side effects can occur in more than 1 in every 10 patients:

  • Headache
  • Abdominal pain/discomfort
  • Diarrhoea
  • Flatulence with discharge
  • Oily discharge
  • Oily or fatty stools
  • Low blood sugar levels
  • Upper respiratory infections
  • Flu

Common side effects (affecting 1 to 10 in 100 patients) include:

  • Rectal pain/discomfort
  • Soft stools
  • Incontinence
  • Bloating
  • Tooth/gum disorder
  • Irregularity of menstrual cycle
  • Tiredness
  • Anxiety
  • Lower respiratory infections
  • Urinary tract infections

The following side effects have been reported, although their frequency is unknown:

  • Allergic reaction (rach, itching, difficulty breathing, nausea, vomiting, and feeling of being unwell). You should contact your doctor immediately if you experience any of these symptoms
  • Skin blistering
  • Diverticulitis
  • Bleeding from the rectum
  • Increased level of liver enzymes found in blood test
  • Hepatitis (yellowing of the skin or whites of the eyes, itching, dark coloured urine, stomach pain, liver tenderness, loss of appetite)
  • Gallstones
  • Pancreatitis
  • Oxalate nephropathy
  • Effects on clotting with anticoagulants


Do NOT take Orlistat if:

  • You are allergic to any of the ingredients in this medication
  • You have chronic malabsorption syndrome (insufficient absorption of nutrients from the alimentary tract)
  • You have cholestasis
  • You are breastfeeding

Take particular precautions if:

  • You eat a meal that is high in fat while taking Orlistat. Gastrointestinal side effects are likely to increase if Orlistat is taken with a high-fat meal.
  • You regularly take an oral contraceptive. Possible failure of your contraceptive may occur if you experience severe diarrhoea while taking Orlistat, so you are recommended to use additional contraceptive methods.
  • Inform your doctor if you suffer from kidney problems, as Orlistat can be associated renal stones in patients with chronic kidney disease

Drug interactions

Before taking Orlistat, inform your doctor or pharmacist if you are taking any other medications, including those purchased over the counter without a prescription. Remember that weight loss can affect the dose of medicines taken for other conditions and adjustments may need to be made to your dosage of other medications. In addition, tell your doctor if you are taking any of the following:

  • Anticoagulants, such as warfarin
  • Ciclosporin
  • Iodine salts and/or levothyroxine
  • Amiodarone
  • Medicines used to treat HIV
  • Medicines for depression, psychiatric disorders or anxiousness
  • Medicines used to treat epilepsy
  • Acarbose (used to treat type 2 diabetes)

How to minimise side effects of Orlistat

Orlistat is not absorbed by the body, but works locally in the stomach and small intestine. The most common side effects of Orlistat are therefore gastrointestinal and include abdominal cramps with oily stools or diarrhoea. This is because your body is getting rid of roughly a third of the fat you are eating, so the best way to avoid these side effects is to maintain a low-fat diet. FIll your plate with wholegrains, fruit and vegetables, drink plenty of water and choose lean cuts of meat and poultry over fatty or red meats. 

Orlistat and alcohol

Orlistat can can increase blood concentration of alcohol, so it is best to avoid drinking alcohol  immediately after taking a dose. While taking Orlistat, you should drink no more than the recommended maximum of 14 units of alcohol per week.

Treatment Options

Orlistat vs Xenical

Orlistat is the generic name of the drug, which is also available under the brand name Xenical. Both contain the same amount of the active ingredient, orlistat,and work in exactly the same way, but Xenical is slightly more expensive.

Orlistat vs over the counter weight loss treatments

While Orlistat (Xenical) is the only weight-loss medication to be proven to be effective and safe, there are many products available over the counter which claim to help you lose weight. Alli is a prescription-free treatment that contains a much lower dose of orlistat and can be purchased under the supervision of a pharmacist. However, most other over-the-counter slimming products lack clinical evidence to suggest they are effective and often come without sufficient information on the packaging. Avoid any product that claims to be a ‘quick fix’, as losing weight too quickly is ineffective in the long term and can be dangerous. If you feel you would like to lose some weight, it is best to do so healthily and sensibly by making long-term changes to your lifestyle. No weight-loss product will help you to lose weight if you maintain a high calorie diet. Some products do come with additional dietary advice, but you should seek advice from a healthcare professional before purchasing them. 

Can I use other weight loss treatments with Orlistat?

Orlistat is the only weight-loss treatment to be recommended by doctors. As it it only works if dietary fats are present in the body, it can be ineffective if used in combination with appetite suppressants and other ‘quick fix’ weight-loss products. 


Is Orlistat an appetite suppressant?

Orlistat is not an appetite suppressant, but works by limiting the body’s absorption of fat.

Do I need to exercise when taking Orlistat?

Exercising regularly is the best way to boost your metabolism and burn extra calories, and is an essential part of any weight-loss programme. You should begin exercising before taking Orlistat, and continue to do so throughout treatment.

Will Orlistat affect my period?

Orlistat works by disrupting the body’s absorption of fat. If your period is irregular, delayed, or stops altogether, it may mean that your body is not absorbing enough necessary fats and treatment may need to be discontinued. If you are worried about disruptions to your menstrual cycle while taking Orlistat, speak to your doctor for advice.

Can I take Orlistat to prepare for surgery?

Orlistat is sometimes prescribed in preparation for surgery, as surgeons will often not operate unless a patient is below a certain weight. Surgery is generally a last resort and will only be undertaken when other weight-loss methods have been tried and failed.

Can I take Orlistat after weight loss surgery?

Orlistat can be taken following surgery, but only if recommended by a doctor. It may be prescribed following liposuction to help you keep off the weight you have lost, but is unlikely to be prescribed to patients who have had a gastric band fitted.

How much weight could I lose on Orlistat?

The amount of weight you can lose with Orlistat depends on your starting weight and whether you follow the correct dietary and exercise programme. 

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