What Is Orlistat?

Orlistat 120mg is used in the treatment of obesity. Orlistat prevents your body from absorbing the fat from the food you eat. By reducing the amount of fat that is absorbed, Orlistat can help you to lose weight more easily.

What is Xenical

Xenical is a brand name for generic Orlistat 120mg. Xenical is manufactured by Roche and contains the active ingredient Orlistat 120mg. Medically there is no difference between generic Orlistat and Xenical although Orlistat is generally available at a lower price.

What is Alli?

Alli is a brand name for Orlistat 60mg and is an over the counter medication. Alli is half the strength of the prescription-only medication Orlistat 120mg and Xenical. There is currently a shortage of Alli due to manufacturer recall due to manufacturing problems.

When should you use Orlistat?

If you have previously tried losing weight through diet and exercise and have not had the desired results you may wish to consider trying to use Orlistat. Orlistat is clinically proven to help you lose 50% more weight than through dieting alone.

Orlistat is only suitable for people with a BMI over 30 or for people with a BMI over 28 who have conditions related to weight such as diabetes or high blood pressure.

Use our online BMI calculator to calculate your BMI.

How does Orlistat Work?

Orlistat works in a unique way. The active ingredient, Orlistat, attaches itself to some of the body’s natural enzymes that break down fat, so you don’t absorb it. This prevents some of the fat you eat from being absorbed.

If you eat an excessive amount of fat or calories, the excess is stored as fat by the body, resulting in weight gain. When you eat fat, your body breaks it down into its simplest components so that it can be digested.

Orlistat works in your digestive system to block about one-third of the fat in the food you eat from being digested.

Enzymes in your digestive system, called lipases, help digest (or break down) fat. When taken with meals, Orlistat attaches to the lipases and blocks them from breaking down some of the fat you have eaten.

The undigested fat cannot be absorbed and is eliminated in your bowel movements. By working this way, Orlistat helps block about one-third of the fat in the foods you eat from being absorbed by your body.

Orlistat isn’t a stimulant or an appetite suppressant. It's formulated to work only in your digestive system and should not affect your heart rate, your brain or cause sleeplessness. The safety and efficacy of Orlistat, has been established in more than 100 clinical studies with data from over 30,000 people.

Targets

When you start taking Orlistat you will be given a weight loss target for the first 3 months. This target is 5% of your weight. If you succeed in losing 5% of your weight, you will be eligible to continue taking Orlistat. Pharmacists can supply Orlistat for up to two years.

Each time Orlistat is supplied you will need to supply your pharmacist with your current weight. If your weight goes up in any three months, Orlistat will need to be stopped. If you lose enough weight for your BMI to fall below 28, Orlistat can no longer be supplied.

Some people do not succeed in losing weight with Orlistat. These people should not be disheartened. They can have a break of 6 months and try again later, or see a doctor or a weight loss clinic as alternatives. Losing weight, like many things that are hard to achieve, takes perseverance and resolve, so do not give up.

How To Take

The recommended dose is one Orlistat 120mg capsule by mouth with liquid at each main meal that contains fat. You should take Orlistat up to three times a day in conjunction with a reduced-calorie diet. Each time you take Orlistat, your nutritionally balanced meal should contain no more than about 30% of calories from fat.

You should evenly divide your daily intake of fat, carbohydrates and protein over three main meals. Take Orlistat during meals or up to 1 hour after a meal. If you occasionally miss a meal or have a meal without fat, you can omit your dose of Orlistat. Doses above 120 mg three times daily have not been shown to provide an additional weight-loss benefit. You should try to follow a healthy eating plan, such as one from which no more than 30% of calories come from fat. Following this eating plan will help you lose weight while decreasing some of the possible gastrointestinal effects you may experience while taking Orlistat.

Because Orlistat interferes with your body's absorption of some fat-soluble vitamins, you should take a daily multivitamin supplement that contains vitamins A, D, E and K and beta carotene once a day at least 2 hours before or after taking Orlistat, such as at bedtime.

How Effective is Orlistat?

Orlistat has been extensively studied. In clinical trials, almost twice as many patients who received Orlistat, an average weight loss of 10 percent or more of their body weight in one year, compared to those on diet alone.

People treated with Orlistat and a reduced-calorie diet with no more than 30% of calories from fat achieved significantly greater weight loss than people who were treated with diet alone. The studies were designed with all participants eating a reduced-calorie diet for 4 weeks, followed by the diet plus Orlistat or the diet alone for 52 weeks. After 52 weeks, those taking Orlistat plus diet lost an average of twice as much weight as those who used the diet alone (approximately 13.4 lbs versus 5.8 lbs). There is clear scientific evidence that if you are overweight, losing as little as 5% to 10% of your body weight can result in improved health. In studies of Orlistat, almost 40% of people treated with Orlistat plus diet successfully lost at least 5% of their body weight after 2 years. In comparison, 24% of the people treated with diet alone managed to lose 5% of their weight. Weight loss with Orlistat and a healthy diet also improves a number of weight-related health risks. Weight loss with Orlistat and a healthy diet also improves a number of weight-related health risks.

Studies show that weight loss with Orlistat can:

• Decrease total and LDL cholesterol (level of low-density lipoprotein-also known as bad cholesterol) total: -2.0% Orlistat vs. +5.0% placebo, LDL: -4.0% vs. +5.0%
• Improve ratio of bad to good cholesterol (LDL/HDL cholesterol): -0.37 Orlistat vs. -0.20 placebo
• Reduce blood pressure: systolic -1.01 vs +0.58 mmHg, diastolic -1.19 vs +0.46 mmHg
• Reduce levels of insulin (hormone that allows glucose or sugar to enter the body's cells), high levels of which are associated with coronary heart disease: -6.7 vs +5.2 pmol/L
• Reduce the risk or delay the progression to type 2 diabetes in patients: incidence rate of 5.5% for Orlistat vs 8.3% for placebo

Side Effects

Like all medicines, Orlistat can cause side effects, although not everybody gets them. The most common side effects associated with Orlistat are wind with or without oily spotting, sudden or more frequent bowel motions and soft stools. These are caused by the way the capsules work and result from some of the fat being passed out of your body. Such effects typically occur within the first few weeks of using the capsules, before you may have learnt to limit the amount of fat in your diet. Such diet-related treatment effects may be a signal that you have eaten more fat than you should have done.

These diet-related treatment effects are largely due to what you eat, so eat lower-fat meals to help manage them. The following tips will help:

• Find out more about how much fat your favourite foods typically contain and the size of your portions (check the labels). By getting used to the recommended portions, you’ll be less likely to accidentally go over your daily fat target.
• Distribute your fat evenly across your meals. Don’t ‘save’ fat grams from lunch and ‘spend’ them at dinner - each meal and snack must be within your fat target.
• Be patient. It may take a little time to familiarise yourself with your fat and calorie targets. Most users who experience diet-related treatment effects at the start learn how to manage them.
• Keeping a food diary is an invaluable tool to help you recognise which foods can lead to diet-related treatment effects. An example of how to keep a food diary together with some blank diary pages are included in this booklet so you can jot down helpful notes and favourite recipes – you’ll soon get into the swing of things.

Patient Information Leaflet

Always read the patient information leaflet before commencing treatment. Patient information can be found here.

Alternatives

There are typically two different kinds of weight-loss prescription medications. Some medications are appetite suppressants. Orlistat is another form of weight-loss medication that works in your digestive system to block about one third of the fat in the food you eat from being digested. There are hundreds of weight loss products on the market, but few have been clinically proven to be safe and effective. Orlistat is the only pharmacy-only medication licensed for weight-loss treatment in the UK.

You may want to consider counselling for The London Centre.