How Does Orlistat Work as a Weight Loss Drug?
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How Does Orlistat Work as a Weight Loss Drug


According to data from the World Population Review, the United States ranks 12th globally for obesity in its population. The Center for Disease Control (CDC) estimates that 36.9% of American adults over the age of 20-years-old are obese, based on data collected in 2016.

The official statistics show that 41.1% of women, and 37.9% of men – or more than 160-million Americans, are battling with obesity. The current statistics show a doubling of obesity in the American population over the last thirty years.

Unfortunately, the data doesn’t look much better for American youth, either. Around 15% of all teens and children are either overweight or obese, which is three times as many compared to the 1980s.

According to data from The State of Obesity, recent data from the Behavioral Risk Factor Surveillance System (BRFSS), shows nine states have obesity levels of more than 35%. Kansas, Florida, New Mexico, Utah, Missouri, Minnesota, and New York all saw obesity rates rise in adults and children between 2017 and 2018. (1,2)

So, why is America dealing with an epidemic of obesity affecting adults and children all across the country? Obesity has strong links to poor lifestyle choices and dietary habits. Children play outdoors less than they did in the 1980s, with advances in technology introducing video games and other forms of entertainment that keep kids sedentary.

Adults have entertainment and food delivery services readily available around the clock. All the additional convenience in our lives adds up to excess consumption of calories, and not enough exercise to burn off the extra energy intake.

Eating too many calories for your energy needs leads to the body, storing surplus energy as fat. Poor lifestyle choices, a calorie-dense diet that’s high in carbohydrate and bad fats, and little to no exercise, is a recipe for obesity – All it takes is time.

1. What is Orlistat?

Obesity limits the affected individual’s quality of life. However, while many Americans realize that being overweight can adversely affect their health, very few decide to do something to stop their progression into obesity.

Most overweight and obese individuals lack the knowledge and discipline needed to execute a body transformation or calorie-restrictive diet. For those that do start a body transformation, less than 5% manage to achieve their goal weight.

The reality is that losing excess body fat when you’re overweight or obese is a challenge that few seem to overcome. Changing lifestyle habits, altering diet, and starting an exercise plan requires a significant amount of dedication on behalf of the obese individual.

Without guidance and inspiration, the obese person loses motivation with their body transformation, causing them to fall back into self-destructive habits.



Advances in nutritional science over the last 20-years produced some interesting and exciting breakthroughs in pharmacological solutions to managing and curing obesity. The “holy grail” of pharma research is to create a breakthrough weight loss pill that allows obese individuals to return their bodies to a healthy BMI.

You might find yourself skeptical of any nutritionist or doctor that tells you there’s an effective weight loss pill for obesity.

Orlistat, otherwise known by its brand names of Alli and Xenical, has the potential to be the miracle weight loss drug that offers obese individuals a chance at restoring their physique to health.

Overweight individuals may buy Orlistat over the counter in 60mg (Alli). The 120mg (Xenical) version, requires a doctor’s prescription for purchase and use. There are numerous generic versions available online as well.

Orlistat is a drug meant to complement an individual’s dietary and exercise program. Therefore, we can’t call it a miracle weight loss pill, because it still requires the user to put some effort into their diet and exercise.

However, user reports suggest that Orlistat is a very effective drug for accelerating weight loss when administered alongside the correct nutritional and exercise guidelines for the obese individual’s needs.

Adults over the age of 18-years old may purchase 60mg Orlistat tablets over the counter, provided that they have a Body Mass Index (BMI) of 25 or over. Severely obese individuals with a BMI over 30 may visit their doctor for a prescription of 120mg Orlistat tablets for use in combination with a weight loss diet.

Doctors may also approve the use of the 120mg version in individuals with BMIs as low as 27, if they are also dealing with other health disorders, such as diabetes or high blood pressure. Those individuals using Orlistat under the supervision of a medical professional may apply to have their insurance cover the costs of the drug.

However, not all insurers may cover the treatment. Finding an Orlistat supplier online is relatively easy, and the Orlistat price guidelines for online vendors vary, depending on reputation and quality.

So, how does Orlistat work?

Orlistat blocks the GI tract from absorbing the fat in the food you eat. As a result, the unabsorbed fat in your diet passes through your gastrointestinal system, where the body excretes it with fecal matter.

Carbohydrates and proteins contain 4-calories of energy in every gram. However, a gram of fat contains 9-calories. Therefore, the idea behind the use of Orlistat is to prevent obese individuals from absorbing this calorie-dense nutrient.

Obese individuals typically eat a high-fat diet, and their food choices are not healthy. By restricting caloric intake and changing the obese individual’s diet to healthy options, the overweight individual will start to see immediate week-on-week results in their body transformation.

However, severely obese individuals may take up to 3 to 5-years of dedicated commitment to changes in diet, exercise, and lifestyle factors, before they return to a healthy BMI.

Remaining steadfast in a weight loss transformation of this magnitude is challenging for any human being. Therefore, severely obese individuals can supplement their diet and exercise program with the use of Orlistat to speed up results.


How Does Orlistat Work as a Weight Loss Drug


2. Is Orlistat Approved as Safe for Use by the FDA?

As with any drug, Orlistat went through meticulous analysis and testing by the FDA. Orlistat FDA approval went through in 1999 under CAS Number 96829-58-2.

The FDA tested the branded versions of the drug in clinical trials during 1999, approving the Xenical version of the medication suitable for use alongside the guidance of a trained medical professional. However, it’s important to note that Xenical is only available under prescription.

The FDA approved Alli (60mg Orlistat) as safe for use in overweight individuals over the age of 18-years-old. However, the 60mg version is available for purchase over the counter. While the OTC version is only for use alongside a calorie-restrictive, low-fat diet, there is no official proof of guidance required when overweight individuals buy Orlistat over the counter.

The FDA tracks all reports of adverse effects in users of Alli and Xenical, the branded versions of Orlistat. The agency received thousands of notifications from users regarding side-effects and adverse health events occurring during the use of the medication.

With this many adverse health reports, it might scare some potential users away from including it in a weight loss program. However, the reality is that the adverse health events reported to the FDA by the public, are only to do with Alli and Xenical, and not specifically Orlistat.

To date, there is no clinical evidence to suggest that Orlistat is responsible for the adverse health events experienced by Alli and Xenical users. It’s entirely possible that these problems may come from another ingredient used in the manufacture of the medication.

The FDA continues to investigate side effects and issues with toxicity around the use of Alli and Xenical. However, it has yet to issue any statement regarding discontinuing the safety and approval of the medications.

The FDA also has some concern over the fact that it receives reports on only 1 out of every ten adverse events. The agency also conducted trials on the liver toxicity of Alli in users in 2007.

The trials included the analysis of the pre-clinical, clinical, post-marketing, and drug utilization data associated with severe liver toxicity and injury due to the use of the Xenical branded medication. (3)

The results of the study conclude that Xenical has no link to creating severe liver toxicity or injury.

However, the FDA did identify 12 cases in post-market analysis related to injuries to the liver caused by Xenical, and one with the use of Alli. Further study of the evidence shows that other contributing factors, such as dehydration, and off-label or prescription drug use, may account for the cause of severe liver injury in these cases. (4)


3. Orlistat as a Weight Loss Drug

The next time you’re walking down the supplement aisle at your local GNC, take a look at the fat loss section. You’ll find dozens of weight loss products in power and pill format. The weight loss supplement business is a billion-dollar industry, and there’s plenty of brands trying to dominate this space.

It’s important to note that Orlistat is a weight loss drug, not a weight loss supplement. If you take too many weight loss supplements, you could experience some mild thermogenic side effects, such as a sore tummy or a slight increase in stimulation and temperature.

However, the misuse or abuse of a pharmaceutical weight loss drug, such as Orlistat, could result in severe adverse side effects that may impact your well-being for an extended period.

Orlistat works well, and some users may decide to increase their protocol to enhance their results. However, this strategy is sure to land the user in some serious trouble with their health. Only use Orlistat in conjunction with medical supervision, especially if you’re using the 120mg format.


How Does Orlistat Work as a Weight Loss Drug


A: How to Lose Weight by taking Orlistat?

When implementing the use of Orlistat for weight loss, the user must follow the advice on a medical doctor, especially when using the 120mg format of the drug. Before the individual starts their weight loss program, they need to have the correct mindset to execute a successful body transformation.

The overweight or obese individual needs to understand that the drug is not the answer to their problems. The only solution to adequate long-term weight loss is through the adjustment of diet, lifestyle practices, and the introduction of a sustained exercise program.

Without this mindset, the obese or overweight individual will eventually try to lean on the overuse of the medication when they don’t see the results they want from their efforts. Overuse of this weight loss drug can involve the development of severe side-effects that may harm the health of the user.

When using Orlistat in any format, ensure you follow the dosage instructions listed on the container, or by the pharmacist dispensing the medication. Orlistat dosage may vary depending on the individual’s BMI. However, do not take the drug for longer than prescribed, or listed on the product packaging insert.

Obese and overweight individuals can use Orlistat alongside a specialized, low-fat, calorie-restrictive diet. When structuring the individual’s diet plan, nutritionists should ensure that fat does not account for more than 30% of the total calories in any meal.

The obese individual must follow their diet and exercise plan, and dose the Orlistat according to their physician’s directions. Most dosing protocols issue three doses of the medication throughout the day spaced evenly apart.

If the user skips a meal, then they must skip the Orlistat dose required for that meal as well.

If you skip a meal or you eat a meal that does not contain any fat, skip your Orlistat dose for that meal. The user should also start paying attention to the nutrition labels on foods. Read through the ingredient and nutrient listing, and avoid high-fat foods.

Orlistat may also interfere with the proper absorption of water-soluble vitamins in your diet. Therefore, patients should ask their doctor to recommend a vitamin brand they can absorb while using the medication.

Users should also monitor their dosage and use of the medication. Orlistat is a drug that has the potential for misuse off-script. Therefore, other people might dip into your medicine if you don’t pay attention to your use.

Take any supplements or other medications at least 2-hours before your dose of Orlistat. This dosing strategy prevents any adverse reactions with other drugs you may be using. If you are on any other form of medication, make sure you tell your doctor before you use Orlistat.

B: What Should I Avoid While Using Orlistat?

When consulting with your doctor about your health and your plan to beat obesity, make sure you discuss all your other health issues with your physician as well. The doctor needs to be aware of all of the medications you are currently taking before they prescribe Orlistat.

Some medications may cause contraindications with other drugs, resulting in severe side effects in the user. You must inform your doctor about your use of any of the following medications.

  • Oral diabetes medications or insulin use
  • Cyclosporine (Sandimmune, Neoral, Gengraf)
  • Digoxin (Lanoxin, digitalis, Lanoxicaps)
  • Levothyroxine (Levoxyl, Synthroid, Levothroid)
  • Blood-thinning medications such as warfarin (Coumadin)

It’s important to note that this is not a comprehensive list of drugs that can cause complications with Orlistat use.

Make an appointment with your doctor to discuss all of your prescription medications, supplements, and other OTC products you use that may cause counter-interactions when using Orlistat.

Under no circumstances should you take Orlistat without consulting a medical professional first. While the 60mg version is readily available for OTC use, the user should still consult a medical professional before adding it to their diet and exercise plan.

When taken at high doses or for prolonged periods, Orlistat can cause severe health problems. Those individuals that think they might have overdosed on Orlistat should call the poison assistance hotline immediately and call for an ambulance.

Patients should avoid taking Orlistat if they have any allergies to ingredients in the medication. Do not take Orlistat if you are dealing with any of the following medical conditions.

  • Chronic malabsorption syndrome
  • Gallbladder problems
  • Underactive thyroid
  • Gallstone history
  • Pancreatitis history
  • Liver disease
  • Diabetes type I or II
  • Eating disorders such as anorexia or bulimia
  • If presently using any other weight loss medication or OTC products


4. What Effects Can You Expect from Using Orlistat?

It’s crucial for individuals to understand that there is no such thing as a “miracle weight loss drug.” While the use of Orlistat alongside a calorie-restrictive diet and exercise program will accelerate weight loss in obese or overweight individuals, they need to set realistic expectations with the process.

Orlistat effects vary from person to person, and probably because every individual has a unique metabolism and body type. However, you can expect the rate of fat loss to be moderate, and using the drug might help you shed a few pounds more per week than with diet and exercise strategies alone.

However, to expect a rapid fat loss is unrealistic. The chances are it took the patient some years, maybe even decades, to reach their current state of obesity. Therefore, expecting the fat to melt away overnight, or even in a few months, will leave the user feeling demotivated and disappointed with their results.

Physicians define clinically meaningful weight loss as a reduction in a person’s body weight, of 5% or more over a year. Studies show that more than 40% of Orlistat users achieve this goal, provided they follow the professional advice of a doctor and nutritionist.

The study also shows that those individuals who were eating a calorie-restricted diet, along with obtaining regular exercise, and the use of Orlistat, lost an average of 5.7-lbs more than the control group who were not using Orlistat. (5,6)

(1) What Are the Benefits of Using Orlistat?

There is a significant benefit to using Orlistat as part of a well-structured and monitored weight loss program. The drug is effective at preventing the body from absorbing fat, thereby dramatically reducing a significant portion of the total calories ingested by the patient.

However, while Orlistat is a useful addition to a weight loss diet, and produces notable effects, we can’t understate that people should not use this drug as a crutch. Those individuals relying on a prescription or supplement as the cornerstone of their weight loss program will experience lackluster results.

Some individuals make no changes to their diet or exercise levels and, instead, rely on Orlistat to do the work. However, these individuals will find themselves disappointed with their weight loss results.

Orlistat benefits a weight loss program that has a defined structure and clear goals. It’s highly unlikely the patient will have the knowledge or motivation to complete their body transformation alone.

Therefore, hiring a nutritionist and trainer, and following a set diet and exercise program is a must for anyone undertaking a weight loss program.

Most overweight and obese individuals find that they experience a significant weight loss in the first two weeks of starting to eat healthily and exercise – and that’s before they introduce any supplements or drugs like Orlistat.

However, some individuals may struggle to lose all of the weight even when following a proper diet and exercise program. Others may find that their progress plateaus quickly using natural methods. These individuals may find that Orlistat benefits them in this situation, allowing them to experience a steady weight loss throughout their body transformation.

(2) What Are the Risks of Using Orlistat?

Individuals considering using Orlistat should take some time to review the list of Orlistat side effects associated with the use of the weight loss drug. Orlistat is a potent medication designed for use alongside a calorie-restrictive diet planned for the obese individual by a qualified nutritionist.

The OTC version of the medication may be readily available for purchase without a prescription, but no one should use Orlistat without speaking to their physician beforehand.

In clinical trials involving the administration of Xenical to patients, 27% developed oily stains in their undergarments, 24% of users experienced gas followed by involuntary fecal discharge, 22% of users experienced the onset of fecal urgency, 11% showed an increase in their number of bowel movements, and 8% experienced fecal incontinence.

For most users, diarrhea is also a common side effect of using the medication, especially when first starting the use of the weightloss drug.

Allergic reactions to the medication are rare, and some of the typical side effects users experience in the first few weeks of using Orlistat include the following.

  • Oily stains or spots in your underwear
  • Fatty or oily stools
  • Brown or orange-colored oils in stool
  • Gas accompanied with an oily discharge
  • Loose stool, increase in fecal urgency, and the inability of the user to control their bowel movements
  • An increase in the frequency of bowel movements
  • Nausea, vomiting, abdominal pain, diarrhea, and rectal pain
  • Fatigue and weakness, clay-colored stools, dark urine, loss of appetite, itching, or the appearance of jaundice (yellowing of the whites of the eyes or the skin)

Other less-common issues patients experience when they take Orlistat include the following.

  • Issues with gums and teeth
  • The development of cold-like symptoms
  • The development of flu-like symptoms
  • Headache and back pain
  • Mild to extreme skin rashes

Users must be aware that this is not a comprehensive list of side effects that may occur when using Orlistat. If you experience a side effect or an adverse reaction to the medication, report your experience to the FDA on 1-800-FDA-1088.


5. What are Users Saying about Orlistat?

Looking around the internet reviews by users, leads to a variety of results, both for and against the use of the drug. Orlistat reviews range from individuals that received outstanding results to those that experienced the worst of the side effects.

However, it seems that the majority of cases involving people who were obese, or with BMIs over 27, has a positive experience with the drug. All the positive reviews we found of the weight loss drug were from informed users that were undergoing a body transformation at the hands of a medical professional.

Therefore, these individuals structured their weight loss strategy correctly. They all hired a nutritionist, got regular quarterly checkups with their doctor, and stuck to the dosing protocol advised by their medical professional.

Here is an example of the real-world Orlistat results we found online.

My name’s Ron, and I was obese to the point where it was ruining my life. With mobility going out of the window, and my health deteriorating, I turned to my doctor for help. The doc put me in touch with a dietician, and I got to understand my calorie needs for the day.

After 6-months of eating well and running every day, I saw good results, but my progress began to stall. My doctor suggested I try Xenical (Orlistat). I didn’t think much of it, but my weight loss continued after the second day using the medication.

A year later, and I feel like a new person. I’m halfway to my goal weight, and the pounds keep coming off.”

Ron Swanson, Jacksonville, FL, USA.

It’s important to note that not everyone will experience this result, but this is a good benchmark of the results you can expect when everything goes right.

In this example, Ron’s results were an optimal outcome, but that’s not to say that someone else can’t replicate the same results for themselves, provided they have the correct medical supervision.

6. Key Takeaways for Using Orlistat as a Weight Loss Drug

Obesity is a threat to the health of Americans all over the country. Rates of obesity are rising in both adults, teens, and children, with the Southern and Eastern States of the US hardest hit by the expanding epidemic.

Obesity leads to the development of numerous chronic health issues, such as diabetes, high blood pressure, and heart disease. The condition also accounts for the death of 18% of all Americans aged 40 to 85-years-old.

Many Americans turn to drugs and supplements to help them accelerate their weight loss programs. However, many of these individuals also don’t do enough to change their lifestyle habits, diet, and exercise before resorting to other weight loss methods.

Americans need to understand that there is no short cut to losing body fat. Gaining knowledge of correct eating and exercise habits is critical to taking back control of your body weight. Before resorting to the use of potentially harmful weightloss drugs, it’s best to ensure your eating right and exercising correctly first.

Only consider using Orlistat after consulting with your doctor about your weight loss goals. Your doctor will send you to a qualified nutritionist for a diet plan that meets your caloric requirements for fat loss.

Those individuals attempting a weight loss program must ensure they build a team around them if they want to see results. Your doctor, nutritionist, physiotherapist, and personal trainer form your support team to give you the best chance of overcoming any obstacles on your path to achieving your weight loss goals.

Orlistat is like adding jet fuel to a finely-tuned performance engine. When patients have their diet and exercise habits under control, adding a weight loss drug like Orlistat can significantly accelerate results.

Before they decide to take Orlistat, patients must consult with a medical health professional to see if they meet the qualifying criteria for treatment.

When reviewing the results of user experiences with Orlistat, it’s a mixed bag of results. However, it seems that those individuals that take Orlistat at the instruction of a doctor and hire the right support team achieve the results they desire.

On the flip side, there are plenty of people with terrible experiences with using Orlistat. It’s for this reason that it’s so vital for individuals to take Orlistat under the care of a medical professional.

Orlistat provides obese and overweight individuals with an FDA-approved over the counter option for enhancing their weight loss efforts.

It’s also important to note that all patients using the drug, require education regarding the continued behavior modification during their use of the drug, as well.



  • Anderson JW, Schwartz SM, Hauptman J, et al. Low-dose orlistat effects on body weight of mildly to moderately overweight individuals: a 16 week, double-blind, placebo-controlled trial. Ann Pharmacother. 2006;40(10):1717-1723
  • Smith SR, Stenlof KS, Greenway FL, et al. Orlistat 60 mg reduces visceral adipose tissue: a 24-week randomized, placebo-controlled, multicenter trial. Obesity (Silver Spring). 2011;19(9):1796-1803.

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