We all know that shedding those extra pounds can be quite a challenge. Consuming excessive dietary fat, commonly called ‘bad fat,’ can significantly impact calorie intake and contribute to obesity.

Orlistat is one of two drugs that are currently available in the US for the treatment of obesity. Orlistat inhibits the absorption of fats in the body, resulting in weight loss.

Orlistat is a medication that falls under the drug class of ‘Peripherally acting antiobesity agents.’ Orlistat is a medication prescribed to aid in weight loss and prevent weight regain. When combined with a calorie-deficit diet and regular exercise, Orlistat can yield optimal outcomes. Typically, this medication is ingested by mouth. In 1999, the FDA approved the prescription use of Orlistat, which was later made available over the counter in 2007. Adults are the intended users of this medication. It is important to note that this medication is intended for individuals 18 or older.

What Is Orlistat?

Orlistat was only available as one branded product called Xenical (120mg of Orlistat) until the expiry of ‘exclusivity’ rights (patent) in 2009. Today, Orlistat is available as a generic medication produced by several drug companies.

In 2009, Orlistat became available as a pharmacy-only medicine (P), known as Alli, for sale to the public without a prescription. Alli can be purchased from a chemist under the supervision of a pharmacist or online from registered pharmacies.

Each capsule of over-the-counter Alli contains 60mg of Orlistat. In contrast, each capsule of prescription-only Orlistat includes 120mg of Orlistat. Both Alli and Orlistat (POM) are indicated for treating obesity in conjunction with a mild-low calorie and fat diet.

Orlistat Ingredients

Orlistat is the active ingredient used in medicine brands. Other ingredients include:

  • Microcrystalline cellulose
  • Sodium starch glycolate
  • Povidone
  • Sodium lauryl sulfate
  • Talc

How Does Orlistat Work?

Orlistat boosts weight loss by reducing the amount of dietary fat absorbed in your intestines. Lipase is found in the digestive tract; it helps the body break down dietary fat into minor compounds stored for energy. Orlistat is used to enhance lipase. For the results, you have to wait for 1 to 3 months. You can expect to lose 5% of your starting body weight in 3 months. If you don’t see any results, the doctor might stop the treatment and recommend something else that might suit you.

How Can You Take Orlistat?

  • Alli: one 60mg capsule is taken three times a day, and each meal contains fat. No more than three capsules should be taken in 24 hours.
  • Orlistat: one 120mg capsule is taken three times a day, also with a meal that contains fat

Orlistat should be taken just before, during, or up to one hour after a meal. Orlistat should not be taken when a meal is missed or contains fat. Patients should take a multivitamin containing fat-soluble vitamins (A, D, E, and K) at night before bed.

Tips To Start Orlistat

Here are some tips to start reducing weight when on Orlistat:

  • Reducing your fat intake to 30% of your total calories is advised while taking Orlistat
  • Take Orlistat after a meal that includes fat
  • Try to choose low-fat dairy products and food in general
  • Follow the proper dosages as prescribed by your doctor
  • Orlistat Foods To Avoid
  • The idea is simple: avoid fats. Thousands (if not millions) of websites, blogs, valuable books, diet plans, and recipes focus on healthy eating. Follow a low-fat, reduced-calorie diet.

Some ideas for a low-fat diet:

  • Aim for meals with fat-derived calories of around 30% (15 grams of fat) per meal
  • Reduce/avoid the use of oils in cooking
  • Use low-fat spreads instead of butter
  • Focus on eating a ‘low-fat range’ of products, for example, low-fat cheese, light or fat-free cream cheese, low-fat/fat-free yogurts, and so on.
  • Avoid ‘takeouts’ and deep-fried foods like chips
  • Eat lean cuts of skin-free meat

Pros And Cons Of Orlistat


  • The unabsorbed fat is flushed out from the body via stool. It helps to prevent the extra unabsorbed fat from staying in your system.
  • Orlistat is readily available at pharmacies as a prescription medicine and over-the-counter medicine.
  • Orlistat works by blocking the consumed fats from being absorbed by the body.
  • Reduced risk of regaining the lost weight
  • Easily available OTC drug
  • Weight loss


  • Orlistat absorbs some fat-soluble vitamins and beta-carotene along with fats. Hair loss is commonly associated with people who lack.
  • Vitamin D. It is advised to include multivitamins in foods and supplements to balance out the adverse effects caused by Orlistat.
  • Orlistat use may cause oxalate kidney stones or oxalate nephropathy. Oxalate nephropathy is often asymptomatic and keeps on aggravating with the help of Orlistat.
  • Some people may experience pale stools as a side effect of Orlistat. It can also cause dark urine, fatigue, nausea, and pale stools, signs of a liver problem.
  • Liver issues
  • Hair loss
  • Kidney issues

Advantages Of Using Orlistat

The primary advantage of using Orlistat is weight loss. People who are having difficulty reducing weight can benefit from the medicine. This medication is beneficial for people who are obese (people with a BMI of 30 or higher). It is also helpful for overweight people (BMI of 27 or higher).

People suffering from heart conditions due to a few extra kilos, such as high blood pressure or heart diseases, can benefit from Orlistat. It also has an excellent mental effect. People can get motivated and feel good about themselves when they see positive bodily changes. People gain self-confidence, leading to their success and happiness in life.

Alli and Xenical are the two brands sold under Orlistat medicine. Alli is available at the strength of 60 mg, while Xenical is available at the strength of 120 mg capsules. Orlistat works by blocking the enzymes in the gut that digest fat. Orlistat blocks approximately one-third of the fat that we consume. Hence, it is an effective medication to lose weight. Orlistat medications are widely available without prescriptions at local pharmacies and online pharmacies.

Orlistat Review Of Clinical Effectiveness: Can You Lose Weight With Orlistat?

Two significant studies related to the Orlistat Clinical Effectiveness


Orlistat, extensively studied in human trials, demonstrated its effectiveness in promoting weight loss. In the Xenical studies, where patients took Orlistat at a 120mg dosage three times a day, seven major trials involving over 3000 obese participants were conducted over one to four years. These trials were placebo-controlled, meaning some patients received a ‘dummy’ pill. Patients were given either Xenical or placebo in conjunction with a hypocaloric, low-fat diet. The results revealed that after one year, those on Xenical lost an average of 6.1kg of body weight, compared to 2.6kg in the placebo group. Notably, 20% of patients on Orlistat lost more than 10% of their body weight, while only 8% of those on the dummy pill achieved a similar result. By the end of the four-year study, 21% of patients using Orlistat had lost over 10% of their body weight, surpassing the 10% in the placebo group.

The effectiveness of Orlistat in weight loss was further supported by studies on Alli, where a 60mg dosage of Orlistat was administered. While specific details about the Alli studies are not provided in the given points, it is reasonable to infer that, like Xenical, Alli demonstrated efficacy in promoting weight loss based on the established findings for Orlistat.


In a 12-month study conducted to assess the effectiveness of Orlistat, participants were divided into two groups: one receiving Orlistat 60mg three times a day and the other taking a placebo pill. Both groups followed a hypocaloric, low-fat diet. The most significant weight loss occurred within the first six months of the trial. At the six-month mark, those taking Alli experienced an average weight loss of 5.20kg, compared to 3.1kg with the placebo in one study and 3.6kg versus 1kg in another study. The average weight loss with Alli was 4.4kg, demonstrating a notable contrast to the 2.1 kilograms observed with the placebo in both studies. Additionally, at the six-month point, more than 16% of participants using Alli lost 10% or more of their body weight, whereas only 6.5% achieved this with the placebo.

Remarkably, the data from these studies also revealed positive effects on cholesterol levels. After six months of treatment, participants on Alli experienced a decrease in total cholesterol by 2.4% and a 3.5% reduction in LDL ‘bad’ cholesterol. In contrast, those taking a placebo saw an increase in cholesterol levels. Furthermore, Alli positively impacted waist circumference, which decreased after six months. Both Orlistat 120mg and Alli (60mg of Orlistat) demonstrated a significant reduction in body weight compared to the placebo, indicating their effectiveness in promoting weight loss and potentially improving cholesterol levels.

Patient Reviews: Real Reviews About Orlistat

Orlistat Pills review 1 | 55 – 64 Female, Dee WebMD Patient

Overall rating: 5/5

“Two stone overweight, no motivation to lose. He enjoys food and snacks, so I’d join in. Several weeks after gallbladder removal, eating food was difficult, and I lost weight. This changed my mentality, so I took Orlistat. After eating, I didn’t know it could cause terrible flatulence and vivid orange oil. This was surprising, but it’s normal. It was not farting in bed and ruining it. Good news: I’m down 1 stone and 9 lbs in 8 weeks. 7 lbs was natural after surgery, and 1 stone 2 lbs after 6 weeks of medication. Orange oil costs nothing.”

Orlistat Pills review 2 | 40 – 44 Female, Nora Drugs.com Patient

Overall rating: 7/10

“Obesity/Overweight Weight Loss with Alli “I took Alli 3 months ago. After treatment years ago and menopause at 44, which lowered my hormones, which assist your body burn fat, I had to act. Without hormones, I jumped from 138 to 172 in a few years. I lost 12 pounds in one month with ALLI. The weight returned once I stopped taking them. I do this with hypertension: I take Alli with meals exceeding 10g of fat. I had neon orange oil in my feces, indicating fat loss. I lowered my food consumption by a third without being hungry. We follow the Mediterranean diet and workout every day. On my monthly cheat day, pie is always served—moderation matters. Be nice to yourself and take tiny steps—you’re not lazy. Just ignore the name-callers here—they’re not empathetic.”

Orlistat Pills review 3 | 25 Female, Gurlo Drugs.com Patient

Overall rating: 6/10

“Xenical (orlistat) for Obesity/Overweight “25, female, starting at 15st 7lbs/99kg/217lbs (I’m 5’7). I wanted a fast remedy for weight reduction, but there is none. After 4 years of gaining 70lbs, I realized how miserable I was. After 20 days, I shed 14lbs/6kg. I follow a tight diet but haven’t exercised. So I can only imagine how much I lost then. I get greasy orange stools in the toilet bowl but haven’t had any embarrassing situations. I’m maintaining within the recommended daily limit of fats. I suggest Orlistat to anybody who needs assistance since it has made me resolve to make better health and weight decisions. I’m thrilled since coworkers and family have noticed a change in my physique, and I can feel it in my clothing.”

Orlistat Pills review 4 | 19 – 24 Female, Elizabeth WebMD Patient

Overall rating: 4/5

“If you’re not ready to alter your lifestyle, don’t take it. I began two days ago with no adverse effects. Today I noticed what everyone was talking about with the orange oily farts, I didn’t take it too far with my food but realized the fat percentage of my meals was higher than I thought, and I can see where I’m going wrong in my diet. I’m excited to change my diet in the future.”

*In conclusion, reviews from individuals using Orlistat, such as those shared by Dee, Nora, Gurlo, and Elizabeth, provide valuable insights into the experiences and outcomes of this weight loss medication.

Dee highlights a significant weight loss of 1 stone and 9lb in 8 weeks, attributing her success to Orlistat despite unexpected side effects like flatulence and orange oil. Nora, facing challenges with weight gain after menopause, acknowledges the effectiveness of Alli, shedding 12 pounds in one month while emphasizing the importance of moderation and self-compassion.

Gurlo, a 25-year-old user, shares a joyous journey, shedding 14 pounds in 20 days with Orlistat, emphasizing the impact on her health decisions and the noticeable change in her physique. Elizabeth, a younger user, stresses the importance of being ready to alter one’s lifestyle when considering Orlistat, acknowledging the initial adjustment period and the motivation it provides to change dietary habits. These reviews collectively suggest that Orlistat can be effective for weight loss, but individual experiences may vary, and lifestyle changes are crucial in maximizing its benefits. Always consult with a healthcare professional before starting any weight loss medication.

Orlistat Review Of Drug Interactions

Please refer to the product information leaflet for a full explanation of the possible interactions of Orlistat.

The following drug interactions are listed in Orlistat’s specifications:

  • Amiodarone (used in the treatment of ventricular fibrillation): in a healthy volunteer, some decrease in levels of amiodarone was observed
  • Ciclosporin (immunosuppressive medication): it is not recommended to use Orlistat while on ciclosporin as plasma levels of ciclosporin may be affected
  • Acarbose (used in the treatment of alcohol dependence): concomitant use should be avoided
  • Oral anticoagulants (for example, warfarin): use of Alli together while on anticoagulants is contraindicated; when prescribed, Orlistat
  • can be considered, providing an international normalized ratio (INR) is monitored
  • Fat-soluble vitamins (A, D, E, K): the majority of patients taking Orlistat during a four-year study had no change in levels of vitamins A, D, E, and
  • K; however, manufacturers of Orlistat recommend taking a multivitamin supplement at bedtime
  • Possible interaction with antiretroviral medicinal products for HIV

Orlistat interaction with oral contraceptives:

There is no direct interaction between Orlistat and oral contraceptive drugs; however, Orlistat manufacturers recommend using additional contraceptives if patients experience severe diarrhea.

Before starting treatment, read the product information leaflet or speak to your GP or pharmacist.

Orlistat Side Effects

Some common side effects caused due to Orlistat are:

  • Oily or fatty stools-(Due to fat not being absorbed when using Orlistat, you might experience oily or greasy stools)
  • Gas discharge
  • Stomach pain-(Orlistat blocks intestinal fat absorption by preventing gastric and pancreatic lipase that causes stomach issues, including stomach pain)
  • Nausea-(Orlistat blocks intestinal fat absorption by containing gastric and pancreatic lipase that causes stomach issues, including nausea)
  • Loose stools

Some adverse side effects caused by Orlistat are:

  • Lower back pain
  • Blood in the urine-(Users have reported bleeding from the rectum, which causes blood in the urine)
  • Signs of Kidney problems-(Orlistat may cause oxalate kidney stones, leading to chronic kidney disease even after stopping the medicine)
  • Signs of Liver problems-(Itching, yellow skin, loss of appetite, or dark urine are all signs of liver problems and immediately must be consulted with your healthcare professional)

Not all side effects are included in this article. It is always better to seek professional help if you have any symptoms or side effects after using Orlistat.

Is Orlistat Worth It?

We think using Orlistat is worth it if you plan to lose weight. Doctors widely suggest it for weight loss, and it is relatively safe to use. It is readily available as an over-the-counter drug or by prescription. You should follow proper guidelines as suggested by your doctor to lower the risks of the side effects.

Who Can Buy Alli (Orlistat)?

Over-the-counter Alli can be used by adults (18 years or over) who are overweight with a body mass Index (BMI) of 28 kg/m2.

Although there is no specific direction to measure a patient’s BMI when a purchase request is made at a conventional pharmacy, customers may be asked to calculate their BMI (weight and height). Online pharmacies have a more relaxed approach to the sale of Alli.

When purchasing Alli online, customers may need to read and agree with a disclaimer confirming the suitability of the drug or answer pre-sale questions; for example, you may be asked to provide your weight and high (to calculate BMI) detail any other conditions you may have.

Orlistat Alternative Drugs

Currently, there are only a limited number of drugs approved for weight loss, with Orlistat being the first one. Additionally, there is a medication called Liraglutide, which is commonly referred to as Saxenda. Saxenda has a unique mechanism of action compared to Orlistat. Check out my post for more information on Saxenda: Saxenda review – assessing the effectiveness of this new weight loss medication.

Final Words From AzDrug

Orlistat is an effective weight loss pill with minimal side effects. When incorporated with a calorie-deficit diet and regular exercise, Orlistat can show the best results. We advise you to have multivitamins when using Orlistat. It is widely used by people all over the world. You can purchase it by prescription or over-the-counter.

How much weight can you lose in a month on Orlistat?

The amount of weight loss with Orlistat varies, but clinical studies suggest an average of 5-10% of body weight within the first six months of use. This makes it a gradual and sustainable weight management option.

Is Orlistat effective as a weight loss drug?

Orlistat can lose weight when combined with a reduced-calorie diet. It works by blocking dietary fat absorption, aiding in weight management. However, its success depends on adherence to a healthy lifestyle, making it a valuable tool for some individuals. Consult your healthcare provider to determine if Orlistat suits your weight loss goals.

What are the significant side effects of Orlistat?

The significant side effect of Orlistat is gastrointestinal issues, including oily stools, flatulence, and frequent bowel movements, as it works by blocking dietary fat absorption.

Does Orlistat remove existing fat?

Orlistat prevents dietary fat absorption during digestion but does not actively remove existing fat from the body. It promotes weight loss by reducing fat absorption from food.

Orlistat: side effect review

Orlistat, a weight-loss medication, may cause gastrointestinal side effects such as oily stools, flatulence, and increased bowel movements. It works by blocking dietary fat absorption, leading to these effects, which can be managed by following a low-fat diet.

Related Blogs

Disclaimer: Please see your healthcare practitioner for any medical queries or concerns. Peer-reviewed research and information from medical societies and government agencies are used to support the articles in Health Guide. They are not, however, a replacement for expert medical advice, diagnosis, or treatment.

Share Post On: