We have written a series of blog posts over the past few months about the effects of various drugs (and certain non-pharmaceutical treatments) used for weight loss. One drug that has received a lot of attention is Orlistat which is also marketed as Xenical and Alli. Alli is sold over-the-counter. You don’t need a prescription for it.
It’s easy to understand how Orlistat works. Its primary function is to prevent the absorption of fats from the human diet by inhibiting an enzyme in the GI tract that the body uses to absorb fat. It is intended for use in conjunction with a healthcare provider-supervised reduced-calorie diet.
Weight loss from Orlistat is not very impressive. Pooled data from clinical trials shows that people given orlistat in addition to diet and exercise, lose about 2–3 kilograms (4.4–6.6 lb.) over the course of a year. Obviously, this is not a lot of weight loss. On average, it’s a loss of half a pound a month.
This unimpressive weight loss is accompanied by a slew of GI side-effects, including
- oily or fatty stools;
- oily spotting in your undergarments;
- orange or brown colored oil in your stool;
- gas and oily discharge;
- loose stools, or an urgent need to go to the bathroom, inability to control bowel movements;
- an increased number of bowel movements; or
- stomach pain, nausea, rectal pain.
These side-effects are very common because they are an expected result of anything that inhibits the absorption of fat.
Other side-effects that have been reported include liver injury and kidney injury.
Orlistat is usually taken 3 times per day with each main meal that contains some fat (no more than 30% of the calories for that meal). You may take the medicine either with your meal or up to 1 hour after eating.
The fat content of your daily diet should not be greater than 30% of your total daily caloric intake. For example, if you eat 1200 calories per day, no more than 360 of those calories should be in the form of fat.
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Orlistat isn’t an easy answer to weight loss. The weight loss seen with Orlistat is not impressive. Plus, it comes with very frequent and very annoying GI side effects. We have to give this one a thumbs down.
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