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Reviewed on April 11, 2025. by
Dr Alexandra Cristina Cowell
Writer & Clinical Content Reviewer
Next review due on April 11, 2028.
Last updated on Jul 01, 2025.
Reduce how much fat you absorb from meals.
Orlistat is a generic tablet that interferes with your bodies’ process of breaking down and storing fat. This excess fat that your body doesn’t store gets passed in your stool.
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Orlistat is a tablet you take with meals to reduce the amount of fat your body absorbs, helping you lose weight. To get the most out of Orlistat, you’ll take it alongside a reduced-fat, low-calorie diet (where you get around 30% of your daily calories from fat).
Who can use Orlistat?
Orlistat is approved to help people with a BMI equal to or greater than 30 (or 28 if you have a health risk or condition related to your weight) lose weight. But it’s not suitable for everyone to use. If any of the following apply to you, speak to your physician about your weight loss options before taking Orlistat:
You have chronic malabsorption syndrome
You have cholestasis (a liver disorder)
You’re breastfeeding
You’re taking medicine for other conditions (like high cholesterol or diabetes)
What are the benefits of Orlistat?
Unlike other popular weight loss drugs like Wegovy or Zepbound, Orlistat comes as a pill rather than an injection; so if you don’t like the idea of injecting yourself, Orlistat could be a good alternative.
Orlistat could also be a good option if you’re looking to build muscle alongside weight loss. Weight loss injections reduce your appetite to help you lose weight, which can make it difficult to eat enough to build muscle. While you’ll still have to eat a reduced-fat diet with Orlistat, it won’t affect your appetite.
How do Orlistat doses work?
Generic Orlistat tablets are only available in one dose: a 120 mg tablet. You’ll take a tablet up to three times a day, with each meal you eat that contains fat. There’s also a branded tablet called Alli, which contains a lower 60 mg dose of orlistat, that’s available as an over-the-counter medicine.
What is Orlistat’s active ingredient?
Orlistat is a generic medication that’s named after its active ingredient: orlistat. It’s sometimes referred to as a ‘fat binder’, because it stops your body from breaking down and absorbing as much fat from your food. But this is a bit of a misnomer, because orlistat targets enzymes responsible for breaking down fat in your digestive system, instead of the fat itself.
How does Orlistat work?
There’s an enzyme in your digestive system called lipase that breaks down and stores the fat from the food you eat as energy. Orlistat targets lipase and interferes with this process, stopping your body from storing as much fat. This excess fat is then excreted when you use the bathroom.[1]
This is why eating a reduced-fat diet is really important when you’re taking Orlistat. If you eat too much fat while on Orlistat, there’s a good chance you’ll get unpleasant side effects, like:
This page was written by The Treated Content Team.
This page was medically reviewed by Dr Alexandra Cristina Cowell on April 11, 2025. Next review due on April 11, 2028.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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How to take Orlistat
You’ll take Orlistat any time you eat a meal with fat in, up to three times a day. You can take your Orlistat capsule before, during, or up to an hour after your meal. For Orlistat to work properly, you should take it alongside a balanced, calorie-controlled diet, where you get no more than 30% of your daily calories from fat. You should try to spread out your fat intake across three meals, and avoid eating fatty foods or snacks in between meals.[1]
This page was written by The Treated Content Team.
This page was medically reviewed by Dr Alexandra Cristina Cowell on April 11, 2025. Next review due on April 11, 2028.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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Orlistat isn’t suitable for everyone, and there are some things that you need to be aware of when taking it.
Here’s all the official info on it. If anything is unclear, let our clinician know, and they can talk with you about it.
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Orlistat: FAQ
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
Are there any Orlistat alternatives?
Answer:
Xenical is a branded medicine that comes in the same dose and contains the same active ingredient as Orlistat. This means it’ll work exactly the same, and is just as effective – it’s just the branding, packaging, appearance of the medicine, and sometimes the price that’s different.
There’s also a lower dose of orlistat available, called Alli. Alli contains only half the dose that Xenical and Orlistat do – so if you’re struggling with side effects, it could be a good option for you. Alli is also available as an over-the-counter medication, so you don’t need a prescription.
But if Orlistat isn’t the right weight loss treatment for you, weight loss injections could be another option. These work a little differently from Orlistat: they affect signals in your brain and the speed your stomach empties to reduce your appetite and cravings. This should help you reduce the amount you eat, and help you to lose weight.
How effective is Orlistat?
Answer:
Orlistat is clinically proven to help with weight loss when used alongside healthy lifestyle changes.
A study in which 80 patients with obesity were randomised into receiving either 120 mg of Orlistat or placebo for three times a day measured weight, waist circumference, BMI, and cholesterol. It found that Orlistat was significantly more effective than placebo, with the Orlistat group losing an average of 4.65 kg (compared to 2.5 kg in the placebo group), and reducing their BMI by an average of 1.91 kg/m2 (compared to 0.64 kg/m2). Waist circumference was also reduced by an average of 4.84 cm in the Orlistat group (vs 2 cm in the placebo group), and cholesterol was reduced by 10.68 mg (vs 6.18 mg).[1]
Do I need a prescription for Orlistat?
Answer:
Yes. A physician will need to make sure that Orlistat is safe for you to use before you start taking it, because it isn’t suitable for everyone. There’s a lower dose version of Orlistat called Alli that’s available as an over-the-counter medication. This means you don’t need a prescription for Alli.
Can I get Orlistat through private health insurance?
Answer:
While some private health insurance plans can cover weight loss treatment, many (including medicare) don’t, because they’re classed as a cosmetic treatment. You should check your insurance plan to see if weight loss drugs are covered.
Some plans also state that you have to get your treatment from specific providers – so even if your plan does cover weight loss treatments, you should check you’re getting it from the right place.
If Orlistat isn’t covered, you might be able to get a branded alternative instead. But even if you can’t get it through your insurance, you’ll still be able to obtain Orlistat online from a prescription and pharmacy service.
How long does it take Orlistat to work?
Answer:
Orlistat gets to work in your system quickly, and can start to affect how much fat you absorb from food in just a couple of days.[2] It can help you start to lose weight within two weeks of starting treatment, with statistically significant weight loss typically coming after two months.[3]
If you haven’t lost weight after 12 weeks of Orlistat, it might not be the right treatment for you – speak to your physician about other weight loss treatment options.
What should I do if I make a mistake when taking Orlistat?
Answer:
If you forget to take Orlistat before or during a meal, you can still take it any time within one hour of eating. If it’s been more than an hour, skip the missed dose and continue to take Orlistat as normal with your next meal. Don’t take two doses of Orlistat to make up for missing one.
If you (or someone else) takes too much Orlistat, get medical advice right away – you might need medical attention.
Are there other approved weight loss treatments?
Answer:
Yes. Certain weight loss treatments work in a different way, like Saxenda. Saxenda is an injectable weight loss medication that works by suppressing appetite. There’s a tablet weight loss treatment called Mysimba too, which also affects parts of the brain that manage how much food you eat to help you control cravings.
Is Orlistat the same as Xenical?
Answer:
Xenical 120mg is a branded version of Orlistat. This means it contains the same active ingredient, and it works in the same way. The only real difference is branding and price, so it pays to compare the two before buying.
As is the case with Orlistat, you will need a prescription to buy it, whether you’re buying it online or not.
Alli vs Orlistat: what’s the difference?
Answer:
Alli 60mg is a similar weight loss medication that contains the active ingredient orlistat. Alli tablets are available over-the-counter at certain high street pharmacies. Meaning you don’t need a prescription to get it. You’ll still need to have a consultation with a pharmacist prescriber at the pharmacy before you can purchase Alli, though.
Orlistat is a little different to Alli as it contains 120mg of the active ingredient, meaning that it’s twice as strong. You need a prescription for it on this basis.
Is Orlistat an approved treatment for weight loss?
Answer:
Yes. Orlistat is a safe and licensed weight loss tablet approved with a prescription. Our clinician will monitor you using it to make sure that it’s working the way that it should for you.
Illegal diet pills, weight loss supplements or ‘fat burning tablets’ are widespread online, so you should always check you’re buying licensed medications from registered pharmacies.
If you notice any issues with the treatment, or if you have any concerns, send us a message.
Treated trusted source:
Jain, S.S. et al. (2011). Evaluation of efficacy and safety of orlistat in obese patients. Indian Journal of Endocrinology and Metabolism. 15(2). pp. 99-104.
Last updated on Jul 01, 2025.
How we reviewed this page:
Our experts continually monitor new findings in health and medicine, and we update our articles when new info becomes available.
Why this page was updated on Jul 01, 2025
We reviewed the content on this page and made some structural changes to make it more reader-friendly and accessible.
Current version (Jul 01, 2025)
Edited by: The Treated Content Team.Medically reviewed by: Dr Alexandra Cristina Cowell, Writer & Clinical Content Reviewer
Aug 01, 2022
Published by: The Treated Content Team.Medically reviewed by: Dr Alexandra Cristina Cowell, Writer & Clinical Content Reviewer
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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Orlistat seems to provide mixed results for weight loss. Some users report successful, albeit slow, weight loss, while others experienced no weight loss and primarily unpleasant side effects like diarrhoea. Many find it easy to use and a good complement to diet and exercise. Effectiveness seems to vary significantly between individuals.
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Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.
Dr Alexandra Cristina Cowell
Writer & Clinical Content Reviewer
Cristina writes content for Treated, and reviews content produced by our other writers to make sure it’s clinically accurate.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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