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Orlistat is a capsule you swallow with meals. It is not a hormone and does not act on the brain or on appetite: it blocks the gut enzymes that digest fat, so roughly a third of the fat in a meal leaves the body in the stool instead of being absorbed. In the EU it is sold as Xenical, taken alongside a slightly reduced-calorie, lower-fat diet.
Active ingredient: orlistat · Dosage: 120 mg with each main meal, up to three capsules a day.

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Can I get it?

Yes, if a doctor decides it is right for you. Orlistat has been authorised for use in the EU since 29 July 1998, so a licensed doctor can prescribe it when it is clinically appropriate for you.

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What it is

Orlistat is a lipase inhibitor, taken as a hard capsule, acting only inside the gut. Unlike GLP-1 medicines, it does not act on appetite — its effect depends on keeping to a suitable diet while taking it. Xenical is centrally authorised, so one EU authorisation covers all 27 member states; the authorisation is now held by CHEPLAPHARM Arzneimittel GmbH. It is prescription-only. The authorised indications are:
  • Treatment of obesity in patients with a BMI of 30 kg/m² or more, together with a mildly reduced-calorie diet
  • Treatment of overweight patients with a BMI above 28 kg/m² who also have associated risk factors, together with a mildly reduced-calorie diet

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How it works

It switches off fat-digesting enzymes

Orlistat blocks the enzymes in the stomach and gut that break down dietary fat.

Dietary fat stays undigested

The inactivated enzyme cannot break dietary fat, which arrives as triglycerides, into the smaller free fatty acids and monoglycerides the gut wall can take up. The fat stays whole, and whole fat molecules are too large to cross into the body.

The blocked fat leaves in stool

The unabsorbed fat passes along the bowel and out in the stool, so those calories never reach you. The European Medicines Agency describes the 120 mg dose as letting about 30% of the fat eaten in a meal pass through undigested.

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What the studies reported

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What has been reported

All frequencies below are from the EU Summary of Product Characteristics.
Orlistat can reduce absorption of vitamins A, D, E and K. The EU product information advises a diet rich in fruit and vegetables, and says a multivitamin supplement — taken at bedtime — may be considered.

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Taking it day to day

Take it with the meal: one 120 mg capsule with each main meal, up to three capsules a day, as part of a mildly reduced-calorie, lower-fat diet. Oily, loose or urgent bowel movements are more likely after a fatty meal.

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How Hi-Doctor handles it

A licensed doctor reviews every weight-loss option and recommends what fits your history and goals. It’s a valid alternative for people who cannot or do not want injectables, though average weight loss is usually lower than with GLP-1 medicines. See how the consultation works, how we handle safety and eligibility, and pricing. For the underlying condition, see obesity or semaglutide as a comparison.

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Common questions

Orlistat is a lipase inhibitor. It blocks the enzymes in the stomach and gut that break down dietary fat, so about a third of the fat in a meal passes through the body instead of being absorbed. Unlike GLP-1 medicines, it does not act on appetite — its effect depends on a suitable diet.
Oily spotting from the rectum, fatty or oily stools, wind with discharge, urgent need to open the bowels and increased bowel movements are all very common. Abdominal pain or discomfort and flatulence are also very common. These effects are more likely after a fatty meal.
Orlistat can reduce absorption of vitamins A, D, E and K. The EU product information advises a diet rich in fruit and vegetables and says a multivitamin supplement taken at bedtime may be considered.
Orlistat is a non-injectable option that works locally in the gut rather than on hunger signals. Average weight loss is usually lower than with GLP-1 medicines, but it is a valid alternative for people who cannot or do not want injectables.
Take one 120 mg capsule with each main meal, up to three capsules a day, as part of a mildly reduced-calorie, lower-fat diet. Oily or urgent bowel movements are more likely after a fatty meal.

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Start a consultation

Weight-loss consultation

Answer the weight-loss questionnaire and a registered doctor reviews it. They decide whether treatment is appropriate, which one, and at what dose — and declining is a normal outcome. See what it costs and how the review works.
This page is reference information, not medical advice and not a prescription. Whether a medicine is appropriate for you is decided by a registered doctor after reviewing your consultation.