Table of contents
Medically reviewed by
Dr Daniel Atkinson
GP Clinical lead
on November 07, 2022.
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How does Orlistat work?

The main active ingredient in all three medications is orlistat – a lipase inhibitor. Lipase is an enzyme in your digestive system that helps you to break down any fat you eat in your meals and snacks, which it stores as energy for you to use later.

When you take orlistat it stops lipase from working, making it difficult for your body to digest and store fat. This is why you’ll need to follow a low-fat diet when you’re taking these tablets. Eating too much fat whilst taking Orlistat can increase your risk of getting stomach problems. Equally, the medication won’t work at all if you completely cut fat out of your diet.

Alli works in exactly the same way as Orlistat, but it’s just a smaller dose. This means that you can take a slower approach to your weight loss.

What does Orlistat look like?

Both Alli and Xenical are branded blue tablets, with the name of the drug and the dosage imprinted on the side of it.

Generic Orlistat tablets will contain exactly the same medication, but the tablet might vary in appearance.

How to take Orlistat

The maximum daily dose for the medication is 360mg. That’s based on taking one 120mg capsule three times a day. The instructions for taking Orlistat, Xenical and Alli are usually the same, but your clinician will be able to advise you best.

It’s best to take orlistat with each meal you have that has fat in it, either:

  • just before you’re about to eat,
  • with your meal,
  • or up to one hour after you’ve finished eating.

If you skip a meal, or you forget to eat, you don’t need to take a tablet. If you know you’re eating a meal that contains no fat at all then you don’t need to take a tablet then, either.

The best time to take Alli, Orlistat or Xenical is at meal times. The simplest way to do it is to have your three doses with your main meals – breakfast, lunch and dinner. You can take it just before food, with your meal or up to one hour afterwards.

To get the best results from orlistat, take it with food. The meal that you eat has to meet certain criteria for the medication to work. You’ll have to follow a low fat diet, but it’s important your meal does contain a little essential fat. If you’re eating a meal that has no fat in it at all, then it’s best not to take your tablet, as it won’t work.

If you follow the right diet, and take it as you’ve been prescribed to, you should find that Xenical and Orlistat start to work pretty fast – you could start to see results after two weeks. With Alli, as the dose is smaller you might have to wait slightly longer to see any results, but often it’s recommended to have a slower weight loss for better long term health benefits.

How long you take Orlistat for depends on your weight loss goals and how long it takes you to reach them. Generally speaking, you shouldn’t take orlistat for longer than three months, as if you haven’t achieved your weight-loss goals within this time, you should perhaps consider using alternative methods. You should also stop taking orlistat if you’ve reached a healthy weight.

Is Orlistat effective?

Yes. In a clinical study, obese patients with a BMI of over 30 were given 120mg or orlistat three times a day. On average they lost 4.65kg, almost 5cm from their waist circumference and reduced their cholesterol levels by 10.6mg.

Orlistat doesn’t burn existing fat, it works to try to stop you from gaining more from the foods you eat. But, by stopping you from absorbing all the calories from the foods you eat, you’ll find it easier to maintain a calorie deficit, forcing your body to make use of its fat stores for energy.

Orlistat isn’t an appetite suppressant. It will simply limit the amount of fat you can absorb from your diet and the meals you eat. When you take it to help you reach your weight-loss goals it can encourage healthier eating habits in the long-term, and encourage you to eat less fat once you’ve stopped taking it.

Orlistat is a very safe treatment to take. Some people might experience a few side effects, such as stomach issues, but these usually stop after a few weeks. Check with a clinician to make sure that it’s safe for you to use before you start taking it.

Is Orlistat right for you?

Orlistat, Xenical and Alli are lipase inhibitors that work to block lipase from being produced by your body when you eat.

When you take either of these alongside a low fat-diet and exercise they can offer weight-loss benefits. The results you see from taking Orlistat will depend on the dose you take and what your weight loss goals are. You can chat with our experts to see if this can be the right treatment for you.

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This page was medically reviewed by Dr Daniel Atkinson, GP Clinical lead on November 07, 2022. Next review due on November 07, 2024.

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