Is Orlistat Safe?

Orlistat (Xenical) is a popular weight loss medication often referred to as a ‘fat-binder’. It works by interfering with certain digestive enzymes in your gut to stop you absorbing fat from the food you eat. Orlistat is considered to be a safe and effective weight loss aid when used correctly. 

Who Can Take Orlistat?

Orlistat is only intended for use by people who are overweight. That means that your BMI should be 25 or more (you can calculate your BMI here). Orlistat should not be used to reduce your weight to unhealthy levels. 

In order to support different weight loss goals, orlistat is available in two different strengths. The lower dose of orlistat is available over the counter under its brand name Alli, while the higher dose is currently only available on prescription in the UK. Both doses can be effective, but some people may find that the lower dose is insufficient. The higher dose is prescription-only due to the increased risk of side effects at this level, however, you should always read the patient information leaflet before taking any medication, whether it is over the counter or prescribed. 

Orlistat is considered to be a safe medication and can be used by most people who are overweight. However, it should not be used during pregnancy or breastfeeding, or by people who have certain medical conditions such as chronic malabsorption syndrome or cholestasis. People who have chronic kidney disease, low blood pressure or absorption problems in their gut, should speak to a doctor before taking orlistat, as they may require supplements or further monitoring whilst taking orlistat. 

As orlistat affects the absorption of fat in your digestive system, the absorption of other medications may also be affected. Speak to your pharmacist or doctor for advice if you take any other medications, especially antiepileptics, the contraceptive pill or antiretrovirals. 

If none of these criteria apply to you, orlistat is considered to be a safe and effective treatment to help you lose weight.

What Are the Side Effects of Orlistat?

Like all medications, orlistat does carry a risk of side effects. The most common side effects, which affect more than 1 in 100 people, include anxiety, abdominal pain, diarrhoea and other gut (gastrointestinal) problems. Many of these side effects are caused by the fact that your body cannot absorb the fat you eat, therefore, some of these symptoms may be reduced by minimising the fat intake in your diet.

Other reported side effects include gallstones, skin reactions, diverticulitis and other problems with your bowels, pancreas or kidneys. 

You should inform your doctor if you experience any medication side effects, as they should be properly recorded and it can be difficult to differentiate between different causes of these side effects yourself. If you experience any rectal bleeding, severe abdominal pain or severe skin reactions, please seek emergency medical attention. 

Does Orlistat Affect Fertility?

Orlistat is not known to have any negative effects on fertility. However, healthy weight loss can have a very positive impact on fertility and orlistat may help you to achieve that. 

Carrying excess body weight can affect the levels of important hormones in the body, affecting fertility in both men and women. In men, this tends to affect sperm health and sperm production; in women, it can disrupt ovulation. Therefore, reducing your weight to a healthy level may help to improve your fertility and your chances of pregnancy. 

Furthermore, if you are having difficulty conceiving, one study has found that orlistat can also improve the success rate of IVF treatment in women with excess weight. If you are overweight and considering IVF, you may want to discuss orlistat with your fertility specialist to see if it could improve your chances of a successful pregnancy. 

Conclusion

Orlistat is a safe and effective drug to help people lose excess body weight. Most people who are overweight can take orlistat safely, provided they do not have certain medical conditions. It is a good idea to discuss orlistat with your doctor if you have any pre-existing medical problems or if you are taking any medications, to check that it is safe for you. 

Orlistat should be avoided by women during pregnancy and breastfeeding, to avoid any risk to their baby. However, orlistat may have a positive impact for couples who are trying to conceive. Orlistat can aid weight loss, which can improve fertility by boosting sperm count and regulating ovulation. It can also improve the success rate of IVF. Speak to your doctor if you would like to explore using orlistat to improve your chances of conception.