NICE guidance - orlistat for the treatment of obesity

Summary points of the guidance on the use of orlistat for the treatment of obesity in adults:

• orlistat should be prescribed only as part of an overall plan for managing obesity in adults who meet one of the following criteria:
  • a BMI of 28.0 kg/m2 or more with associated risk factors
  • a BMI of 30.0 kg/m2 or more
• therapy should be continued beyond 3 months only if the person has lost at least 5% of their initial body weight since starting drug treatment
• the decision to use drug treatment for longer than 12 months (usually for weight maintenance) should be made after discussing potential benefits and limitations with the patient
• the co-prescribing of orlistat with other drugs aimed at weight reduction is not recommended

Notes:

• rates of weight loss may be slower in people with type 2 diabetes, so less strict goals than those for people without diabetes may be appropriate. These goals should be agreed with the person and reviewed regularly

Reference:

1. NICE. Obesity: identification, assessment and management. Clinical guideline CG189. Published: 27 November 2014 Last updated: 26 July 2023