Orlistat

Orlistat is a lipase inhibitor which acts by reducing the absorption of dietary fat. It prevents absorption of around 30% of dietary fat (1)

• Indication - 'in conjunction with a mildly hypocaloric diet for the treatment of obese patients with a body mass index (BMI) greater or equal to 30 kg/m^2, or overweight patients (BMI >= 28 kg/m^2) with associated risk factors'
  • orlistat should be prescribed only as part of an overall plan for managing obesity in adults who meet one of the following criteria (2):
    • 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

Reference:

1. Drew BS, Dixon AF, Dixon JB. Obesity management: update on orlistat. Vasc Health Risk Manag. 2007;3(6):817-21.
2. NICE. Obesity: identification, assessment and management. Clinical guideline CG189. Published: 27 November 2014 Last updated: 26 July 2023