Orlistat: Over-the-counter weight loss support

Orlistat is used to treat obesity. It reduces the absorption of fat from food and thereby supports weight loss. Orlistat should only be used in conjunction with a low-fat diet, otherwise side effects such as abdominal pain,  diarrhea  and greasy stools can increase. We will inform you about the correct use, effects and side effects of orlistat.

Orlistat: Decreased fat absorption in the intestine

Orlistat inhibits fat-splitting enzymes (lipases) in the stomach and small intestine so that fats from food are not broken down. As a result, some of the fats in the intestine cannot be absorbed and are excreted undigested in the stool.

Taking orlistat can reduce  fat absorption by up to 30 percent  . For example, if the fat content of the daily diet is 60 grams, up to 18 grams of fat can be saved per day.

Here’s how Orlistat increases weight loss on a diet: If you lose 2 pounds on a low-fat, low-calorie diet alone, you can lose an extra pound by taking Orlistat.

Low-fat diet necessary

Orlistat should always be used as part of a low-fat, low-calorie diet. On the one hand, side effects such as diarrhea or greasy stools occur more frequently after meals that are too high in fat. On the other hand, sufficient weight loss cannot be achieved by the sole effect of orlistat. If the overall fat content of the diet is still too high, even though fat intake is reduced by orlistat, too much fat will still be consumed and weight loss will not be successful. In addition, orlistat should not be taken for more than six months and can therefore only support weight loss in the initial phase of losing weight.

Important:  For permanent weight loss, it is therefore essential that you change your diet to a balanced mixed diet in the long term. Also, make sure you exercise regularly to build muscle and increase calorie expenditure.  

Use orlistat correctly

The active ingredient is available in the form of capsules with 60 milligrams and 120 milligrams. Orlistat has been  available in pharmacies without a prescription in a 60 milligram dosage since 2009 . However, a doctor’s prescription is required for the higher dosage.

As a rule, one capsule is taken with the main meals. However, orlistat only works if the diet contains fat. For example, if you have a fruit salad with low-fat quark for breakfast, you should avoid taking orlistat. The same applies if you skip a meal. However, you should not increase the dosage if you have a particularly high-fat meal. Also, make sure not to exceed the maximum dose of three capsules per day.

Orlistat: Indigestion as a common side effect

Gastrointestinal side effects are common when using orlistat. Among other things, the following symptoms can occur:

• stomach pain
• Diarrhea
• gas
• greasy stool
• fecal incontinence

In order to reduce the occurrence of side effects, you should pay attention to a low-fat diet, since these side effects are mainly caused by the increased excretion of fat in the stool.

In addition, taking orlistat can lead to deficiencies in vitamins A, D, E and K, since these vitamins are fat-soluble and can only be absorbed by the body in conjunction with fat. In this case, after consulting a doctor, taking a multivitamin preparation can be useful.

In rare cases, bile stasis can also lead to liver inflammation. Symptoms include yellowing of the skin and eyes, pain in the upper right abdomen, and  itching . Other rare side effects include intestinal bleeding, inflammation of the colon, inflammation of the  pancreas  and an increase in liver values ​​or oxalic acid in the blood.

Contraindications of Orlistat

Orlistat can only be used by adults aged 18 and over with a  body mass index  of at least 28. Children and adolescents should not take the drug. Orlistat should also not be used during pregnancy and breastfeeding, since the effect and possible side effects in pregnant women have not yet been sufficiently researched. In addition, orlistat must not be taken in the following diseases:

• Gallenstau (Cholestase)
• Disturbed absorption of food components in the intestine (malabsorption syndrome)
• Hypersensitivity to the active substance orlistat
• Medical conditions that require the use of ciclosporin (rheumatoid  arthritis , certain  skin conditions , organ transplants)
• Erkrankungen, die die Einnahme von blutverdünnenden Medikamenten wie Marcumar® oder Warfarin erfordern

Patienten, die unter Diabetes oder unter einer Nierenerkrankung leiden, sollten Orlistat nur nach Rücksprache mit einem Arzt einnehmen.

Wechselwirkungen: Vorsicht bei gerinnungshemmenden Medikamenten

Bei der Einnahme von Orlistat kann es zu einer Reihe von Wechselwirkungen mit verschiedenen anderen Medikamenten kommen. So kann bei gleichzeitiger Einnahme von Aspirin die blutverdünnende Wirkung verlängert werden, wohingegen die Wirkung des gerinnungshemmenden Wirkstoffs Prasugrel verkürzt wird. Falls Sie eines dieser Arzneimittel einnehmen, sollten Sie Orlistat nur nach Rücksprache mit Ihrem Arzt anwenden. Medikamente mit den Wirkstoffen Phenprocoumon (Marcumar®) und Warfarin dürfen hingegen nicht gleichzeitig mit Orlistat eingenommen werden.

Weiterhin hemmt Orlistat die Aufnahme der Wirkstoffe Amiodaron und Ciclosporin sowie die Wirkung des Krebsmedikaments Irinotecan. Zudem kann es zu Wechselwirkungen mit Schilddrüsenhormonpräparaten und bestimmten Medikamenten gegen Epilepsie kommen.

Women who are taking contraceptive medicines such as  birth control pills  should use additional contraceptive measures if necessary, since severe diarrhea can reduce the effectiveness of the birth control pill.