Obesity has reached epidemic levels nationwide. It is associated with increased risk of many other diseases, including diabetes, coronary heart disease, and certain cancers.including a reduced-calorie diet, increased physical activity, and behavior therapy, should be the cornerstone of any weight-loss program. Drug therapy should always be used in conjunction with lifestyle changes. Orlistat provides an FDA-approved OTC option for weight loss. Patients should be educated about the importance of continued behavior modification if orlistat is added.
Because the absorption of orlistat is minimal, there are very few systemic effects. Common adverse effects are gastrointestinal (GI) and are caused by the increased amount of fat in the GI tract. These effects may include flatulence with discharge, fecal urgency, oily spotting, fatty or oily stool, abdominal pain or discomfort, and increased defecation. These symptoms seem to improve over time, usually lasting no longer than 4 weeks. Rarely, severe liver injury has been reported with orlistat use, but a causal relationship has not been established. Patients should be instructed to stop taking orlistat and to speak with their healthcare provider if they develop signs and symptoms of liver injury, including itching, yellowed eyes or skin, dark urine, fever, right-upper-quadrant abdominal pain, or loss of appetite.
Some common side effects include flatulence, frequent bowel movements, soft stool, oily rectal leakage, and abdominal pain. Speak with a healthcare provider if any of these side effects become severe or troublesome. If you experience any serious side effects, such as hives, rash, skin blistering, right-sided upper stomach or abdominal pain, pain radiating toward the back, or fever, stop taking the medication and immediately contact a healthcare provider.