The weight loss drug:Lepastin (orlistat) and your health – what you should know


Orlistat belongs to a class of drugs called lipase inhibitors, and helps with weight loss for obese and overweight individuals. A popular brand is ‘LEPASTIN’ from swipha.

It works by interfering with the way fat is digested and absorbed into the body and so nearly a third of what you eat is blocked, undigested and passed out with your stools or faeces. Some data suggest that it helps reduce the amount of a particularly dangerous type of belly fat called visceral fat, which has been linked to type 2 diabetes, high blood pressure, heart disease and stroke. Orlistat is the only prescription medicine readily available to help with weight loss. Some other medicines previously used are no longer available because of concerns over their safety.




It should however be noted that ORLISTAT IS NOT A ‘WONDER DRUG’!

It will not work without a weight reducing diet and exercise. In fact, absence of a weight reducing diet will easily cancel out the effect of orlistat. It is expected that you lose 5% of your weight by three months from starting orlistat. Otherwise, it should be discontinued.

It comes in capsule form and is taken by mouth three times a day, either with a meal that contains a little bit of fat, or up to one hour afterward. If you eat no fat meal, you may need to skip your dose.

Tips when taking orlistat (lepastin):

Taking orlistat may make it more difficult for the body to absorb fat-soluble vitamins and as such daily intake of multivitamin supplements while on orlistat may be necessary. Multivitamin supplements should be taken at bedtime – a time when you will not be taking orlistat – to help ensure adequate vitamin intake.

The main side effects of orlistat are caused by the fat passed out with your stools (faeces) and they include

  • fatty smelly stools
  • urgency to go to the toilet
  • oily spotting on your underclothes, and
  • excess gas

These side effects are less likely if you eat a low-fat diet.

If you develop any sign of liver injury such as those below, orlistat should be stopped and medical care sought.

  • dark urine
  • fatigue
  • fever
  • light coloured stools
  • loss of appetite
  • severe, persistent itching
  • weakness
  • vomiting
  • yellowing of the skin or eyes (jaundice)

Note: Orlistat is a prescription medicine and should only be taken under clinical supervision

Related research

  1. A systematic review of research works on the effectiveness and safety of orlistat (in addition to diet low in calories) from 1966 to December 2003, found that three 120 mg of orlistat/d is effective for improving both weight loss and serum lipid profiles in
  • obese patients at low and high risk of cardiovascular disease
  • obese patients with type 2 diabetes

Authors: Hutton B, et al. in American Journal of Clinical Nutrition 2004.

  1. A randomised placebo-controlled trial to assess the effectiveness and tolerability of orlistat for weight loss and prevention of weight regain in obese patients found that orlistat taken with an appropriate diet promotes clinically significant weight loss and reduces weight regain in obese patients over a 2-year period

Authors: Sjöström L et. al. in Lancet 1998 Jul 18;352(9123):167-72.

Summary: studies say orlistat is effective in weight reduction, should be used only as prescribed and properly monitored


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