How Long Does Orlistat Take To Work?

Let’s be frank. Weight loss can be difficult at the best of times, but with summer coming and you want all that ‘feel good’ sunshine on your skin you know you’ve got to get a move on if you’re going to have any chance of fitting into your beachwear. Honestly, we all tend to accumulate a bit of fat over the colder months which can be hidden under layers of clothing but now’s the time to shed that and get you feeling your best. Carrying extra weight can put a lot of strain on our health, bodies and wellbeing. According to the World Health Organisation, a weight loss of up to 10%, for people carrying extra weight, improves blood glucose control, reduces both blood pressure and cholesterol levels, improves lung function and breathlessness, reduces the frequency of sleep apnoea, improves sleep quality, and reduces daytime drowsiness. And can also alleviate osteoarthritis, back and joint pain.


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Weight loss often results in feeling more confident and having more energy to do what you want, be it bike rides with the kids or evening walks with a loved one. I mean, who doesn’t want more energy to enjoy life? And the thought of fitting into your clothes better? Well, that’s a no-brainer.

When you go for your health check with the nurse or doctor they assess several factors in your lifestyle and also take measurements. First, they will want to assess whether your current weight is healthy or not. This means measuring your weight and height to calculate your body mass index (BMI). You may also have your waist measured. Measuring your waist is a good way to check you’re not carrying too much fat around your stomach, which can raise your risk of heart disease, type 2 diabetes and stroke. You can have a healthy BMI and still have excess tummy fat – meaning you’re still at risk of developing these diseases. Your GP may take your blood pressure and carry out other tests, such as a blood test, to check for any health conditions that may be related to your weight.

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You can also check your BMI yourself using an online BMI calculator such as this one.

Your BMI will fit into one of 4 categories:

  • underweight – those with a BMI of under 18.5
  • healthy weight – those with a BMI between 18.5 and 24.9
  • overweight – those with a BMI between 25 and 29.9
  • obese – those with a BMI between 30 and 39.9
  • morbidly obese – those with a BMI of 40 or over


It’s important to remember that BMI isn’t a suitable measurement for certain people, including:

  • children
  • pregnant women
  • athletes or those who’re extremely muscular


What do the stats look like with regards to being overweight? In 2016, 26 per cent of adults were classified as obese. This has increased from 15 per cent in 1993 but has remained at a similar level since 2010.

One way to help with weight loss is to reduce the amount of fat in your diet. Orlistat works by interfering with the way that fat is digested and absorbed into the body.  If you take orlistat, it may possibly interfere with the absorption of some vitamins, so you should take a multivitamin supplement at bedtime. 

Orlistat is a medicine which can help you to lose weight if you are overweight or obese. Orlistat works by blocking chemicals (enzymes) in your gut which digest fat. Nearly a third of the fat that you consume is blocked by orlistat. The undigested fat is not absorbed into your body and is passed out with your stools (faeces). The normal dose is one capsule – 120 mg, three times a day with each meal. However, you do not need to take one if there is no fat in the meal or if you miss a meal.

It is recommended that you reduce your fat intake to 30% of your total calorie intake whilst taking orlistat. Reported side-effects of eating too much fat include flatulence, oily spotting on underwear, increased urgency and loose bowel movements.

Tips on how to reduce your fat intake:

  • Change from butter or regular spreads to a low-fat spread such as Flora light, Bertolli light or supermarket versions
  • Choose lean cuts of meat and trim visible fat. Avoid skin on chicken and crackling on pork.
  • Avoid added fat/oil when cooking, (or use a spray oil) – grill, poach, bake or microwave instead.
  • Choose low-fat dairy foods such as semi-skimmed or skimmed milk, low-calorie yoghurts, reduced fat cheeses and low fat spreads.
  • Choose lower fat cook-in sauces with less than 5g fat per 100g sauce.

Fibre is needed in the diet to help maintain a healthy digestive system, fill you up and it can also help to reduce raised cholesterol levels. To increase your fibre intake:

  • Choose high fibre breakfast cereals such as Weetabix, Shreddies or Branflakes.
  • Choose wholemeal bread, wholewheat pasta and brown rice
  • Include pulses, peas, beans and lentils

Aim to have five or more portions of fruit and vegetables each day, fresh, frozen or tinned. They are both low in calories and provide essential nutrients to promote healthy skin, immune function and general well being. One portion is: 1 medium fruit, such as apple, small banana, pear 2 small fruits, such as 2 plums, 2 apricots, 2 kiwis A handful of berries/grapes 3 tablespoons cooked fruit or vegetables A small mixed salad A small glass of fruit juice approximately 150 ml (limit to one small glass per day as fruit juices are high in sugar).

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Starchy foods should make up around one quarter to one-third of your plate at meal times, for example, bread, potatoes, pasta, rice and cereals. Try to include high fibre varieties, for example, wholegrain bread and cereals, as these are generally more filling. Don’t add fat to these, for example, butter to mashed potatoes.


Balanced diet, healthy food concept


Provided that portion sizes of dairy foods and meats and alternatives are not too large, and extra fat isn’t added to these foods, they will not cause any unpleasant side effects whilst you are taking Orlistat.

Foods which are high in sugar and fat usually contain lots of calories so cutting down on, or avoiding these foods can help you lose weight. Aim to reduce the amount of sugar in your diet as much as possible: have hot drinks without sugar or instead, use a sweetener, choose ‘no added sugar’ squashes, diet, slimline fizzy drinks and choose tinned fruit in natural juice rather than in syrup.

Preparing to lose weight

  1. Choose your start date. Choose the day you will start taking the capsules ahead of time. Orlistat should be used along with a reduced calorie, lower-fat diet. Try to start this diet before beginning treatment. Before you start taking the capsules, begin your reduced calorie, lower-fat diet and give your body a few days to adjust to your new eating habits. Keep a record of what you are eating in a food diary. Food diaries are effective because they make you aware of what you are eating, how much you eat, and give you the basis to make changes.
  2. Decide on your weight loss goal. Think about how much weight you want to lose and then set a target weight. A realistic goal is to lose between 5% to 10% of your starting weight. The amount of weight you lose may vary from week to week. You should aim to lose weight at a gradual, steady pace of about 0.5 kg (1 lb) per week.
  3. Set your calorie and fat targets. To help you reach your weight-loss goal you need to set two daily targets, one for calories and one for fat.

How do I know if Orlistat is suitable for me? Well, several factors will determine whether you can take Orlistat. We talked about BMI before and this is one factor which will be taken into account. If your BMI is over 28 then you could take Orlistat, if it is below then you can’t.

How do I take orlistat? One orlistat capsule is taken with water immediately before, during or up to one hour after, each main meal (up to a maximum of three capsules a day). If you miss a meal, or the meal doesn’t contain any fat, you shouldn’t take the orlistat capsule. Treatment with orlistat should only continue beyond three months if you’ve lost 5% of your body weight. It usually starts to affect how you digest fat within one to two days.

So I can see results in one or two days? You will feel the effects of orlistat within a day or two, the weight loss will be gradual depending on your diet and level of exercise. If you think about it, your weight gain would have been fairly gradual so for you to lose weight too quickly can be unsafe. If you’re trying to lose weight, the safe weekly rate of weight loss is between 0.5kg and 1kg. That’s between around 1lb and 2lb a week.


Lots of Nutrition factsUnderstanding food labels: how to choose low-fat foods. When reading food labels look at ‘total fat’ as it is this part of your diet that can cause the unpleasant side effects from Orlistat if your fat intake is too high. On the food label look at the ‘per 100g’ column: • Total fat per 100g of product Choose foods with a total fat content of less than 5g/100g product and preferably 3g/100g or less. Remember not to add any extra fats to other foods eaten with the meal, for example by adding butter or oils to a jacket potato, pasta or rice. Tips when reading food labels • Check the labels of the foods you buy regularly for the fat content and switch to healthier options where appropriate. • Assume your first few shopping trips will take longer than usual while you are learning to understand food labels. Nutrition labels on the front of packaging Some supermarkets and food manufacturers also display nutritional information on the front of pre-packaged foods. This can be helpful to compare different food products. The figures used on these labels are ‘per portion’ and not ‘per 100g’. Use caution when reading this information as portion sizes on these labels might be different to the portion size you choose to help you lose weight. You still need to look at the total amount of fat per 100g.


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  1. WHO Consultation on Obesity (1999: Geneva, Switzerland) Obesity: preventing and managing the global epidemic: report of a WHO consultation. (WHO technical report series; 894).
  4. Statistics on Obesity, Physical Activity and Diet – England, 2018, NHS digital
  6. Your guide to healthy eating whilst taking Orlistat, Departments of Nutrition and Dietetics Norfolk and Norwich University Hospitals NHS Foundation Trust James Paget University Hospitals NHS Foundation Trust

Assured Pharmacy is not liable for the currency or accuracy of the information contained in this blog post. For specific information about your personal medical condition, please contact our doctors or pharmacists for advice on [email protected].