How effective is Orlistat

Orlistat, as an over-the-counter weight loss medication, mainly achieves weight loss by inhibiting fat absorption, with clinical data showing an average weight loss of 5% -10%. The efficacy is mainly influenced by factors such as medication adherence, dietary coordination, basal metabolic rate, exercise participation, and individual differences.

1. Fat absorption inhibition:

Orlistat is a gastrointestinal lipase inhibitor that can block the breakdown and absorption of approximately 30% of dietary fat. The combination of drugs with lipase in the stomach and pancreas forms an inactive complex, preventing triglycerides from hydrolyzing into absorbable free fatty acids, and undigested fat is directly excreted through the intestine. This mechanism is particularly suitable for people with high fat content in their diet.

2. Short term weight loss effect:

Under the premise of standardized medication, the average weight loss effect within 3-6 months is 5% -8% of the initial weight. Clinical trials have shown that when combined with a low-fat diet, the medication group lost 2.5-3.5 kilograms more weight than the placebo group. The effect shows a trend of first fast and then slow, with a faster weight loss rate in the first three months.

3. Long term maintenance effect:

Continuous medication for more than 1 year can maintain the weight loss effect, but there is a plateau phenomenon. About 35% of users can still maintain a weight loss of over 5% after one year. Its value is more reflected in preventing weight rebound, which requires lifestyle changes to break through the plateau period.

4. Significant individual differences:

The effect of high-fat diet is better than that of balanced diet, and the response is more pronounced in people with BMI ≥ 27. Genetic testing shows that those with fast CYP3A4 enzyme metabolism have poorer efficacy, and the composition of gut microbiota can also affect drug sensitivity. About 15% of users may experience insignificant effects.

5. Safety impact:

Common gastrointestinal reactions such as fat diarrhea and oily spots may reduce the duration of medication. Dysabsorption of fat soluble vitamins requires attention to supplementation. Patients with metabolic diseases such as diabetes and hypertension need to monitor the changes of the primary disease, and some patients may have abnormal liver function indicators. During the use of orlistat, it is recommended to maintain a daily fat intake of less than 60 grams to avoid exacerbating gastrointestinal side effects with a high-fat diet. Combining 150 minutes of moderate intensity aerobic exercise per week can improve the effect, and low impact exercises such as brisk walking and swimming are recommended. Pay attention to supplementing fat soluble vitamins such as vitamin D and E, and regularly test liver function after taking medication for more than 6 months. If severe diarrhea or abdominal pain occurs, medication should be suspended. Women of childbearing age should be aware that medication may affect the effectiveness of contraceptive pills. It is recommended to develop a personalized medication plan under the guidance of a doctor or nutritionist to avoid prolonging the medication cycle on one's own.