Can Orlistat really help you lose weight?

Orlistat (Orlistat) is the only prescription or over-the-counter drug approved by the U.S. Food and Drug Administration (FDA) for weight loss and calorie reduction. The over-the-counter version of orlistat (60 mg) is indicated for use in conjunction with a low-calorie, low-fat diet in overweight adults 18 years of age or older. Orlistat has no systemic effects; instead, it exerts its therapeutic activity in the gastric and small intestinal lumen by inhibiting gastric and pancreatic lipases that hydrolyze triglycerides into free fatty acids and monoglycerides. This limits the intestinal ability to absorb triglycerides, which are excreted in the feces, thereby inhibiting dietary fat absorption by approximately 30%.

In a 16-week randomized controlled study, orlistat 60 mg resulted in significant weight loss compared with placebo (3.05 kg vs. 1.9 kg, respectively); another study evaluated the ability of 60 mg orlistat to change visceral adipose tissue in overweight patients. After 24 weeks, orlistat showed significant reductions in visceral adipose tissue compared with placebo. Additionally, there was a trend toward greater reductions in liver fat and intermuscular adipose tissue. These findings suggest that orlistat 60 mg, combined with a low-calorie, low-fat diet, may be an effective weight loss tool to reduce metabolic risk factors associated with upper body obesity.

The original drug of Orlistat has been marketed in China, but it has not yet entered the scope of medical insurance. There are also domestically produced drugs developed by other pharmaceutical companies on the market. The price of each box may be around tens of RMB, which is cheap. The price of the Indian version of Orlistat listed overseas is 120mg*84 capsules per box, which may be around a few hundred yuan (the price may fluctuate due to exchange rates). The ingredients of the two drugs are basically the same, but the manufacturers are different, and patients can choose by themselves.