Orlistat binds to gastric and pancreatic lipase enzymes and does 2 main things:

• Inhibits gastric and pancreatic lipase it forms a covalent bond with the active (serine) site of these enzymes in the gut, which stops them from breaking triglycerides down into absorbable free fatty acids and monoacylglycerides.

Medication	Onset of action	Uses
Obezita 120mg Capsule	12-24 hours	Weight loss management, Type 2 Diabetes
Obezita 60 Capsule	12-24 hours	Weight loss management, Type 2 Diabetes
O-Stat 120 Capsule	12-24 hours	Weight loss management, Type 2 Diabetes
O-Stat 60 Capsule	12-24 hours	Weight loss management, Type 2 Diabetes
Lipophage 60 Capsule	12-24 hours	Weight loss management, Type 2 Diabetes

• Reduces dietary fat absorption because triglycerides aren’t broken down, roughly a third of the fat eaten in a meal passes through the digestive system unabsorbed rather than being taken up into the body, which contributes to a calorie deficit and supports weight loss.

Safety and Efficacy

Efficacy

• Produces greater weight loss than diet and lifestyle changes alone; in a 2-year randomised trial, patients on orlistat lost about 10% of body weight in year one, compared with about 6% on placebo.
• Helps prevent weight regain: patients who stayed on orlistat in year two regained about half as much weight as those switched to placebo.
• Produces modest but consistent improvements in total cholesterol, LDL cholesterol, blood pressure, and fasting glucose and insulin levels.
• Its weight-loss effect is considered definite but modest compared with newer agents such as GLP-1 receptor agonists.
• Effects depend on continued use and a reduced-fat diet; weight tends to be regained if the drug is stopped and dietary habits aren’t maintained.

Safety

Its side effects are mostly gastrointestinal and related to unabsorbed fat passing through the gut, and may vary from person to person, i.e., oily spotting, flatulence with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased bowel movements, and fecal incontinence. These effects are usually more pronounced with higher dietary fat intake and tend to lessen over time. Because it reduces fat absorption, it can also lower absorption of fat-soluble vitamins (A, D, E, K), so a daily multivitamin taken at a different time from the dose is generally recommended.

Precautions

• If you have chronic malabsorption syndrome, cholestasis, or a known hypersensitivity to orlistat, avoid taking this medication.
• Use with caution in people with a history of kidney stones (oxalate nephropathy), gallbladder disease, or pancreatitis.
• Pregnant women should avoid taking this medication.