When an overweight or obese person needs to lose weight, treatment should rely first and foremost on non-drug measures such as individual support, a well thought-out diet and appropriate physical exercise, taking into account associated complication factors.

For several years, Orlistat 120 mg (Xenical°) has been authorised in France as a prescription drug for the treatment of obesity. Since May 2009, the 60 mg version, marketed as Alli°, has been authorised for sale without a prescription.

For obese or overweight patients, orlistat, combined with a hypocalorific diet, results at best in only modest and often short-term weight loss. It has not been shown to have any benefit with regard to the severe complications of obesity.

The drug has frequent, sometimes very embarrassing or harmful adverse effects: gastrointestinal disorders such as oily anal discharge, occasionally severe diarrhoea, abdominal pains, difficulty in absorbing vitamins, interactions with drugs whose efficacy can be affected (contraceptives, etc.).

Orlistat is no miracle drug either for obese or overweight patients, and even less so for young women anxious about their figure.

©Prescrire July 2009

Source: "Orlistat sans ordonnance : les patients n'en auront pas pour leur argent" Rev Prescrire 2009; 29 (308): 420-421.

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