Orlistat weight loss tablets

Orlistat is a fat-blocking weight-loss tablet, available over the counter as Alli or on prescription as Xenical. It is one of the longest-established weight-loss medications in the UK, and a gentler, non-injection alternative to the newer GLP-1 medications.

How orlistat works

Orlistat is a lipase inhibitor. Lipases are the gut enzymes that break down the fat in your food so the body can absorb it. Orlistat blocks them, so some of that fat passes straight through rather than being digested and stored, which means fewer calories absorbed from fat.

Unlike the GLP-1 medications, it does not touch your appetite. It works in the gut rather than the brain, so you will not feel less hungry on it.

How you take it

Orlistat comes in two strengths under two names: Alli, the lower 60 mg dose available over the counter, and Xenical, the higher 120 mg dose available on prescription and also sold as unbranded generic orlistat.

Both are capsules taken with meals that contain fat. A doctor or pharmacist talks you through the right routine before you start.

Results to expect

Orlistat gives a steadier, more modest result than the injections. Alongside changes to diet and lifestyle, people lose around 4% of their body weight after three months and around 8% after a year. For comparison, the GLP-1 medications reach 10 to 20% over a year.

The medication does the fat-blocking, but the weight loss only sticks when the eating and lifestyle habits change with it.

Side effects and tolerability

Orlistat is generally well-tolerated, and fewer than one in ten people stop because of side effects. Most are digestive and tied to how much fat is in a meal, so the more fat you eat, the more noticeable they are. Eating less fat usually keeps them in check.

A doctor or pharmacist checks it is suitable for you before you start.

Who it is for

Orlistat is usually considered for adults with a BMI of 28 or above who also have a weight-related condition, or a BMI of 30 or above, when a doctor or pharmacist agrees it is right for you. It is not usually recommended during pregnancy or breastfeeding.

It tends to suit people who want a gentler option, or who would rather not use, or cannot take, an injection.

What you get with Second Nature

Orlistat blocks some of the fat you eat, but it does not change why you reach for certain foods or build the habits that keep weight off. That is what Second Nature focuses on.

Your plan is a structured programme around your eating, behaviour and lifestyle, with a registered dietitian and daily coaching in the app, built to help the weight stay off for good.

Frequently asked questions

How does orlistat help with weight loss?

It is a lipase inhibitor, which blocks the gut enzymes that digest fat, so some of the fat you eat passes through rather than being absorbed. It does not reduce your appetite.

What is the difference between Alli and Xenical?

They are the same medicine at different strengths. Alli is the lower 60 mg dose available over the counter, and Xenical is the higher 120 mg dose available on prescription, also sold as generic orlistat.

How much weight can I lose on orlistat?

Alongside diet and lifestyle changes, people lose around 4% of their body weight after three months and around 8% after a year, which is more modest than the GLP-1 injections.

Can I get orlistat on the NHS?

Yes, if you meet the criteria, usually a BMI of 28 or above with a weight-related condition, or 30 or above. It is also available over the counter as Alli or through a private prescription.

What are the side effects of orlistat?

It is generally well-tolerated, with fewer than one in ten people stopping because of side effects. Most are digestive and depend on how much fat is in your meals.

Is orlistat better than Wegovy or Mounjaro?

It depends on what you want. The GLP-1 medications deliver more weight loss (around 15 to 20% a year versus 4 to 8% for orlistat), but cause side effects in more people. Orlistat suits people wanting a gentler, non-injection option.

Can I take orlistat if I am pregnant or breastfeeding?

No, orlistat is not usually recommended during pregnancy or breastfeeding. Speak to your GP or pharmacist about suitable options.

Sources

Orlistat weight loss (around 4% at three months, around 8% at a year): Second Nature published guides.

Comparison with GLP-1 medications (around 15 to 20% a year versus 4 to 8% for orlistat): Second Nature published guides.

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12-month guided programme

Think of it like a masters for your health. A structured programme proven to build lasting habits and sustainable weight loss.

Worth £600

A dedicated nutritionist

Get a consultation and ongoing support from a dedicated nutritionist who will monitor your side effects and give you tailored health advice.

Worth £1,400

Monthly clinical reviews

Get ongoing clinical reviews, dose optimisation and a tailored plan to maintain and come off the medication when you're ready.

Worth £500

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Join a close knit support group that shares your worries, wins and journey. You don't need to feel alone anymore.

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Anneka lost 38 kg

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Steven lost 32 kg

"Nothing else worked for me until Second Nature. My clothes have gone from 5XL to Large."

Steven W.

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Ann lost 19 kg

"After years of struggling to lose weight and always feeling uncomfortable in my body. I have finally found something that works for me."

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FAQs

Wegovy (semaglutide) and Mounjaro (tirzepatide) are both once-weekly injections that help most people to lose weight. However, they have different active ingredients. In Wegovy, the active ingredient is semaglutide and in Mounjaro the active ingredient is tirzepatide. Orlistat, unlike Wegovy and Mounjaro, comes in the form of a pill that is taken up to three times a day, every day. Wegovy is used solely for weight loss and works by mimicking a single hormonal receptor (GLP-1) which slows down gastric emptying, making you feel fuller for longer. Mounjaro activates both the GLP-1 receptor as well as the GIP receptor, which promotes energy storage. Mounjaro is used for both weight loss and for managing type 2 diabetes. Both GIP and GLP-1 receptors are expressed in the areas of the brain important for appetite regulation. Orlistat works in the stomach and intestines by blocking the enzymes (lipases) that break down dietary fats. This in turns prevents a percentage of the fats you've eaten (approximately one-third) from being absorbed into the body. Instead, this undigested fat is excreted with your stools. This ultimately creates a calorie deficit that aids in weight loss. Because Wegovy and Mounjaro are different medications, this also means that their starting, escalation doses and maintenance are different. They also have different manufacturers: Wegovy is made by Novo Nordisk, whilst Mounjaro is made by Eli Lilly. Orlistat is available in the UK in two different dose strengths depending on patient eligibility: a 60mg Pharmacy Medication and a 120mg Prescription Only Medication. However, there is no escalation process; patients start and maintain on the same dose for the duration of their treatment. This service only offers the 60mg dose of Orlistat, which is made by Haleon UK Trading Limited.

If you want a deeper breakdown, read our Wegovy vs Mounjaro comparison guide.

We can't give you a yes or no without completing our health assessment; the clinical prescribing clinician will evaluate your individual situation.

Previous gallbladder removal, certain thyroid conditions, and other health issues require careful consideration but in many circumstances, you can take Mounjaro alongside these conditions. HRT typically isn't a problem.

The onboarding includes a detailed health questionnaire and clinical review. Be completely honest about your health history.

It depends on the habits you've built while on medication. Research shows people typically regain two-thirds of lost weight without proper support.

Our data suggests something different: participants who develop sustainable habits with our programme show only 3.2% weight regain after stopping, compared to 6%+ without support.

We focus on building these habits from day one; when appetite is lower and it's easier to learn what healthy eating actually looks and feels like.

The medication gives you a window to change your relationship with food, not just lose weight temporarily.

Your health coach is a UK-registered dietitian or nutritionist, available 5 days a week through the app. You message them directly and get responses typically same day.

They help with managing side effects, adjusting eating habits as your appetite changes, and building practical skills around food. You're also placed in a small group with others on similar journeys for peer support.

The support continues throughout your programme, not just at the start.

Yes, in most cases you can continue your current dose after a clinical assessment.

Our prescribing pharmacists will review your current medication, how long you've been taking it, and your medical history. If you're stable and everything checks out medically, you can typically continue rather than starting from the beginning.

You'll complete a health questionnaire and have a consultation with our clinical team, then get access to the full programme alongside your medication.

On our standard monthly plan you can cancel anytime, with no penalty.

If you choose a 6 or 12-month commitment plan, you get a lower monthly price in return for staying for the term. You can still leave early, and it's always free if you cancel within your first 14 days, within your first month, or for a clinical reason such as side effects. Otherwise, leaving early simply means repaying the monthly discount you've already received, capped at £100.

If you're thinking about cancelling because of side effects, cost, or feeling stuck, it's worth speaking to your health coach first - they might be able to help.

For mild side effects like nausea or constipation, message your health coach.

For moderate or persistent issues, they'll escalate to the clinical team. For severe symptoms (severe abdominal pain, allergic reactions), contact 111 or go to A&E immediately; don't wait to message us first.

Common side effects typically improve over time. Our research showed 69% of participants reported no side effects by month 12.

The clinical provider depends on your medication programme. Foundayo and Mounjaro are prescribed by Second Nature's clinical team. If approved, Blueco Healthcare, our registered pharmacy partner, dispenses and delivers your medication. For other medication programmes, Blueco Healthcare may provide the clinical assessment and prescribing as well as pharmacy services.

All prescribing decisions are made by qualified, registered clinicians. Your health coaches are UK-registered dietitians or nutritionists with specialist training in weight-loss medications. Dr Rachel Hall (MBChB) provides medical review and oversight at Second Nature.

We've had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.

Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro and Wegovy) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.

At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We're here to support that change every step of the way.

With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK's most trusted weight-loss programme.

We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.

If you're comparing providers, you can also read our guides on how to buy Mounjaro online and buy Wegovy online.

Yes. If you find that one medication isn't working for you, either because you aren't losing enough weight or because the side effects aren't tolerable, let the clinician know. The clinician will typically have a discussion with you to determine what the issue is and if a change in medication would be in your best interest. You should note that some of the weight loss medications work similarly and have similar side effects. Therefore, switching medications does not necessarily mean that you'll lose more weight or that your side effects will change. When you switch from one medication to another, the same protocol is followed as if you are starting your weight loss journey afresh. This means that you will be prescribed the lowest dose of the new medication to begin and then gradually you'll work up to larger doses as your tolerability increases.

For Wegovy (semaglutide) and Mounjaro (tirzepatide), not unless you're already being prescribed the same weight loss medication by another provider. For Orlistat, there is only one dose offered on this service, and there is no escalation/titration path. Both Wegovy and Mounjaro have been designed with a set titration path for your safety and wellbeing (a titration path is when the dose is increased each month). This staggered approach also helps to reduce the impact of any gastrointestinal (GI) side effects by giving your body time to adjust to the medication. Some patients may even find that they need to titrate more slowly than other patients in order to give their body more time to get used to the medication.

For Orlistat, whilst there are two dose strengths available in the UK, only one dose strength (60mg) is available on this service. The difference in dose strengths for Orlistat is tied to patient eligibility and how much oversight from a clinician is required. The different doses of Wegovy and Mounjaro are part of a set titration path with your safety and wellbeing in mind. Weight loss medications commonly cause gastrointestinal (GI) side effects. The titration path for both Wegovy and Mounjaro starts you at a low initial dose of medication and then gradually increases your dose over time. This helps to reduce the impact of these side effects by giving your body time to adjust.

That depends. While most patients follow the set titration path for Wegovy and Mounjaro (which means that their dose is increased each month), other patients remain on the same dose for more than 1 month in order to allow their body more time to adjust to the medication. It all comes down to your body and how you tolerate the medication. The clinician will work with you to ensure that the next dose up is safe and effective for you. If you're having more side effects than usual, or you find that the side effects aren't tolerable, let your clinician know. You may be prescribed the same dose again or, in some cases, have your dose lowered if needed. If you're taking Orlistat, your dose won't increase at all. You'll take the same dose of the medication throughout your treatment.

Many patients start to notice weight loss within a month of starting medication. However, for some patients, it can take longer. Based on a clinical trial, patients taking 2.4 mg of Wegovy (semaglutide) can expect to lose up to 15% of their body weight after 68 weeks. In a separate clinical trial, patients taking Mounjaro (tirzepatide) 10 mg or 15 mg lost up to 20% of their body weight after 36 weeks. For patients taking Orlistat 60mg in a clinical trial, 46% lost at least 5% of their body weight in 6 months and 16% of patients lost 10%. In all clinical trials, patients were using the medication alongside a change in lifestyle (i.e. a reduced calorie diet and increased physical activity). If within six months of being on Wegovy or Mounjaro, or within three months of being on Orlistat, you do not lose at least 5% of your body weight, the clinician will work with you to understand why and, together, you'll decide if it is in your best interest to continue with the medication.

For Wegovy and Mounjaro, this is entirely up to you. The medications prescribed are intended for long-term use and sustainable weight maintenance, rather than being a quick fix. Once your rate of weight loss has stabilised and/or you've reached your target weight, the clinician will have a chat with you to understand whether continuing your weight loss treatment is in your best interest. For Orlistat, treatment should not exceed six months.

Some patients start to lose weight within a month of starting medication, but for others it may take longer. It's important to consistently take your medication as prescribed and to make diet and lifestyle changes alongside this. If within six months of being on Wegovy or Mounjaro, or within three months of being on Orlistat, you do not lose at least 5% of your body weight, the clinician will work with you to understand why and, together, you'll decide if it is in your best interest to continue with the medication.

This is entirely understandable. However, you should note that the medication is designed to be used long-term, without gaps or breaks. It takes time for your body to get used to the medication and, for Wegovy and Mounjaro, for you to build up your tolerance of the maintenance dose. Because of this, a gap or break of 2 doses or more when taking Wegovy or Mounjaro typically means that you'll need to start over. This means you'll have to begin on the starting dose when you decide to start taking the medication again. Orlistat is designed for consistent, daily use alongside meals containing fat, but it can be taken intermittently if you miss a meal or eat a fat-free meal. If you regularly need to take breaks from medication, it may be worth discussing this with the clinician to determine whether the medications prescribed are the most appropriate course of action for you.

Weight loss medications commonly cause gastrointestinal (GI) side effects. These should subside in time and, in many instances, can often be managed by diet modification and over the counter medications. Side effects are most likely to be experienced during dose escalations (if you are taking Wegovy or Mounjaro) or when you first start treatment (if you are taking Orlistat). Some of the very common side effects for Wegovy (affecting 1 in 10 patients) include: Headaches, Vomiting, Diarrhoea, Constipation, Nausea, Bloating, Fatigue, Weakness. Some of the very common side effects for Mounjaro (affecting 1 in 10 patients) include: Vomiting, Diarrhoea, Constipation, Nausea. Some of the very common side effects for Orlistat (affecting 1 in 10 patients) include: Oily spotting, Flatus (gas) with discharge, Faecal urgency, Fatty oily stool, Oily evacuation, Flatulence (gas), Soft stools.

You can also read our detailed Mounjaro side effects guide and Wegovy side effects guide.

For nausea and mild abdominal pain, try reducing your meal size. Aim for smaller, more frequent meals that have an appropriate protein content and are not high in fat. Eat slowly, remain hydrated, and focus on simple, plain foods. If your lack of appetite is extreme, it's important to set reminders to eat and maintain proper nutrition. It may help to keep a food diary, or to eat whenever you do feel hungry, even if this is not at a normal mealtime. For issues with bloating, try to remember to eat small, more frequent meals and to eat slowly. Avoid fizzy drinks and be sure to take small sips. If you are experiencing headaches, stay hydrated and avoid too much screen time. It may also be helpful to get some fresh air and to lie down for a rest or take a nap. When diarrhoea occurs, it's important to stay hydrated and avoid caffeine. Continue to eat, but make sure your meals are small and frequent and that you eat slowly. Reduce your intake of fatty foods and insoluble fibre and consider taking some probiotics. If instead you become constipated, ensure that you remain hydrated and move about regularly. Consume regular and balanced meals and check your overall intake of fibre. If you are experiencing side effects associated with Orlistat, try reducing your dietary consumption of fat.

Orlistat is a hard capsule pill taken up to three times daily that works in the stomach and intestines by blocking the enzymes (lipases) that break down dietary fats. This in turns prevents a percentage of the fats you've eaten (approximately one-third) from being absorbed into the body. Instead, this undigested fat is excreted with your stools. This ultimately creates a calorie deficit that aids in weight loss.

No, you do not need a prescription for the dose of Orlistat (60mg) offered on this service. Whilst it is not a prescription medication, however, it is still a pharmacy medicine, which means that it must be obtained from a pharmacy and used under supervision. There is a 120mg dose of Orlistat available in the UK that is a prescription medication. However, this dose is not offered as part of the service.

Some of the very common side effects for Orlistat (affecting 1 in 10 patients) include: • Oily spotting • Flatus (gas) with discharge • Faecal urgency • Fatty oily stool • Oily evacuation • Flatulence (gas) • Soft stools For most patients, these side effects are experienced when they first begin treatment and will often subside over time. To reduce side effects, you can decrease your dietary fat consumption.

Orlistat is generally safe for individuals who meet the established criteria, i.e. those who are overweight or obese and who do not have exclusionary conditions or factors. It is important, as with any medication, to use Orlistat as directed under the guidance of a clinician. The screening and consultation process in place helps to determine if Orlistat will be safe and effective for you. The ongoing check-ins help to ensure that this remains the case for the duration of your time with the service. As with any medication, there are potential side effects associated with Orlistat, which vary in severity and frequency for different patients. You can view the full list of these side effects, as well as other important information, in the Patient Information Leaflet for Orlistat.

Orlistat weight loss tablets

How orlistat works

How you take it

Results to expect

Side effects and tolerability

Who it is for

What you get with Second Nature

Frequently asked questions

How does orlistat help with weight loss?

What is the difference between Alli and Xenical?

How much weight can I lose on orlistat?

Can I get orlistat on the NHS?

What are the side effects of orlistat?

Is orlistat better than Wegovy or Mounjaro?

Can I take orlistat if I am pregnant or breastfeeding?

Sources

What you'll get

The Complete Programme

12-month guided programme

A dedicated nutritionist

Monthly clinical reviews

Exclusive member community

Second Nature App (4.8★)

12-month guided programme

A dedicated nutritionist

Monthly clinical reviews

Exclusive member community

Second Nature App (4.8★)

Health team in your pocket

You don't need to figure it out alone anymore

The Second Nature App

4.8

out of 5

6.2K Ratings

The Second Nature App

4.8

out of 5

6.2K Ratings

Join thousands of our members transforming their health

Anneka lost 38 kg

Steven lost 32 kg

Ann lost 19 kg

Anneka lost 38 kg

Steven lost 32 kg

Ann lost 19 kg

Speak to someone

Mike Gibbs

FAQs

Second Nature®

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