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Can you get Orlistat on the NHS?

Robbie Puddick
Written by

Robbie Puddick

Medically reviewed by

Fiona Moncrieff

3 min read
Last updated July 2024
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Jump to:  What is Orlistat? | How much weight will I lose on Orlistat? | Should you try Orlistat?

You can get Orlistat on the NHS from your GP (doctor) if you’ve previously made attempts to lose weight that haven’t been successful.

How do you qualify for an NHS Orlistat prescription?

To get Orlistat on the NHS, the following criteria must be met:

  • A doctor or pharmacist believes it’s the best medicine for you
  • You’ve made a significant effort to lose weight through diet, exercise, or changing your lifestyle
  • Orlistat is only prescribed if you have either:
  • A body mass index (BMI) of 28 or more and other weight-related conditions, such as high blood pressure or type 2 diabetes
  • A BMI of 30 or more
  • Orlistat isn’t usually recommended for pregnant or breastfeeding women.

What is Orlistat?

Orlistat is a lipase inhibitor. Lipases are gut enzymes that break down fat from food, enabling the gut to transport fat into the body to be burnt for energy or stored in our fat cells for later use.

Orlistat blocks lipases, preventing some of the dietary fat from our meals from being digested. This leads to fewer calories being absorbed, which can support weight loss.

Orlistat is a prescription medication produced by two pharmaceutical companies in the UK:

  • GlaxoSmithKline: Alli, 60 mg and available over the counter (no prescription)
  • Roche: Xenical, 120 mg and available with a prescription
  • Orlistat is also sold unbranded under its active ingredient name, ‘Orlistat’ and comes in the 120mg form

However, it’s recommended that you consult with a healthcare professional or a pharmacist before purchasing weight-loss pills.

How much weight will I lose on Orlistat?

Orlistat (Xenical/Alli) has been shown to lead to a weight loss of 4% of body weight after three months and around 8% after one year. It’s generally well-tolerated, with fewer than 10% of people stopping the medication due to adverse effects.

However, research has shown that other weight-loss medications lead to significantly more weight loss, with orlistat often performing worse than other medications, such as liraglutide (Saxenda).

In a review comparing orlistat with four other weight-loss medications, including liraglutide, orlistat was found to be the least likely to lead to more than 5% weight loss.

At the same time, a clinical trial with 237 participants investigated the impact of orlistat in a real-world setting to determine adherence to the medication and whether they were well tolerated.

The results showed that participants lost around 4% of body weight after three months. 80% of participants reported being satisfied with the drug due to its positive effect on weight loss.

This suggests that despite its modest effects on weight loss, the medication’s tolerability may support some people to stay on it for longer and change their diet and lifestyle.

Should you try Orlistat?

Lipase inhibitors like Xenical and Alli can lead to weight loss of 4-8% after one year, alongside changes to diet and lifestyle.

They’re also well-tolerated, with human clinical trials indicating less than 10% of people stop taking the medication due to adverse effects.

However, all medications come with risks and rewards, and not everyone is suitable for weight-loss medications like Orlistat.

Deciding to start a new medication is a highly personal choice. So, ultimately, it depends on whether you believe it’s the best decision for your health going forward.

All weight-loss medications are designed to be taken alongside changes to your lifestyle. Without this, the effects of the drug will not last, and you’ll likely regain any weight you lose in the future.

Second Nature’s medication-supported programmes

Second Nature has two medication-supported programmes: a Wegovy weight-loss programme and a Mounjaro weight-loss programme.

If you’ve made the decision to try Wegovy or Mounjaro (assuming you’re eligible), why should you choose Second Nature over other medication providers?

For peace of mind.

Second Nature has worked with the NHS for over 6 years providing weight-loss programmes across the UK.

Whilst our Wegovy and Mounjaro weight-loss programmes are private and not currently used by the NHS, we’ve built the programmes with a focus on scientific evidence, patient safety, and data security.

We hope that our 6+ years of working with the NHS and building a track record of effective weight-loss results will give you peace of mind to give us a try.

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