Orlistat is a drug created for treating obesity. It was developed later than similar medications but Orlistat the first drug for the obesity treatment which acts only in the gastrointestinal tract. It’s been approved for use in the USA since 1999. Orlistat is the first weight loss medicine that doesn’t work systematically, but effective in the gastrointestinal tract only.
Orlistat blocking fat. It inhibits gastric and pancreatic lipases that prevents absorption of approximately 30% of dietary fats. It belongs to the group of pentanoic acid esters and forms covalent bonds with the active sites of serine residues in gastric and pancreatic lipases by inhibiting their activity and preventing the absorption of approximately 30% of fats our body gets from food. Weight loss effect from Orlistat caused by two factors: a decrease in intake of fat and development of side effects – unpleasant sensations in the stomach when taking fatty food that causes the patient to limit fatty food.
When you are following a 2000 calories diet plan made up of 30% fat, Orlistat blocks the digestion of 22 grams of fat which equals the intake of 200 kcal a day. This helps you to eat 6000 less calories a month and reduce your body weight by nearly 900g. The second treatment factor motivates you to change your diet plan. When used properly, this medication can reduce your body weight even if the initial change in lifestyle proved to be ineffective.
How Orlistat Works
The effectiveness of Orlistat in treating obesity has been proved by several randomized, placebo-controlled clinical trials each lasting for 1-2 years. Alli side effects were studied in two placebo-controlled trials. Patients were taking 120 mg Orlistat 3 times a day. At first, all participants were following a low-calorie diet plan for 1 year. After that, they started to take either Orlistat or placebo for another year. The research results were similar. The average weight loss was 10% when treated with Orlistat and 6% when treated with placebo. During the following year, patients who continued taking Orlistat increased their body weight by 1.5-3 kg and patients who kept taking placebo gained 4-6 kg (this body weight was close to the original). Besides, Orlistat has shown a positive change in the contents of total cholesterol, LDL, glucose, insulin and blood pressure levels. This drug was revealed to have a unique property. It affected the concentration of lipids in serum by inhibiting the absorption of fat in the digestive tract. Orlistat can be used for the correction of lipid levels.
Another study involved patients who suffered from both obesity and type 2 diabetes and were treated with sulfonylurea drugs. As statistics shows, Orlistat has significantly improved the plasma glucose levels and reduced the hemoglobin A1c, and lipids in the blood. It also helped to reduce the dose of sulfonylurea.
For patient compliance with the treatment it is very important to control the severity of side effects. All patients who didn’t control the consumption of fats in their diet plan had a problem with oily loose stools. In about 20-40% cases Xenical caused other side effects in the gastrointestinal tract, including frequent defecation, bloating, intense flatus, soiled clothes, peremptory urging to stool, and fecal incontinence. Thus it is very important to explain patients the rules of taking this drug and the importance of reducing the dietary fat content.
The most significant concerns of Xenical therapy are big chances of malabsorption of fat-soluble vitamins A, D, E, K, B-carotene and other carotenoids. Indeed, Orlistat treatment decreased the amount of these substances in the plasma compared to placebo treatment. Still it remained within normal limits. Nonetheless, manufacturers recommend that all patients who take Orlistat should also take multivitamins with B-carotene and fat-soluble vitamins 2 hours before or after taking Orlistat.
Doctors usually prescribe their patients to take Orlistat 120mg 3 times a day during fat meals. It is allowed to take the drug during or within 1 hour after a meal.
There is one more precaution that concerns Orlistat treatment. The caloric value of food is determined by 4 groups of substances: fats, carbohydrates, proteins, and alcohol. Orlistat partly prevents the absorption of only one of them. If a patient increases the intake of other substances instead of fats, the total caloric value of a diet plan also increases along with body weight. In order to make Orlistat treatment effective, it is necessary to pay attention at your diet plan and reduce its total caloric value.
How Effective is Orlistat
For example: if you observe the 2000 calorie diet, which contains 30% fat, orlistat will block the digestion of approximately 22 grams of fat that is 200 calories per day.
At this rate, one month of treatment, the total caloric of your food is reduced by 6000 calories, which will reduce weight by nearly 2.2 lbs, or nearly 25 lbs per year of treatment.
Xenical vs Alli
Xenical and Alli contain the same active ingredient (orlistat), but they are not identical. The drugs have different indications and dosage. Xenical is manufactured by Roche, contains 120 mg of orlistat and prescribed by doctors for people with a body mass index (BMI) greater than or equal to 30, or greater than 28, which is associated with risk factors. Alli contains 60 mg of orlistat and is licensed in the EU and the US, as OTC diet pills for adults with a BMI equal to or higher than 25 who hold a low-calorie diet with low fat diet.
Xenical at 15% More Effective than Alli. Traditionally, Orlistat was available in one 120 mg dose and sold under the brand name Xenical. It was produced by Roche and sold by prescription only since 1999.
The American company GlaxoSmithKline Consumer Healthcare presented the results of their own research in 2007 assuring that their version of Orlistat (Alli) available in 60 mg doses was only 15 percent less effective than Xenical. In other words, Alli 60 mg capsules provided roughly 85 percent of Xenical 120 mg dose effectiveness. Source: NyTimes.com.
Besides, the reduction of dosage, in theory, helps to reduce the frequency of side effects.
Buying Xenical or Alli
The Food and Drug Administration has approved only 2 versions of Orlistat for online sales in the U.S.:
1. Xenical 120 mg capsules sold by prescription only.
2. Alli 60 mg pills sold without a prescription (over-the-counter).
The only difference because of which buying Xenical require a prescription, but Alli is over-the-counter – is due dosage form of each tablet.
Alli is Smaller no Prescription Version of Xenical. Alli is also known as half-reduced form of Xenical.