In the battle against obesity, many resort to pharmacological or surgical methods. Orlistat, marketed as Xenical or Alli, is a weight loss drug available over-the-counter. The Merck Manual suggests weight loss drugs only if the patient's body mass Index is more than 30 or, in the case of the presence of obesity-related complications such as diabetes or hypertension, more than 27. Orlistat is a fat blocker. It blocks the absorption of fats in the intestine by preventing the action of an enzyme called intestinal lipase. It also has several side effects, according to Merck Manuals Online Medical Library.
Gastrointestinal Side-Effects
By virtue of its fat-blocking effect, orlistat causes the stools to be greasy and soft. Merck says that the symptoms of mal-digestion---gas, diarrhea, and oily fatty stools---tend to eventually resolve, usually during the second year of use. Other possible gastrointestinal side effects include abdominal pain and discomfort, passing an oily discharge with gas, fecal incontinence and anal pain. Gastrointestinal side-effects are more common if the patient consumes a diet very high in fat.
Liver Injury
The U.S. Food and Drug Administration has issued completed safety review information about orlistat warning patients of potential severe liver injury that could be associated with use of a fat blocker. While there is not enough evidence to ascertain whether orlistat causes this severe liver damage, the FDA issued a warning that users should report to a physician if they experience any symptoms of live injury such as yellowish discoloration of the skin or the eyes, lightness in the color of the stools and dark urine accompanied by loss of appetite. This warning was issued in 2010 after 13 cases of severe liver injury possibly associated with orlistat were reported to the FDA. Out of the 13 patients, there were two fatalities and the condition of three other patients deteriorated enough to warrant liver transplantation.
Other Side Effects
Other reported adverse events associated with orlistat use include headache, back pain and increased risk of respiratory tract infections. Merck states that sometimes diabetics taking oral anti-diabetes drugs need adjustment of their dosage of orlistat.
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