This finding is important as the side effects in question occur when the individual consumes fatty food, suggesting that the fundamental changes to diet, attitude and lifestyle required for sustainable weight loss have not been adopted. Participants also reported other medical, psychological, social and personal circumstances as barriers to weight loss, which could be overcome through better education, counselling and support to understand and address the reasons for their obesity.
Orlistat also known as Xenical or Alli works by reducing the amount of fat absorbed from food by the body. If fat is consumed while taking the medication, unpleasant side effects such as foul-smelling oily stools and incontinence can occur. Crucially, orlistat is not a 'magic' weight-loss drug: it can only play a supporting role as part of a wider and sustained change in an individual's lifestyle.
Doctors may likewise be able to make a more informed decision as to whether the medication should be prescribed, with potential savings for the NHS through reducing the waste of medications.
Dr Hollywood and colleague Professor Jane Ogden conducted and analysed interviews with people who had been prescribed orlistat 18 months earlier but now weighed even more than they had before. By Mayo Clinic Staff. Thank you for Subscribing Our Housecall e-newsletter will keep you up-to-date on the latest health information. Please try again. Something went wrong on our side, please try again.
Show references Frequently asked questions Alli. Accessed Sept. Orlistat Xenical prescribing information. Hoffmann-La Roche, Inc. Orlistat Alli prescribing information. Khera R, et al. Association of pharmacological treatments for obesity with weight loss and adverse events: A systematic review and meta-analysis.
Micromedex 2. Bray GA. Obesity in adults: Drug therapy. Accessed Dec. Journal of the Academy of Nutrition and Dietetics. Food and Drug Administration. Accessed Jan. Coconut oil for weight loss Dietary supplements for weight loss Cortisol blockers Ear stapling for weight loss Endoscopic Intragastric Balloon Endoscopic sleeve gastroplasty Endoscopic Sleeve Gastroplasty Gastric Sleeve Gastric bypass Roux-en-Y Weight-loss surgery Hoodia Intragastric balloon Phentermine for weight loss Prescription weight-loss drugs Protein shakes Biliopancreatic diversion with duodenal switch Laparoscopic adjustable gastric banding Roux-en-Y gastric bypass Sleeve gastrectomy Vitamin B injections Natural diuretics Weight-loss surgery Why does diet matter after bariatric surgery?
Show more related content. An information sheet and questionnaire were then sent out to participants by post. Those who returned the baseline questionnaire were sent a similar followup questionnaire at six months.
Baseline and followup questionnaires examined demographics, beliefs about obesity, beliefs about side effects, and behaviour. Most alphas were above the established cutoff level illustrating acceptable reliability. Some were lower, but this is generally acceptable if there is diversity in the constructs being measured. Participants were included if they registered with the MAP program within a four-month period, were 18 years or over, and had been prescribed orlistat by their GP and if they had completed the baseline questionnaire within the first three months of starting to take orlistat and also returned the followup questionnaire at six months.
Further, the data were analysed to assess the role of baseline demographics, beliefs, and behaviour in predicting improvements in BMI and to assess the role of changes in beliefs and behaviour over the course of 6 months in predicting improvement in BMI by 6 months.
The results showed that the mean age of the people who returned a completed questionnaire at both time points responders was 50 years and that the majority were white, female, not working, married, educated up until college, and with a mean BMI of Further, the responders and nonresponders those who returned the baseline questionnaire but not the followup questionnaire at 6 months were comparable on all baseline demographics apart from age with the responders being older than the nonresponders.
The results showed that by 6 months the majority of the responders had lost weight and decreased their BMI. The mean weight loss was 4. In addition, the majority had increased their healthy eating and decreased their unhealthy eating and were no longer taking orlistat although a large minority reported either full adherence or being lifestyle users by 6 months.
The results were then analysed to assess the role of beliefs and behaviour in predicting an improvement in BMI by 6 months both in terms of baseline and change scores using Multiple Regression Analysis and using forced entry method.
The role of baseline beliefs and behaviour in predicting improvements in BMI are shown in Table 3. The results showed that an improvement in BMI was predicted by a greater endorsement of a medical solution to their weight problem at baseline, accounting for 7. No other baseline variables were significant. Change scores in beliefs and behaviour were calculated T1-T2. The role of these variables in predicting improvements in BMI is shown in Table 4. The results showed that a decrease in BMI over 6 months was predicted by a decrease in endorsing a medical solution to their weight problem, a decrease in unhealthy eating, an increased belief in treatment control, and an increased belief that the side effects are both due to their eating behaviour and just part of the drug, accounting for The present study aimed to explore the predictors of weight loss following 6 months after being prescribed orlistat with a focus on both baseline variables and changes in beliefs and behaviour over the course of taking the drug.
The results showed that by the end of 6 months three quarters of patients reported both weight loss and a reduction in their BMI with the majority falling within the expected range inline with previous outcome studies [ 4 , 5 , 7 ]. Furthermore, just less than half had stopped taking their medication by 6 months, and a large minority reported using it flexibly in response to their dietary choices which is consistent with high attrition rates found in previous studies and the use of orlistat as a lifestyle drug [ 4 , 8 ].
In terms of predictors of outcomes, only one baseline variable was related to a reduction in BMI by six months. In particular, the results showed that a greater endorsement of a medical solution to obesity predicts a greater reduction in BMI by followup indicating that those who have greater expectations of success for the drug show greater improvements. This finds reflection in the focus on baseline predictors reported for other forms of medical management e. The data were also analysed, however, to explore the role of changes in beliefs and behaviour over the course of taking orlistat and produced more promising results.
In particular, those who lost most weight showed a decrease in beliefs in a medical solution, a decrease in unhealthy eating, an increased belief in treatment control, and an increased belief that the side effects are both due to their eating behaviour and just part of how the drug works. Therefore, it would seem that taking orlistat may encourage patients to focus on their behaviour rather than medical factors as solutions to obesity and subsequently improve their diet and that if such changes in beliefs and behaviour occur, weight loss is greater.
This provides quantitative support for previous smaller-scale qualitative research [ 14 ] and indicates that the highly visual side effects of orlistat, while being unpleasant and a deterrent for some users, for others may help educate them towards a more behavioural focus on their weight problem.
There are some issues with the study which need to be addressed. First, the study did not include a control group as the study aimed to explore the predictors of outcomes after taking orlistat rather than to assess the effectiveness of this drug.
The effectiveness of the drug has been explored elsewhere [ 4 ]. Second, both diet and weight were assessed using self-report rather than an objective measurement tool. This means that there may well be inaccuracies in the data as research has shown that people tend to underestimate both their weight and what they eat.
However, for the present study such self-report measures represented the best means of measuring these variables in a large-scale nationwide survey as it would not have been feasible to call all participants into the clinic to collect more objective data. Third, due to the recruitment procedure, participants were generally completing the questionnaires within the first 3 months of taking orlistat. The baseline data, therefore, reflects their beliefs and experiences at the start of their course of taking orlistat but does not reflect that, either before or at the very start of this process.
Future research should aim to recruit participants just before they take their first prescription of orlistat in order to gain a true baseline. Finally, the data does not show exactly when the participants stopped taking orlistat. However, by followup it is known whether the participants were currently taking the drug or if they had stopped within the last month.
Therefore, although we do not have an exact marker of when the course of medication was stopped and therefore when its impact upon beliefs and behaviour ceased to occur, we do have an approximate measure which enables some assessment of the interrelationships between drug use and beliefs and behaviour change.
Given these limitations, however, the study does provide some insights into the mechanisms of orlistat with a focus on the role of beliefs and behaviour in predicting weight loss. To conclude, orlistat is currently the only prescribed obesity medication available for obese patients. Although research indicates that it can promote weight loss, there remains problems with adherence and much variability in patient outcomes.
The present study aimed to explore predictors of outcomes as a means to improve its effectiveness. The results indicate that changes in beliefs and behaviour occurring throughout the course of taking orlistat are the best predictors of outcomes rather than baseline variables.
Further, the results indicate that those patients, who show a shift away from a medical model of their problem towards a focus on their own behaviour and show improvements in their diet, lose more weight. These results have implications for patient management and the use of orlistat for weight loss. In particular, orlistat causes unpleasant side effects which may cause nonadherence. Therefore, when prescribing orlistat, clinicians should not only alert patients to the possibility of such consequences of eating high-fat foods, but also encourage them to focus and learn from them in terms of what they are eating, what this looks like when it is excluded from their bodies, and what this would do to their bodies if it had remained inside.
Ask a doctor or pharmacist if it is safe for you to use orlistat if you are also using any of the following drugs:. This list is not complete. Other drugs may interact with orlistat, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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