Alli (orlistat 60 mg) is the only FDA-approved over-the-counter weight loss aid that works by preventing the absorption of dietary fat. It is designed for use in conjunction with a reduced-calorie, low-fat diet and increased physical activity in adults with a body mass index (BMI) of 25 or higher. By blocking approximately 25% of ingested fat from being absorbed, Alli supports a caloric deficit necessary for weight loss. This non-systemic medication acts locally in the digestive system, offering a mechanism of action distinct from appetite suppressants or central nervous system stimulants. Clinical studies demonstrate that individuals using Alli in combination with lifestyle modifications lose significantly more weight than those relying on diet and exercise alone.

Features

• Contains 60 mg of orlistat per capsule
• Non-prescription strength; available over-the-counter
• Acts locally in the gastrointestinal tract; minimal systemic absorption
• Prevents absorption of approximately 25% of dietary fat
• Gluten-free formulation
• Packaged with a customized weight loss support plan and dietary guidelines

Benefits

• Supports clinically significant weight loss when combined with a reduced-calorie diet
• Encourages adherence to healthier eating habits by providing immediate dietary feedback
• Helps users develop sustainable, long-term weight management skills
• Reduces absorption of fat-soluble calories without affecting central nervous system function
• Provides a non-stimulant alternative to other weight management supplements
• FDA-approved with an established safety and efficacy profile

Common use

Alli is indicated for weight management in overweight adults (BMI ≥25) as an adjunct to a reduced-calorie, low-fat diet. It is commonly used by individuals who have struggled to lose weight through diet and exercise alone and seek pharmacological support to initiate or overcome a weight loss plateau. The medication is often incorporated at the beginning of a weight loss journey to establish momentum or during maintenance phases to prevent regain. Typical users include those with obesity-related comorbidities such as prediabetes, hypertension, or dyslipidemia who benefit from modest weight reduction. It is not intended for cosmetic weight loss or for use by individuals with normal body weight.

Dosage and direction

Take one 60 mg capsule with water immediately before, during, or up to one hour after each main meal containing fat (maximum three capsules daily). If a meal is missed or contains no fat, omit the dose. The capsule should be swallowed whole and not crushed or chewed. For optimal results, meals should contain no more than 15 grams of fat to minimize gastrointestinal side effects. Consistent use alongside a nutritionally balanced diet averaging 1,200–1,800 calories daily is recommended. Regular physical activity (e.g., 150 minutes of moderate exercise weekly) should accompany treatment. Treatment duration beyond six months should be reevaluated based on weight loss progress and tolerability.

Precautions

• Not for use by individuals under 18 years of age
• Should not be used during pregnancy or breastfeeding
• Use with caution in patients with history of hyperoxaluria or calcium oxalate nephrolithiasis
• May reduce absorption of fat-soluble vitamins (A, D, E, K); a daily multivitamin containing these vitamins should be taken at least 2 hours before or after Alli
• Monitor for signs of liver injury (e.g., itching, yellow eyes/skin, dark urine, loss of appetite)
• Not recommended for patients with chronic malabsorption syndrome or cholestasis
• May increase the risk of kidney stones in susceptible individuals
• Discontinue use if experiencing severe or persistent abdominal pain

Contraindications

• Organ transplant recipients (due to potential interaction with cyclosporine)
• Patients with reduced gallbladder function or history of gallstones
• Individuals with known hypersensitivity to orlistat or any component of the formulation
• Patients taking anticoagulants (unless closely monitored) due to potential vitamin K deficiency
• Those with anorexia nervosa or bulimia
• Patients with pancreatic insufficiency or pancreaticitis
• Concurrent use with acarbose or other weight loss products

Possible side effects

Common (≥1/10):

• Oily spotting from rectum
• Flatus with discharge
• Fecal urgency
• Fatty/oily stool
• Oily evacuation
• Increased defecation

Less common (1/100 to 1/10):

• Abdominal pain/discomfort
• Liquid stools
• Soft stools
• Rectal pain/discomfort
• Tooth/gum disorder
• Headache

Rare (<1/1000):

• Allergic reactions (rash, urticaria, bronchospasm)
• Liver injury (elevated hepatic enzymes, hepatitis)
• Oxalate nephropathy
• Diverticulitis
• Pancreatitis

Drug interaction

• Cyclosporine: Alli may decrease cyclosporine absorption; administer at least 2 hours apart
• Warfarin: Monitor INR regularly as Alli may affect vitamin K absorption
• Levothyroxine: May reduce efficacy; administer at least 4 hours apart
• Antiepileptic drugs (e.g., valproate, lamotrigine): Potential reduced absorption
• Amiodarone: Possible reduced absorption
• Oral contraceptives: Use additional contraception method if experiencing severe diarrhea
• Fat-soluble vitamins: Supplement separately with at least 2-hour interval
• Antidiabetic medications: May require dosage adjustment as weight loss occurs

Missed dose

If a dose is missed, resume with the next scheduled dose before a fat-containing meal. Do not double the dose to make up for a missed one. Consistency with meal timing optimizes therapeutic effect but occasional missed doses have minimal impact on overall efficacy.

Overdose

Single doses up to 400 mg have been studied without severe consequences. Suspected overdose may manifest as severe gastrointestinal effects including oily stools, abdominal cramping, and diarrhea. Treatment is supportive and symptomatic. Maintain hydration and consider a low-fat diet for several days following overdose. There is no specific antidote. Contact a poison control center (1-800-222-1222) or healthcare provider for management guidance.

Storage

Store at room temperature (20–25°C or 68–77°F) in original container. Keep tightly closed and protect from moisture and light. Do not freeze. Keep out of reach of children and pets. Discard any medication that has expired or shows signs of capsule damage.

Disclaimer

This information is for educational purposes only and does not replace professional medical advice. Individual results may vary. Alli should be used as part of a comprehensive weight management program under healthcare provider supervision, especially for individuals with pre-existing medical conditions or those taking other medications. The FDA maintains a voluntary reporting system for adverse events at 1-800-FDA-1088.

Reviews

Clinical studies demonstrate that individuals using Alli lose 50% more weight than with diet alone. In a 16-week trial, participants averaging 207 lbs lost 5.4 lbs with placebo versus 8.4 lbs with Alli when combined with lifestyle modification. Long-term studies show maintained weight loss advantage at 12 months. User experiences frequently note improved dietary awareness and portion control, though gastrointestinal effects remain the most commonly reported challenge. Healthcare providers often recommend Alli as a first-line pharmacological option for motivated patients committed to concurrent dietary changes.