Alli (orlistat 60 mg) is the only FDA-approved over-the-counter weight loss aid that works by preventing the absorption of dietary fat. Designed for adults with a body mass index (BMI) of 25 or higher, it is intended to be used in conjunction with a reduced-calorie, low-fat diet and regular physical activity. This non-systemic agent acts locally in the gastrointestinal tract, offering a mechanism of action distinct from appetite suppressants or central nervous system stimulants. Clinical studies demonstrate that individuals using Alli alongside lifestyle modifications can lose significantly more weight than with diet and exercise alone.

Features

• Contains orlistat 60 mg per capsule
• Non-prescription strength (OTC)
• Prevents absorption of approximately 25% of dietary fat
• Works locally in the gastrointestinal tract
• Gluten-free formulation
• Packaged with a customized weight loss support plan

Benefits

• Supports clinically significant weight loss when combined with a reduced-calorie diet
• Encourages adherence to lower-fat dietary choices due to its mechanism of action
• Provides a tangible pharmacological adjunct to behavioral weight management strategies
• Helps establish long-term healthier eating patterns
• Non-systemic action minimizes impact on cardiovascular or central nervous systems
• Accessible without a prescription, facilitating broader patient engagement in weight management

Common use

Alli is indicated for weight management in overweight adults, aged 18 years and older, when used along with a reduced-calorie and low-fat diet. It is commonly utilized by individuals who have struggled to achieve or maintain weight loss through diet and exercise alone. The product is often incorporated at the beginning of a weight loss journey or during periods when patients need additional support to overcome weight loss plateaus. Healthcare providers may recommend it as part of a comprehensive weight management strategy that includes nutritional counseling and increased physical activity.

Dosage and direction

The recommended dosage is one 60 mg capsule taken three times daily with each main meal containing fat (up to 30% of calories from fat). The capsule may be taken during the meal or up to one hour after. If a meal is missed or contains no fat, the dose of Alli should be omitted. Daily fat intake should be distributed evenly across three main meals. Patients should adhere to a nutritionally balanced, reduced-calorie diet containing no more than 30% of calories from fat. Exceeding the recommended dosage does not increase efficacy and may increase the likelihood of adverse effects.

Precautions

Patients should undergo a health evaluation before starting Alli to exclude secondary causes of obesity. Not recommended for use beyond six months without reassessment of weight loss progress and risk-benefit ratio. Use with caution in patients with history of hyperoxaluria or calcium oxalate nephrolithiasis, as orlistat has been associated with kidney stones. May reduce absorption of fat-soluble vitamins (A, D, E, K) and beta-carotene; patients should take a daily multivitamin containing these nutrients at least 2 hours before or after Alli administration. Monitor for signs of liver injury (rare but reported). Not intended for use during pregnancy or by individuals with eating disorders.

Contraindications

Alli is contraindicated in patients with chronic malabsorption syndrome or cholestasis. Should not be used by patients with organ transplant requiring immunosuppression due to potential interaction with cyclosporine. Contraindicated in those with known hypersensitivity to orlistat or any component of the formulation. Not for use in children under 18 years of age. Avoid concurrent use with other weight loss products, including prescription orlistat (Xenical). Contraindicated in patients with reduced gallbladder function or history of pancreatitis.

Possible side effects

The most common side effects are gastrointestinal in nature and result from increased fat excretion: oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased defecation, and fecal incontinence. These effects are generally mild to moderate, decrease in frequency with continued use, and are often management through dietary fat reduction. Other reported effects include abdominal discomfort/pain, nausea, infectious diarrhea, rectal pain/discomfort, tooth/gum disorder, headache, upper respiratory infection, and back pain. Rare cases of severe liver injury, hypersensitivity reactions, and oxalate nephropathy have been reported.

Drug interaction

Orlistat may reduce absorption of fat-soluble vitamins and some lipophilic drugs. Patients taking cyclosporine should separate administration by at least 3 hours. May reduce plasma levels of amiodarone, anticonvulsants (e.g., valproate, lamotrigine), antiretroviral agents, and thyroid hormones (levothyroxine); monitor therapy and adjust dosages as needed. Can potentially affect absorption of warfarin; monitor INR regularly. May decrease efficacy of oral contraceptives; recommend additional non-hormonal contraception. Separate administration of fat-soluble vitamin supplements by at least 2 hours.

Missed dose

If a dose is missed, resume with the next scheduled dose. Do not double the dose to make up for a missed administration. The medication is only effective when taken with meals containing fat, so taking a dose without dietary fat provides no therapeutic benefit while potentially increasing side effect risk.

Overdose

There are no reports of serious adverse events from orlistat overdose. Single doses of 800 mg and multiple doses up to 400 mg three times daily have been studied without significant adverse effects. In case of suspected overdose, provide supportive care. The primary risk would be increased gastrointestinal effects due to excessive fat malabsorption. Maintain hydration and monitor for electrolyte imbalances in cases of significant diarrhea.

Storage

Store at room temperature (20-25°C or 68-77°F) in the original container with desiccant. Excursions permitted between 15-30°C (59-86°F). Keep tightly closed and protect from moisture and light. Do not use if the seal under the bottle cap is broken or missing. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Individual results may vary. Alli should be used as part of a comprehensive weight management program under healthcare provider supervision, especially for patients with pre-existing medical conditions or those taking other medications. Read and follow all label instructions carefully. Consult with a healthcare professional before starting any weight loss program, particularly if you have a history of kidney stones, liver disease, diabetes, thyroid disorder, or eating disorders.

Reviews

Clinical trials demonstrate that individuals using Alli with a reduced-calorie diet lose approximately 50% more weight than those using diet alone over six months. In a 16-week study, 57% of Alli users achieved ≥5% weight loss compared to 31% with placebo. Many users report successful weight loss when combining the medication with consistent dietary modifications, though gastrointestinal effects are frequently noted during the adaptation period. Healthcare providers often emphasize that optimal results require commitment to lifestyle changes, with Alli serving as an adjunct rather than a standalone solution. Long-term maintenance varies significantly based on individual adherence to behavioral modifications after discontinuation.