Orlistat 120 mg: who it's for and how much weight people really lose
| Availability: | Yes |
| Delivery: | 4-7 days |
| Payment: | credit cards, bank transfer |
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Generic Xenical contains orlistat, the active ingredient in Xenical. It stops your gut absorbing some of the fat in your meals. In Spain, orlistat 120 mg is prescription-only and is used for adults with obesity, or who are overweight with other risk factors, always alongside a reduced-calorie diet.
Below the price table we explain who it's meant for (with a BMI calculator), how much weight people lost in the trials, how to take it, the digestive side effects and which medicines need care. In Spain, prescription-only medicines may not be sold online, and customs can hold a parcel that contains them. We do not check prescriptions: talk to your doctor before you order.
| What it is | A lipase inhibitor: it blocks the enzymes that digest fat. It works in the stomach and gut, and hardly any reaches the bloodstream. |
|---|---|
| Active ingredient | Orlistat |
| What Spanish pharmacies stock | Xenical 120 mg and 120 mg generics (Cinfa, Sandoz, Stada, Teva and others) on prescription; Alli 60 mg and similar brands without one. |
| Prescription needed? | Yes for 120 mg (CIMA). The public health system doesn't fund it. |
| Who it's for | Adults with a BMI of 30 or more, or 28 or more with risk factors such as high blood pressure, type 2 diabetes or high cholesterol. |
| Dose | One 120 mg capsule with each main meal that contains fat; three a day at most. |
| In this shop | «Xenical Generic» 120 mg, packs of 10 to 180 capsules. The manufacturer isn't stated. |
Who it's meant for
The Spanish product information (ficha técnica) limits it to adults with obesity, or who are overweight and have related health problems. Your body mass index (BMI) is your weight in kilos divided by your height in metres squared. It's only a rough guide, since it can't tell fat from muscle; your doctor will also look at your waist and your general health.
BMI calculator and orlistat criteria
How much weight do people lose?
In the trials, everyone followed a reduced-calorie diet, whether they took orlistat or a placebo. This is what the medicine added:
| Result | Orlistat 120 mg | Placebo |
|---|---|---|
| Lost at least 5% of body weight by 12 weeks (five 2-year studies) | 37% | 19% |
| Lost at least 10% after one year (same studies) | 20% | 8% |
| Average extra weight loss after one year | 3.2 kg more with orlistat | |
| XENDOS study: average difference after 4 years | 2.7 kg more with orlistat | |
Put simply, the diet does most of the work and orlistat adds a few kilos on top. Of the people who hadn't lost 5% by 12 weeks, only 5% went on to lose 10% within the year, which is why the product information says to stop at that point. In XENDOS there were also fewer new cases of type 2 diabetes with orlistat (3.4% against 5.4%), mostly among people whose blood sugar was already raised.
Taking it
- One capsule with water just before, during or up to an hour after each main meal.
- If you skip a meal, or it has no fat in it, skip that capsule.
- No more than three a day: higher doses don't help you lose more.
- You'll see the effect in your stools within 24 to 48 hours; it wears off 2 to 3 days after stopping.
The diet that goes with it
The product information calls for a balanced, moderately low-calorie diet rich in fruit and vegetables, with about 30% of calories from fat, spread over three meals. On 2,000 kcal a day, that's roughly 67 g of fat at most. Go above that, or eat one very fatty meal, and digestive side effects become more likely: it's the unabsorbed fat leaving your body.
Spanish home cooking uses plenty of olive oil, and a generous plate of fried food or a long tapas lunch can easily go over that limit. Measuring oil with a spoon rather than pouring it straight from the bottle makes a real difference.
Vitamins A, D, E and K
Absorbing less fat can also mean absorbing fewer fat-soluble vitamins. In trials lasting up to four years, levels stayed normal in the vast majority of people. If your doctor suggests a multivitamin, take it at least two hours after orlistat, or at bedtime.
Who shouldn't take it
- People with chronic malabsorption or cholestasis (poor bile flow).
- Women who are breastfeeding; in pregnancy, only on medical advice.
- Anyone allergic to orlistat or the other ingredients.
- Children: it isn't indicated for them.
It needs a doctor's assessment first if you have chronic kidney disease (risk of oxalate stones and kidney damage), type 2 diabetes (your diabetes medicines may need adjusting), an underactive thyroid or epilepsy.
Side effects
Most are digestive and ease off over time: oily spotting on underwear, wind with some discharge, urgent need for the toilet, fatty, loose or more frequent stools, tummy pain and sometimes incontinence. Headaches and colds are also very common. People with type 2 diabetes may get low blood sugar.
- you have heavy bleeding from the back passage;
- you get severe tummy pain that won't settle, which can mean pancreatitis or gallstones;
- your skin or the whites of your eyes turn yellow, or your urine goes very dark (possible hepatitis);
- your face or throat swells, or you struggle to breathe.
Interactions
| Medicine | What the product information says |
|---|---|
| Ciclosporin | Blood levels fall. Not recommended together. |
| Warfarin and other oral anticoagulants | INR needs monitoring. |
| Levothyroxine | Thyroid control can slip: needs monitoring. |
| Epilepsy medicines (valproate, lamotrigine) | Seizures have been reported: needs monitoring. |
| HIV medicines, antidepressants, antipsychotics, lithium | Some reports of reduced effect: think carefully before starting. |
| The contraceptive pill | If you have severe diarrhoea, use condoms as well. |
| Amiodarone, acarbose | Amiodarone: closer monitoring. Acarbose: avoid the combination. |
Xenical, Alli and other options in Spain
Alli and other 60 mg orlistat brands are sold over the counter in Spanish pharmacies for adults with a BMI of 28 or more. For obesity there are also prescription injections such as Wegovy (semaglutide), Saxenda (liraglutide) and Mounjaro (tirzepatide), prescribed and monitored by a doctor. Our weight products are listed under weight loss; none of them should be started without a doctor's advice.
Be wary of «natural» slimming capsules sold online. The Spanish Medicines Agency (AEMPS) has issued warnings about several that contained undeclared drugs: in 2020, for example, about Lida Daidaihua, which contained sibutramine, a medicine withdrawn because of heart risks.
Getting a prescription in Spain
With a tarjeta sanitaria (health card), start with your médico de familia, the GP at your centro de salud; an endocrinologist, public or private, can also prescribe it. Expect to be weighed and measured and asked about blood pressure, diabetes and your other medicines. Xenical comes in packs of 84 capsules, four weeks at three a day, and you pay the full price, as it isn't publicly funded.
A prescription from another EU country can be dispensed in Spain if it has the required details; UK prescriptions aren't covered by those rules. For scale: a 10-capsule pack from this shop lasts just over three days, and the 12-week trial period in the product information takes around 250 capsules.
Delivery
We don't run a shop and don't offer collection: orders are sent by post or courier. Times and terms are on our delivery conditions page.
Questions people ask
Can I buy orlistat without a prescription in Spain?
Not the 120 mg strength: it needs a prescription and can't legally be sold online. The 60 mg strength (Alli and similar) is sold without a prescription, but only in pharmacies.
How much weight will I lose on orlistat?
In the trials, on average about 3 kg more over a year than with diet alone. If you haven't lost 5% of your weight after 12 weeks, the product information says to stop.
Do I take it with a fat-free meal?
No. If a meal has no fat, or you skip it, skip that capsule too.
Why am I getting oily spotting?
That's fat your body hasn't absorbed. It usually means the meal was too fatty; spreading fat over your three meals helps.
Can I drink alcohol with orlistat?
No interaction with alcohol is listed, but alcohol is high in calories and won't help you lose weight.
Xenical or Alli?
Same active ingredient, different strength: 120 mg on prescription for obesity, 60 mg over the counter for overweight adults. Your doctor or pharmacist can tell you which fits.
Sources: Spanish product information (ficha técnica) for Xenical 120 mg and Alli 60 mg (CIMA, AEMPS); Xenical product information (European Medicines Agency); BIFIMED, Spanish Ministry of Health (funding status); AEMPS warnings on illegal slimming products; Royal Decree 81/2014 (EU prescriptions). General information only: it doesn't replace advice from a doctor. In Spain, prescription-only medicines may not be sold online, and customs can hold a parcel that contains them. We do not check prescriptions: talk to your doctor before you order.
