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Learn more about the results we get at Within

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Orlistat for weight loss (Alli, Xenical)

Orlistat, is a medication sold under the brand names Alli and Xenical that is available over the counter and as a prescription from a doctor. It's typically used to help individuals manage weight in conjunction with physical activity and a low-calorie eating plan. Prescription orlistat (Xenical) is generally used for people in higher-weight bodies who have heart disease, high cholesterol, diabetes, or high blood pressure.1

 minutes read
Last updated on 
January 18, 2024
Alli for weight loss
In this article

What are the dangers of taking Alli weight loss pills?

People may take Alli weight loss pills to try to lose weight, especially since the Food and Drug Administration (FDA) approved the over-the-counter medication in 2007.2 However, there are many dangers and risks—physical and psychological—associated with taking Alli and Xenical as “weight loss” medications.

Orlistat is currently the only weight-loss drug available without a prescription, making it dangerously accessible for people with disordered eating behaviors or a clinical eating disorder. It can be particularly risky for people with an active eating disorder to take orlistat since eating disorders and orlistat can cause malabsorption, leading to undernutrition and nutritional deficiencies.3

Orlistat side effects and health risks

Taking Alli weight loss pills can cause many adverse and unwanted effects, including:1,3

  • Loose stools
  • Increased number of bowel movements
  • Problems controlling bowel movements
  • Pain in the rectum
  • Abdominal pain
  • Oily spotting on clothes or underwear
  • Anxiety
  • Headaches
  • Irregular menstruation
  • Anal fissures

If you are prescribed orlistat and are experiencing side effects that won’t go away, notify your doctor—they may adjust your dose or switch your medication.

Alli weight loss pills can cause severe and potentially dangerous side effects, such as:1,3

  • Issues with swallowing or breathing
  • Extreme or ongoing stomach pain
  • Weakness and fatigue
  • Dark-colored urine
  • Yellow eyes or skin
  • Hives
  • Rash

Aside from expected side effects, there are also health risks involved with using Xenical for losing weight, including:4

  • Severe liver injury
  • Acute kidney injury
  • Increased risk of osteoporosis
  • An impaired ability to absorb vital vitamins and nutrients, which can lead to nutritional deficiencies

Can you overdose on orlistat?

Theoretically, it’s possible to overdose on orlistat, but there isn’t much research available about specific doses or dangers. Most orlistat overdose cases that have been reported have been asymptomatic or have included side effects that are similar to those associated with taking the recommended dose.6

If you or someone you know takes more than the recommended dose of Alli or Xenical, call 911 or seek medical attention right away. Some of the side effects associated with using the recommended dose can include severe liver damage, so it’s essential to get immediate care.4

Unpacking the problem of taking orlistat for “weight loss”

Taking a weight loss or diet pill like orlistat could indicate that someone is struggling with disordered eating or an active eating disorder, especially when other symptoms are present like body dissatisfaction, restricted eating, a fear of gaining weight, purging, excessive exercise, and more.7

People with eating disorders or who struggle with disordered eating sometimes use weight loss medications like Alli or Xenical. Some studies have confirmed this, with reports of participants with eating disorders using Alli weight loss pills.2

During one study, nearly 58% of individuals who used Alli or Xenical for weight loss met the criteria for an eating disorder, including bulimia nervosa, binge eating disorder, and anorexia nervosa.2 Additionally, case reports have revealed that people with bulimia may misuse orlistat as a purging mechanism.4

Diet culture and weight stigma

Diet culture, anti-fat bias, and weight stigma are to blame for the reason medications like orlistat are so popular. False ideals around what size, shape, or weight your body should be can cause body dissatisfaction, distorted body image, low self-esteem, self-criticism, and eating disorders. Diet culture is also responsible for our societal beliefs surrounding certain foods being “bad” and others being “good,” as well as how we punish ourselves for eating “bad” foods that we enjoy. As such, using medication to lose weight and attain the “ideal body” has been normalized in our diet-obsessed society.

However, there is a way to break the cycle. Learning intuitive eating, improving body image, and healing your relationship with movement and food are all possible.

Remote treatment is available

Within Health’s remote treatment program offers individualized treatment planning through compassionate, nonjudgmental, trauma-informed, and person-centered care that prioritizes your needs and goals.

Partial hospitalization and intensive outpatient programs
Personalized meal delivery and support
Insurance options
Dedicated care team
Group counseling, family therapy, individual therapy
Nutritional counseling
Remote medical care

Call (866) 293-0041 for a free consultation and learn more about remote eating disorder treatment options.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.


  1. Orlistat. (2016). U.S. National Library of Medicine. Retrieved April 26, 2023.
  2. Steffen, K. J., Mitchell, J. E., le Grange, D., Crow, S. J., Attia, E., Bulik, C. M., Dellava, J. E., Bermudez, O., Erickson, A. L., Crosby, R. D., & Bansal-Dev, V. P. (2010). A prevalence study and description of alli use by patients with eating disorders. The International Journal of Eating Disorders, 43(5), 472–479.
  3. Bansal, A. B., Al Khalili, Y. (2022). Orlistat. Treasure Island (FL): StatPearls Publishing.
  4. Fernández-Aranda, F.,  Amor, A., Murcia, S., Giménez-Martínez, L., Turón-Gil, V, & Vallejo-Ruiloba, J. (2002). Bulimia nervosa and misuse of orlistat: Two case reports. The International Journal of Eating Disorders, 30(4), 458-461.
  5. O’Connor, M.B. (2001). An orlistat “overdose” in a child. Irish Journal of Medical Science, 179, 315.
  6. New Zealand Data Sheet: Xenical (120 mg capsules). (n.d.). New Zealand Medicines and Medical Devices Safety Authority. Retrieved April 27, 2023.
  7. Eating Disorders. (2023). National Institute of Mental Health. Retrieved April 27, 2023.


What is orlistat?

Orlistat is an over-the-counter and prescription weight loss drug, sold under the brand names Alli and Xenical.

Can you overdose on orlistat?

You can potentially overdose on orlistat, although there haven’t been many reports of Xenical or Alli overdoses. However, you should always take the recommended dose and report any adverse effects to your doctor.

Is orlistat safe for weight loss?

Although orlistat can help people lose body weight, there are a myriad of health risks and dangers associated with taking Alli weight loss pills. Plus, using orlistat can be a sign of disordered eating or an eating disorder and can exacerbate these issues.

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Further reading

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