What to eat when taking Orlistat or Xenical

Reviewed by our clinical team

Orlistat is a weight loss treatment used within the NHS that works by preventing the body from digesting some of the fat in your diet. It’s the only “diet pill” in the UK that’s considered both safe and effective as a weight loss aid. 

However, Orlistat must be taken as part of a healthy lifestyle – you should eat fewer calories and healthier foods, and should try to exercise regularly when you’re on the treatment.

If you’ve been prescribed Orlistat or Xenical (the brand-name version) your doctor will normally give you guidance about diet. If you’re looking for more diet inspiration, read on.

How much should I be eating when I’m taking Xenical/Orlistat

According to the Patient Information Leaflet for Xenical. Orlistat should be taken as part of a balanced and calorie-controlled diet that is rich in fruit and vegetables.

You should aim to get approximately 30% of your calories from fat, and should distribute your intake of fat, carbs (starchy foods), and protein evenly across three meals each day. Avoid skipping meals or snacking between meals (no pastries, crisps or nuts!), and avoid eating individual meals that are very high in fat.

What happens if I eat too much fat while taking Xenical/Orlistat?

You don’t need to completely cut out fatty foods when you’re taking orlistat – in fact if you eat a very low fat diet, Orlistat won't work properly. Over time you will notice where the hidden fats are: if your fat intake is high, you will get oily stools. 

Orlistat works by preventing the digestion of dietary fat, and passing undigested fat out in your poo. This means that having too much fat – whether across the day as a whole, or in individual meals – will probably result in symptoms like fatty or oily poos. You may also get oily discharge from your rectum, stomach pain, and needing to go to the toilet more often.

What to eat when taking Xenical/Orlistat

If you're not sure what to eat, ask your doctor about how many calories to aim for each day, and what kinds of foods to eat.

However, you can also find guidance and suggestions for meal ideas in this guide from Norfolk NHS. Using this guide, we’ve compiled a few meal suggestions. 

Breakfast

• Cereal or porridge and semi-skimmed milk with: 
  • Fruit or one glass of unsweetened fruit juice 
• Bread or toast with: 
  • Low-fat spread and jam or marmalade 
  • Fruit or one glass of unsweetened fruit juice 

Lunch

• Meat, meat alternative, fish, or low-fat cheese with: 
  • Salad 
  • Jacket potato, bread, or pitta bread 
  • Fruit, or diet yoghurt 
• Non-cream soup with:  
  • Bread or toast 
  • Salad 
  • Fruit, or diet yoghurt 
• Sandwiches with: 
  • Lean meat or boiled eggs 
  • Salad 
  • Fruit, or diet yoghurt

Dinner

• Meat, meat alternative, or fish with: 
  • Vegetables or salad 
  • Potatoes, pasta, rice, or noodles

Can I snack while taking Xenical/Orlistat?

It’s not recommended that you eat between meals, however if you’re hungry it’s OK to have some small, low-fat snacks. Good snacks for the orlistat diet include fruit, plain biscuits, crackers, low-calorie hot drinks, and chopped vegetables with salsa or tzatziki.

What are some recipes I can make while taking Xenical/Orlistat?

You can find some fantastic, Xenical-friendly recipes at the NHS site Change 4 Life, including:

• Spaghetti bolognese – 431 calories and 6.5g of fat 
• Meat-free cottage pie – 345 calories and 6g of fat 
• Veggie chilli – 400 calories and 5g of fat

Other tips for maintaining your diet when taking Xenical/orlistat

• Don’t skip meals 
• Eat smaller portions, use a smaller plate or bowl 
• Eat more fruits and vegetables 
• Chew more slowly 
• Avoid fried food and high fat foods – that's anything that’s been deep fried 
• Trim fat and remove skin from meat  
• Use cooking methods that don’t involve fat e.g. steaming, boiling, grilling, baking and poaching 
• Choose low-fat, low-calorie alternatives wherever possible

For more guidance about generally following a healthy diet, check out the Eatwell Guide from the NHS.

How to keep track of your calorie and fat intake

If you struggle to keep track of what you’re eating throughout the day, consider getting a fitness tracker like a Fitbit. You can log everything you’re eating and the device will calculate percentages, including how much fat you’ve had that day.

Get Xenical through Online Doctor

If you’re struggling to lose weight with diet and exercise alone, visit our online weight loss clinic. Our doctors can safely prescribe Xenical or generic Orlistat to anyone with a BMI over 30, or anyone who has a BMI over 28 and accompanying weight-related health issues.

References

https://www.nhs.uk/conditions/obesity/treatment/
https://patient.info/news-and-features/orlistat-healthy-eating-guide
https://www.medicines.org.uk/emc/files/pil.2592.pdf