What to eat when taking Orlistat or Xenical

Reviewed by Dr Bhavini Shah

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. When taking Orlistat you should eat fewer calories and healthier foods, and should try to exercise regularly.

If you’ve been prescribed Orlistat or Xenical (the brand-name version) your doctor will normally give you guidance about diet. In this article we’ll look at food plans and diet tips.

Why is diet important when taking Orlistat or Xenical?

Orlistat and Xenical support weight loss when taking alongside a low-calorie diet and regular exercise. The pills work by stopping your body absorbing the fat from your food. The fat that isn't absorbed is then passed out of your body in your stools.  

Orlistat should be taken as part of a balanced and calorie-controlled diet that is rich in fruit and vegetables. When taking Orlistat or Xenical you should eat a lower-fat diet. The amount of fat you eat should be 30% of your total calories for the day. This will help support your weight loss and lessen any side effects.

How many calories should I eat on Orlistat or Xenical?

“Weight loss all boils down to calories. Essentially, losing weight depends on eating and drinking less calories than we use up.” - Dr Sameer Sanghvi

To lose weight the NHS recommends reducing your calorie intake by 600 calories. So, men should have 1,900kcal instead of 2,500kcal and women should have 1,400kcal instead of 2,00kcal per day. A calorie deficit, where you burn more calories than you eat can help you to lose weight.

You should also 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 snacking between meals and avoid eating individual meals that are very high in fat.

What happens if you take Orlistat or Xenical without eating?

If you miss a main meal or have a meal containing no fat you don’t need to take Orlistat or Xenical. The treatments only work when your meal contains fat. So, if you're not going to eat or have any fat in the meal the medication won’t have anything to do.

“Skipping meals or eating the bare minimum puts our bodies into ‘self-defence mode’, resulting in the metabolism slowing down. When you eventually go back to eating normally, it takes longer to burn off food.”

“Also, you’re missing out on essential nutrients, it could result in you feeling low on energy. This can trigger cravings for high-fat and high-sugar foods. It’s a slippery slope - even if crash dieting works temporarily, it’s extremely unhealthy.” - Dr Sameer Sanghvi  

Orlistat and Xenical food plan

If you're not sure what to eat, we’ve got some meal ideas for you. We’ve taken inspiration from this guide which is full of meal ideas. You can also ask your doctor about how many calories to aim for each day, and what kinds of foods to eat. 

Breakfast ideas

• 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 ideas

• 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 ideas

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

Orlistat/Xenical recipe ideas

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

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.

Tips for reducing fat intake while taking Orlistat or Xenical

Orlistat works by preventing the digestion of dietary fat and passing undigested fat out in your poo. This means having too much fat – whether throughout the day 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.

You don’t need to completely cut out fatty foods when you’re taking orlistat. If you eat a very low-fat diet, Orlistat won't work properly.

Ways you can cut down fat when using Orlistat (Xenical):

• Eat more fruits and vegetables
• Choose lean meat and cut off any visible fat
• Check food labels to see how much fat they contain
• Eat low-fat versions of foods such as yoghurts
• Avoid frying food instead bake, grill or boil
• Use herbs and spices to flavour food rather than oil or butter 

High-fat foods to avoid

You still need some fat when taking Orlistat (Xenical), however you should avoid some high fat foods like:

• Visible fat and skin on meat
• Fatty meat like sausages, duck and pork belly
• Pastry like sausage rolls
• Oily fish
• Fried fish or meat
• Fried eggs
• Whole milk
• Cream
• Full fat cheese
• Full fat greek yoghurt
• Takeaways
• Chocolate and sweets
• Butter, lard and margarine
• Crisps
• Chips and roast potatoes
• Cakes
• Biscuits
• Snacks like samosas or pakoras 

Over time you will notice where the hidden fats are. If your fat intake is high, you will get oily stools.

H2: How to maintain your diet when taking Xenical or Orlistat

It can take time to lose weight even when taking weight loss treatments. But there are ways you can keep your diet going:

• 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 calorie and fat intake

When taking Orlistat (Xenical) it’s a good idea to track your calories and fat intake. You still want to make sure you’re eating enough and getting some fat as the treatment won’t work without it.

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

Get Orlistat or Xenical with 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.

Alternative weight loss options

Weight loss injections might be another option if you’re looking to lose weight. Like weight loss pills, they need to be used alongside a calorie-controlled diet and regular exercise.

Available weight loss injections include:

Find out more about medicated weight loss options.

Conclusion

Weight loss pills like Orlistat and Xenical can help you to reach your weight loss goals. They need to be taken with a reduced fat and calorie diet and regular exercise. This will help you get the best results. Visit our online weight loss clinic to find out more about weight loss treatments available at Online Doctor.

References

https://www.medicines.org.uk/emc/files/pil.2592.pdf
https://patient.info/news-and-features/orlistat-healthy-eating-guide
https://patient.info/healthy-living/obesity-overweight/orlistat-weight-loss-medicine
https://www.nhs.uk/better-health/lose-weight/calorie-counting/
https://www.nhs.uk/conditions/obesity/treatment/
https://clinicaltrials.gov/study/NCT04184622
https://www.royaldevon.nhs.uk//patient-information-leaflet-dietary-advice-for-renal-patients-taking-orlistat.pdf
https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/the-eatwell-guide/