Orlistat (Xenical) and a reduced calorie diet

You have been advised to take Orlistat to help you lose weight. This leaflet tells you more about how diet and Orlistat can work together to help you lose weight. Orlistat (also called Xenical): What is Orlistat? Orlistat is a capsule prescribed by your GP to help you to lose weight. It works in your gut to prevent around one third of the fat you eat from being absorbed. The unabsorbed fat is then passed out of your body through your motions, which means a reduction in energy intake for the body, therefore causing weight loss. Who can take Orlistat? Orlistat is a drug licensed for weight loss in the UK at present. You must have a BMI of 30kg/m 2 or above, or a BMI of 27kg/m 2 or above with co-morbidities (such as type 2 diabetes, high blood pressure etc.) If you have problems with your kidneys, gallbladder or bowels such as chronic malabsorption syndrome, Irritable Bowel Syndrome, you will need to discuss with your medical team first whether this is suitable for you before taking this medication. Are there any treatment effects? If you eat too much fat whilst taking Orlistat, then you may experience the following effects: - liquid or oily stools - oily leakage from the bottom - unable to control bowel movements - stomach ache. If you follow a low fat diet and the advice given by your dietitian, you can avoid the treatment effects of Orlistat and lose weight more effectively. What do I need to look out for? Taking Orlistat: Take 1 Orlistat capsule 3 times per day, either with or up to one hour after your meals. Diet: A reduced fat diet is used alongside Orlistat to help you lose weight. It is important that you do not have more than15g of fat intake in any one meal to avoid treatment effects of the drug. You may find it easier if you plan out your meals daily. Food labelling: The table below will help you to identify foods low in fat when you are looking at food labels. Avoid foods which are high in fat, and only have foods which are medium in fat very occasionally. 4 6 Per 100g Low Medium High best choice choose only avoid completely occasionally Total fat 5g or less 5-15g More than 15g 1 2

The following table lists some common foods high in fat with their lower fat alternatives: Food Meat and meat products Fat Spreads,oils and salad dressings Cheese and dairy products Processed foods Common foods high in fat (to avoid and watch out for) Sausages Meat with visible fat, e.g. steak, lamb or pork chops, skin of poultry, streaky bacon Pate Meat pies/ Pork pies Butter/ lard/ ghee/ suet/ dripping Mayonnaise/ cream based dressing such as thousand island or blue cheese dressing Cream based sauces Oil in cooking Coconut milk Full fat hard cheese Full fat cheese spread Single/double/whipping/clotted or sour cream, crème fraiche Creamed coconut Full fat yoghurt Full fat milk Goats milk 6 Sausage rolls Pastry based desserts Deep fried foods Creamy dips Pre-fried frozen products such as chicken nuggets, chicken kiev Peanut butter Lower fat choices to go for Low fat sausages Meat with visible fat or skin removed and cooked with no extra fat Reduced fat pate Pastry free meats Low fat spread Low fat salad creams Vinegarette based or fat free salad dressings Tomato based sauces Spray oil 4 Half fat hard cheese e.g. half fat cheddar, paneer (go for stronger flavour so that you can use less) Light/ low fat cheese spread Reduced fat crème fraiche, low fat plain yoghurt instead of cream in dishes Reduced fat coconut milk Diet yoghurt Semi skimmed / 1% / skimmed milk Milk based dessert made with low fat milk, sugar free jelly Use low fat cooking methods such as grill/ steam/poach. Tomato salsa or tomato based chutney/ relish General tips for weight loss The way you cook can make a big difference to the amount of calories and fat in your food. Try to grill/ steam/ poach/ boil/ dry oven roast your food instead of frying or roasting with oil. Below are some general tips to help you: l Use plenty of herbs and spices to flavour food l Use tomato based sauces rather than creamy ones for pasta dishes l Try to steam/ boil/ microwave vegetables in a little water to conserve as much nutrients as possible. Fresh/ frozen/ canned vegetables can all be used l Plan meals or snacks in ahead so that you are in control at meal times l Don t go shopping when you are hungry and stick to the foods on your shopping list. 3 4

Drinks Fluids are vital to keep your body hydrated and for your metabolism to work most effectively. Thirst can often be mistaken for hunger, so when you are hungry try to have a drink first. Aim for at least 8-10 cups of fluids per day, more when the weather is hot or if you are more active. Go for drinks low in calories such as water, coffee or tea (with no sugar or use sweeteners in hot drinks), no added sugar squash, diet variety of soft drinks or sugar-free flavoured water. Remember if you are taking your Orlistat medication as prescribed, and not experiencing treatment effects, this means that you are having a diet low in fat. This will help you to lose weight. This does not mean that the medication is not working. What should I do if I get treatment effects? Experiencing treatment effects means that you are eating too much fat. It is advisable for you to: l Re-read this leaflet to ensure you are following the advice l If you are not doing so already, look at food labels closely and opt for low fat foods l Keep a food and symptom diary write down everything that you eat for at least a week, and note down when you get treatment effects. This should help you to identify foods which are causing the problem l Get in touch with your dietitian for further advice. What support will I get? It is essential to keep a food diary whilst you are taking Orlistat. This can help you plan your intake throughout the day. You can write down any physical activities you may have done as well as thoughts or feelings related to food throughout the day. This helps to tell you more about your physical activity level and food related emotions. It can also help to identify which food has caused treatment effects if you suffer from them. You will be reviewed regularly by your dietitian, who will support you through the weight loss process and monitor your progress in clinic. What happens if I don t lose weight? You must lose at least 5% of your start weight in the first 3 months for your prescription to continue. If you do not lose this, your prescription will be stopped. My 5% weight loss target is kg / st Resources Websites www.allrecipes.co.uk (look under healthy or low fat ) www.weightlossresources. co.uk www.myfitnesspal.com www.nhs.uk/change4life (recipes and meal ideas) www.xenical.com Your Dietitian is: Telephone: 0161 206 1223 5 6

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