Pillar Number Eight Of Successful Weight Loss

Inhibiting the Lipase Enzyme by Life Extension

According to, the author, William Faloon, Orlistat is an inhibitor of pancreatic and gastric lipase.  It decreases the intestinal absorption of ingested dietary triglycerides by 30%.  By reducing the breakdown and absorption of dietary fat, orlistat enhances weight loss and lessens insulin resistance.

In studies of obese subjects, orlistat treatment improves insulin and glucose blood levels while significantly decreasing C-reactive protein, a marker for chronic inflammation. Orlistat treatment favorably influences other blood markers (such as leptin and adiponectin) that are involved with obesity.

In a one-year trial of overweight women, a group with metabolic syndrome treated with orlistat (120 mg three times a day) and lifestyle modification lost 20.5 pounds compared with only 0.44 pounds weight loss in the placebo control group. A group of overweight women without metabolic syndrome taking the same dose of orlistat + lifestyle modification lost 20.2 pounds more than the control group with metabolic syndrome.

In a three-month open-label trial of overweight patients without type 2 diabetes treated with orlistat (120 mg three times a day), men lost 17.4 pounds and women lost 12.3 pounds. In overweight patients with type 2 diabetes mellitus, men lost 18.7 pounds and women lost 12.5 pounds. In this study, leptin levels decreased by 51% in men with type 2 diabetes and 25% in women with type 2 diabetes mellitus. Leptin levels dropped by 48% in overweight men and 23% in overweight women without type 2 diabetes mellitus.  A reduction in leptin blood levels is considered a favorable response as it indicates a reduction in the “leptin resistance” phenomenon that so often precludes successful weight loss.

Not all studies demonstrate this much weight loss in response to orlistat. Poor compliance is always a factor in the variability that exists among studies of the same compound.  Another reason for these discrepancies is that orlistat users are warned to avoid excess ingestion of dietary fats, and are likely to switch to consuming more simple carbohydrates.  Overweight individuals often suffer metabolic disturbances, meaning that ingested sugars more readily convert to stored (triglyceride) fats on the body.  This is why taking carbohydrate-blocking agents (alpha-glucosidase and amylase inhibitors) in conjunction with orlistat for the first 60 days of a weight-loss program may be necessary to induce some immediate reduction of fat pounds that overweight and obese individuals expect.

Orlistat is available by prescription in 120 mg capsules as Xenical®, or over-the-counter under the trade name alli® in 60 mg capsules.  The suggested dose for the 60-day initiation period is 120 mg before each meal (three times a day).  Make sure to take fat-soluble nutrients such as omega-3 fish oil, vitamins D, E, and K, and carotenoids (like lutein and zeaxanthin) at the time of the day most removed from the last orlistat dose as its fat-blocking effects can interfere with absorption of these critical nutrients into the blood.

If you have any questions on the scientific content of this article, please call a Life Extension Health Advisor at 1-800-226-2370, or visit the website life extension.

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