What to eat on orlistat: A practical diet guide

If you’ve just started Orlistat and are already worried about what you can and can’t eat, or about the side effects you may have read about online, this article is a practical plan you can actually follow, specific to people living in the UK.

In this article:

• What should I eat on Orlistat?

• A 7-day Orlistat diet plan you can follow

• How much fat per meal is safe on Orlistat?

• Which foods should I avoid or reduce on Orlistat?

• Why am I getting oily stools on Orlistat, is it my diet?

• Do I need a multivitamin with Orlistat, and what about other medications?

• Can I eat out, have a takeaway or go on holiday on Orlistat?

• How much weight should I expect to lose on Orlistat, and when should I stop?

• Frequently asked questions about what to eat on Orlistat

What should I eat on Orlistat?

When you’re taking Orlistat, meals should fit within your daily calorie target and under 15g of fat included in your main meals. Aiming to stay under 15g of fat will help towards preventing oily stools and urgency.

Aim to have three main meals a day, each containing around 500 calories and under 15g fat, spread evenly throughout the day. Orlistat stops your body absorbing around 30% of the fat in anything you eat (1), and going over that 15g limit for each meal is the biggest cause of oily stools, urgency and flatulence (releasing gas).

Build meals on lean protein (chicken, white fish, prawns, tofu, 5% mince, Quorn), complex carbs (wholegrain bread, brown rice, oats, wholewheat pasta, jacket potato), vegetables and fruit, and low-fat dairy (0% Greek yoghurt, skimmed milk). Keep healthy fats as small as possible, for example 1 tsp olive oil, a quarter of an avocado, a handful of nuts.

Try to cut down on fried food, pastries, creamy sauces, full-fat cheese, takeaway curries and alcohol. And two things that are easy to remember: if you aren't having any fat at all with a meal, feel free to skip taking your Orlistat, and if you forget a dose, don't double up for the next meal.

Orlistat 120mg requires a prescription in the UK. If your doctor or another prescriber has given you a prescription and you would like a pharmacist to help you look at your eating habits and work out how to use these fat-per-meal guidelines, a pharmacist at Oxford Online Pharmacy can help you.

A 7-day Orlistat diet plan you can follow

Each of the meal ideas below has under 500 calories and under 12g of fat, which is within Orlistat’s 15g per meal limit recommendations.

The NHS doesn't have a specific 7-day Orlistat diet plan as a downloadable PDF. However, the plan below is based on the NHS’s general guidelines for eating a lower fat and reduced calorie diet (2), which can be used as a good starting point.

Is there a 7-day Orlistat diet plan from the NHS?

The NHS doesn't provide a specific Orlistat plan for a week. However, the NHS does set out what to do in general (lower calories, under 30% fat per meal) and it also recommends referring people to specialist weight management services to get a diet plan that is tailored to them (2). The plan above follows those guidelines and can be used alongside NHS Digital Weight Management or Tier 2/Tier 3 services. Feel free to show it to your GP or a dietitian at your next appointment and adjust it to cater for any allergies or other health conditions you may have.

How much fat per meal is safe on Orlistat?

When you’re taking Orlistat, you should aim for under 15g of fat in your main meals and under 5g in snacks. Ideally, about 30% of all the calories you get each day should come from fat.

Most people taking Orlistat eat between 1500 and 2000 calories a day, meaning they can have 50 to 66g of fat in total across their three meals and snacks. For saturated fat specifically, the NHS Eatwell Guide says women should have under 20g a day and men under 30g. The guide classes something as low in fat if it has 3g or less of fat per 100g (4).

If you’re at the supermarket, it’s a good idea to use the ‘traffic light’ labels on the front of the packaging to quickly decide whether to buy something or not. Green means under 3g of fat per 100g, amber is 3 to 17.5g and red is anything over 17.5g. You should be choosing mostly green options with amber ones only now and then.

Good choices from the supermarket include: 0% Greek yoghurt, wholemeal pitta, 5% beef mince, tinned tuna in brine, skinless chicken breast, frozen berries, wholewheat pasta. Items that are acceptable but need portion control include: hummus, granola, rice cakes with nut butter, oatcakes. Foods to be very careful with include: pastries, creamy sauces, full-fat cheese, curries, fish and chips, mayo-heavy sandwiches.

The main way people accidentally eat too much fat is when it’s hidden in sauces and dressings, and in foods you might think of as healthy snacks. So, always look at the information on the packaging.

Which foods should I avoid or reduce on Orlistat?

When you’re taking Orlistat, try to steer clear of foods that are deep-fried, very creamy or are in a pastry – they nearly always go over the 15g of fat limit and may cause you to have oily, urgent bowel movements.

Instead of just saying what you can and can't have, it’s better to think of food in three levels:

• Avoid most of the time: deep-fried food, creamy curries, full-fat pastries, battered fish and chips, pizza with extra cheese, carbonara, creamy salad dressings, chocolate bars over 20g fat per bar.

• Reduce the portion size: cheese (up to 30g per meal), full-fat yoghurt, butter, peanut butter, olive oil (up to 1 tsp), nuts (a small handful).

• Eat as much as you like: vegetables, salad leaves, most fruit, skinless chicken and turkey breast, white fish, prawns, tofu, pulses, 0% Greek yoghurt, wholegrains, jacket potato.

Alcohol is not blocked by Orlistat, but it’s common to have it with a fatty meal (beer and curry or wine and a creamy pasta dish) and will increase calorie intake due to the high calorie content in alcohol. If you do have a drink, make sure your food at that time isn't too high in fat. The aim here is to deal with the side effects of Orlistat, and not about being judgmental about food, so think about lessening portion size or picking alternatives, instead of totally banning or forbidding anything.

Why am I getting oily stools on Orlistat, is it my diet?

When you’re taking Orlistat and your stools are oily, it’s generally because of what you’re eating. Try to divide the fat in your food equally between breakfast, lunch, and dinner and have no more than 15g of fat in each meal. The unpleasant symptoms will usually go away in a week or two with that adjustment.

Most of the time, the oily stools, urgency and flatulence are caused by your diet and will settle down if you keep each meal under 15g of fat, spread evenly across three meals. The NHS says these side effects are a direct result of going over the 15g limit for each meal (1). The table below shows typical symptoms and solutions you can try at your next meal.

With a consistent low-fat diet, these symptoms will generally settle down in one or two weeks. The official information for the medicine includes the advice to skip a dose if your meal has no fat in it at all, but most people aren't informed of this. If you have pain in your stomach that won't go away and is really bad, yellowing of the skin (jaundice) or very dark urine, these are not related to diet. Stop taking Orlistat and see a doctor as quickly as possible; liver damage is very unusual but has been reported.

Do I need a multivitamin with Orlistat, and what about other medications?

Yes, take a multivitamin containing vitamins A, D, E and K once a day, at least 2 hours before or after taking Orlistat. Bedtime usually works well.

Orlistat lowers how much of the fat-soluble vitamins A, D, E, and K your body absorbs, as these vitamins are absorbed with fat from your food. The official product information recommends taking a daily multivitamin and that you take it at least 2 hours before or after taking Orlistat or at bedtime. Most standard multivitamins from the UK high street (like Centrum, Sanatogen, Tesco or Boots own brands) will have the right vitamins in them.

Looking at the medicines you might be currently taking, three types are particularly important. If you are on the combined contraceptive pill and get really bad diarrhoea, the pill might not get fully absorbed into your system. You should use a condom as a back-up until your bowels are back to normal. If you have Type 2 diabetes and are taking metformin, sulfonylureas or insulin, you’ll need to talk to your doctor as you lose weight because you might need a lower dose. For thyroid hormone replacement (levothyroxine), ciclosporin, certain epilepsy drugs (such as lamotrigine), warfarin and amiodarone, there are known ways they can be affected by Orlistat. Therefore, you need to have a chat with a pharmacist or the person who prescribes your medicines before you begin Orlistat if you are on any of these.

NICE guideline NG246 details the requirements for obesity treatments for the NHS (3). If you’d like a pharmacist to look over all the medications you’re currently on alongside Orlistat, you can start a free consultation to decide if Orlistat is suitable for you.

Can I eat out, have a takeaway or go on holiday on Orlistat?

When you’re on Orlistat, eating at restaurants is perfectly fine. Just try to choose grilled or steamed food, or something in a tomato sauce for your main course, and avoid anything that’s been deep fried or is really creamy. If a meal has no fat in it at all, you can skip a dose of Orlistat.

Below are some examples of good options and ones to avoid from each cuisine.

• Pub: safe – grilled chicken salad, jacket potato with beans. Avoid – beer-battered fish and chips.

• Italian: safe – tomato-based pasta, Margherita pizza. Avoid – carbonara.

• Indian: safe – tandoori chicken, dhal with plain rice. Avoid – korma or any creamy curry.

• Chinese: safe – steamed dumplings, stir-fried prawns with vegetables. Avoid – sweet-and-sour crispy pork.

• Greek: safe – grilled fish, Greek salad. Avoid – moussaka.

• Japanese: safe – sashimi, chicken teriyaki with rice. Avoid – tempura.

• Lebanese: safe – grilled skewers, tabbouleh. Avoid – large portions of hummus and falafel.

For travelling, Orlistat doesn't require refrigeration, but you should pack a prescription letter to show at airport security if needed. At the airport, Pret, Leon and Itsu all offer low-fat meals. You can usually get away with one normal meal while you are on holiday, but two weeks of lots of fatty foods will probably undo your progress and will likely cause unpleasant side effects.

How much weight should I expect to lose on Orlistat, and when should I stop?

Product literature suggests that the average weight loss aim on Orlistat, plus lifestyle change, is around 0.5 to 1 kg per week (6). Treatment should only continue past 3 months if you’ve lost at least 5% of your starting body weight (7).

Both the NHS and NICE recommend continuing to take Orlistat beyond three months only if you’ve managed to lose a minimum of 5% of your original body weight (1)(3). Everyone gets different results, and you’ll usually find weight loss gets slower as your body gets used to the medication.

The XENDOS study (a 4-year trial by Dr Torgerson and colleagues in 2004, and involving 3,305 people) found that patients with obesity taking 120mg Orlistat plus lifestyle changes were 37.3% less likely to develop type 2 diabetes over 4 years than those taking placebo. They also lost around 5.8kg with Orlistat, against 3.0kg with the placebo, which is a difference of 2.8kg (5). Importantly, these results are just for illustrative purposes for the people in that specific study and don't change what Orlistat is officially approved for in the UK.

If your weight loss plateaus, double-check how much fat is in your food and how big your portions are, and try to do more exercise. Avoid reducing your food intake even further.

For related educational content from Oxford Online Pharmacy’s blog, see how Orlistat works for weight loss, how a calorie deficit works alongside Orlistat, getting the best results from Orlistat and the difference between Orlistat, Xenical and Alli.

Frequently asked questions

What can I eat for breakfast on Orlistat?

Keep breakfasts under 10g fat. Try porridge with skimmed milk and berries, 0% Greek yoghurt with granola, two poached eggs on wholemeal toast, or overnight oats with banana. Avoid fry-ups, croissants, buttered toast and pastries, which generally contain more than 20g fat.

What foods should I avoid when taking Orlistat?

Avoid deep-fried food, creamy curries, pastries, battered fish and chips, extra-cheese pizzas, carbonara and creamy dressings. They exceed the 15g of fat per meal limit and may trigger oily stools and urgency. Have cheese, butter, oils, peanut butter and nuts in small portions, and watch out for hidden fat in sauces and shop-bought sandwiches.

How much fat per meal is safe on Orlistat?

Keep each main meal under 15g fat and each snack under 5g, roughly 30% of total calories should come from fat. Exceeding this limit is the biggest single cause of oily stools, urgency and flatulence, so fat should be spread evenly across all three meals.

Can I eat takeaways on Orlistat?

Yes, with care. Try to choose grilled, steamed or tomato-based mains over creamy, deep-fried or pastry-based ones. Safer options include tandoori chicken, sushi, Margherita pizza without extra cheese, grilled kebabs and stir-fried prawns. If a meal is clearly high-fat, skipping that dose is safer than waiting to see what happens.

Why am I getting side effects on Orlistat, is it my diet?

In most cases oily stools, urgency and flatulence are caused by diet but they settle once fat stays under 15g per meal, spread across three meals. Double-check what you’ve eaten in the last 24 hours for hidden fat in sauces, cheese or takeaway food. See a doctor immediately if you experience severe abdominal pain, jaundice or dark urine.

What snacks are allowed on Orlistat?

Good snacks while taking Orlistat sit under 5g fat, with good examples including: fresh fruit, carrot with low-fat hummus, 0% Greek yoghurt, rice cakes with a small amount of peanut butter, edamame, a boiled egg, or a wholemeal pitta with tuna. Avoid crisps, cheese and biscuits, chocolate bars and shop-bought flapjacks.

Do I need to take a multivitamin with Orlistat?

Yes. It’s advisable to take a general multivitamin containing vitamins A, D, E and K once a day, at least 2 hours before or after taking Orlistat or at bedtime. Orlistat blocks around 30% of dietary fat and reduces fat-soluble vitamin absorption. Most UK high-street brands (Centrum, Sanatogen, Tesco or Boots own-brand) contain the relevant vitamins.

What is the Orlistat meal plan in a nutshell?

Three main meals of roughly 500 calories with under 15g fat in each, one snack under 5g fat, 1.5 to 2 litres of water, and a multivitamin at bedtime. Meals should centre on lean proteins, wholegrains, vegetables and low-fat dairy.

Does Alli 60mg work as well as prescription Orlistat 120mg?

Alli 60mg is a UK over-the-counter medicine licensed for adults with a BMI of 28 or above. Orlistat 120mg is a prescription-only medicine approved for obesity (BMI of 30, or 28 with other risk factors). Both work by blocking the absorption of dietary fat. The two doses are not interchangeable and any decision on which is appropriate should be made with a pharmacist or prescriber who can assess eligibility.

Can I switch from Orlistat to another weight management treatment?

Any switch between weight management treatments should be made with your prescriber based on BMI, pre-existing conditions and other eligibility criteria. It is not something to do on your own. If you are considering a change, speak to your GP or an independent prescriber, who will assess the options available to you under their clinical judgment and the current UK licensed medications. This article does not recommend one weight management medicine over another.

References

1. Orlistat. NHS inform. [Accessed 2026 Apr 17].

2. Obesity: treatment. NHS. [Accessed 2026 Apr 17].

3. National Institute for Health and Care Excellence. Overweight and obesity management. NICE guideline NG246. Published 2025 Jan 14.

4. How to eat less saturated fat. NHS Eatwell Guide. [Accessed 2026 Apr 17].

5. Torgerson JS, Hauptman J, Boldrin MN, Sjöström L. XENical in the prevention of diabetes in obese subjects (XENDOS): a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care. 2004;27(1):155–61.

6. Xenical (orlistat) Consumer Medicine Information. [Internet] Medsafe (NZ), reproducing Roche/Cheplapharm-authorised text. 2017.

7. National Institute for Health and Care Excellence. Obesity: identification, assessment and management of overweight and obesity in children, young people and adults. [Internet] NICE guideline NG246. 2025.