Orlistat in Australia
Orlistat Key Facts
Yes, including over-the-counter
Widely available. 60mg dose (Alli) can be purchased OTC without a prescription. 120mg (Xenical) requires a doctor's script. One of the most accessible weight loss treatments in Australia.
27 years of global use; well-understood
Longest-established weight loss drug globally. Does not act on the brain or nervous system. Works in the gut by blocking fat absorption. Side effects are GI-related and directly tied to dietary fat intake.
27 years on market (oldest option)
FDA approved April 1999. TGA approved 2000. OTC availability added subsequently. Longest track record of any weight loss medication.
$50-80/month
Alli (OTC 60mg): ~$50-60/month. Xenical (Rx 120mg): ~$70-80/month. Not PBS subsidised, but the cheapest weight loss medication available.
OTC at pharmacies (60mg) or Rx (120mg)
60mg: no prescription needed, buy at any pharmacy. 120mg: GP prescription required. No supply issues. Widely stocked.
Orlistat Australian Regulatory Status
Orlistat Mechanism of Action
Completely different mechanism to GLP-1 drugs. Inhibits gastric and pancreatic lipase enzymes, preventing approximately 30% of dietary fat from being absorbed. Unabsorbed fat passes through the digestive system. Does not affect appetite or the brain. Most effective with a reduced-fat diet.
Orlistat Dosing Schedule
| Dose | Period | Note |
|---|---|---|
| 60mg OTC | With each meal | Up to 3 capsules/day |
| 120mg Rx | With each meal | Up to 3 capsules/day |
Orlistat Side Effects
Very common
- Oily/fatty stools
- Oily spotting
- Increased flatulence
- Faecal urgency
Common
- Abdominal discomfort
- Liquid stools
- Frequent bowel movements
- Headache
Serious (rare)
- Liver injury (very rare)
- Kidney stones (rare)
- Reduced fat-soluble vitamin absorption (A,D,E,K)
- May affect absorption of some medications
Orlistat Clinical Evidence
XENDOS
5.8kg loss vs 3kg placebo
Multiple Phase 3
~3-5% body weight reduction
Compare Orlistat with Other Medications
Orlistat vs Ozempic
GLP-1 receptor agonist
~15% avg. weight loss
Orlistat vs Wegovy
GLP-1 receptor agonist
~15-17% avg. weight loss
Orlistat vs Mounjaro
Dual GIP/GLP-1 receptor agonist
~21% avg. weight loss
Contrave vs Orlistat
Opioid antagonist + NDRI combination
~5-8% avg. weight loss
Orlistat vs Saxenda
GLP-1 receptor agonist
~8% avg. weight loss
This website is for informational and research purposes only. We are not medical professionals and nothing on this page constitutes medical advice, diagnosis, or treatment. Always consult a qualified doctor or specialist before making any decisions about medication.
The weight loss medication landscape in Australia is changing rapidly. Information on this page may become outdated without notice. Data sourced from the TGA, FDA, MHRA, NICE, PBAC, Australian Prescriber, Obesity Evidence Hub, and clinical trial publications. Last reviewed March 2026.