Orlistat vs Wegovy
Orlistat and Wegovy sit at opposite ends of the cost and efficacy spectrum. Orlistat is available over-the-counter at $50-80/month with ~3-5% weight loss by blocking fat absorption. Wegovy is a weekly prescription injection at $350-460/month producing ~15-17% weight loss through GLP-1 appetite suppression, with PBS listing pending.
Compare Orlistat vs Wegovy at a Glance
| Orlistat | Wegovy | |
|---|---|---|
| Drug class | Lipase inhibitor | GLP-1 receptor agonist |
| How taken | Oral capsule with meals (up to 3x daily) | Weekly injection (oral pill in US only) |
| Avg. weight loss | ~3-5% | ~15-17% |
| First approved | 1999 (FDA), 2000 (TGA) | 2021 (FDA), 2024 (TGA) |
| AU cost/month | $50-80 (OTC available) | $350-460 private |
| PBS status | No | Pending (Jan 2026 rec.) |
| Prescription needed? | OTC (60mg) / Rx (120mg) | Yes |
| AU supply status | Widely available | Stable |
Compare Orlistat vs Wegovy Cost in Australia
Orlistat: $50-80 (OTC available)
Wegovy: $350-460 private (PBS: Pending (Jan 2026 rec.))
Compare Orlistat vs Wegovy Weight Loss Efficacy
Orlistat Clinical Trials
XENDOS
5.8kg loss vs 3kg placebo
Multiple Phase 3
~3-5% body weight reduction
Wegovy Clinical Trials
STEP 1
14.9% weight loss vs 2.4% placebo
STEP UP (7.2mg)
21% weight loss
SELECT
20% reduction in CV events
OASIS-4 (pill)
16.6% weight loss (oral form)
Clinical trial data at highest approved doses. Individual results vary.
Compare Orlistat vs Wegovy Side Effects
Orlistat
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
Wegovy
Very common
- Nausea (up to 44%)
- Diarrhoea
- Vomiting
- Constipation
Common
- Headache
- Abdominal pain
- Fatigue
- Dyspepsia
- Injection site reactions
Serious (rare)
- Pancreatitis
- Gallbladder disease
- Acute kidney injury
- Suicidal ideation (under investigation)
- Potential fracture risk (Dec 2025 warning)
Compare How Orlistat and Wegovy Work
Orlistat
Lipase inhibitor
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.
Wegovy
GLP-1 receptor agonist
Same mechanism as Ozempic but at higher dose (2.4mg vs 1mg) optimised for weight management. Mimics GLP-1 hormone, reducing appetite, slowing gastric emptying, and improving satiety. The oral pill (US only) uses SNAC technology to protect the molecule in the stomach.
Compare Orlistat vs Wegovy Dosing Schedule
Orlistat
Oral capsule with meals (up to 3x daily)
| Dose | Period | Note |
|---|---|---|
| 60mg OTC | With each meal | Up to 3 capsules/day |
| 120mg Rx | With each meal | Up to 3 capsules/day |
Wegovy
Weekly injection (oral pill in US only)
| Dose | Period | Note |
|---|---|---|
| 0.25mg | Weeks 1-4 | Starting dose |
| 0.5mg | Weeks 5-8 | Escalation |
| 1mg | Weeks 9-12 | Escalation |
| 1.7mg | Weeks 13-16 | Escalation |
| 2.4mg | Week 17+ | Maintenance dose |
Compare Orlistat vs Wegovy Australian Regulatory Status
Orlistat
Wegovy
Full Orlistat profile
View Orlistat DetailsFull Wegovy profile
View Wegovy DetailsCompare Other Medications
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.