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    Caution use in individuals below 18 yrs old and those who have had organ transplant, or other health conditions such as diabetes. Long-term use may require intake of fat-soluble vitamins to be taken at least 2 hours before or after orlistat dose. This product should not be given to patients with known allergy to orlistat or to any of its components. Patients taking immunosuppressants like cyclosporine and those with chronic malabsorption syndrome or cholestasis should not take this product. Not recommended for use in pregnant or breastfeeding women. A few weeks ago, a middle-age patient who has been taking orlistat regularly for weight loss asked about the increased risk of developing cancer, especially colon cancer, with prolonged intake of the product. Orlistat, which is available locally under different brand names, is the only anti-obesity drug approved for over-the-counter sale. When a drug is approved as such, that means there’s no significant risk for people to take it even without a doctor’s prescription. For those who have taken the product, they know that it is a potent inhibitor of the absorption of dietary fats in the intestines. Hence, one needs to go to the bathroom shortly after eating a fatty meal because the fat goes down the gut with reduced absorption and has to be passed out. reported in 2006 that in preclinical studies using experimental rats, orlistat was associated with increased numbers of cells believed to be potential precursors of colon cancer. Therefore, common side effects experienced by those who take it include oily stools, fecal spotting, diarrhea and abdominal pain. They called these cells as “aberrant cryptic foci.” The experts were divided whether or not these are real precursors of colon cancer. I remember a patient telling me this about her experience with orlistat: “I don’t trust it when I fart, because almost always, something goes with it.” Despite the “small accidents” one can have with orlistat, a lot of patients doctors prescribed it to seem not to mind because they get the kind of waistlines they want. US FDA conclusion However, the various clinical trials involving orlistat didn’t show any red flag as to the possibility of developing cancer.

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