Can you take Orlistat and Saxenda together?

You've probably heard of a bunch of weight loss drugs in the news and on the internet from Ozempic to Saxenda and Orlistat.

These new medications have been a massive breakthrough for weight loss, helping people with obesity and type 2 diabetes lose weight when combined with improved diet and exercise.

But, can you take different weight loss drugs together? If you're wondering whether you can take Saxenda and Orlistat together then we've put together a handy guide to understanding how these prescription medications work, their respective side effects and the drug interactions between them.

What is Orlistat?

Orlistat (sold under the brand name Xenical or as a lower dose medication called Alli) is a gastrointestinal lipase inhibitor containing the active ingredient Orlistat that's used as a weight loss medication [1]. When used in combination with lifestyle changes like diet and exercise, the medication can help people with obesity or who are overweight lose weight.

Orlistat works by blocking enzymes in the gut that digest fat where roughly a third of the fat from foods you eat is stopped from being digested. Instead of being digested and absorbed by the body, the fat is passed out with your stools and helps to reduce calorie intake to achieve weight loss [1].

Unlike other weight loss medications you might have heard of like Ozempic and Saxenda, Orlistat is a form of oral medication where Orlistat capsules are taken 3 times a day with each meal you eat usually with meals containing fat.

When taking Orlistat, it's recommended that you follow a low-fat diet because the medication decreases the amount of fat that's absorbed from the gut. Eating a high-fat diet while taking Orlistat can increase common side effects like needing to go to the toilet more often and suddenly, increased flatulence or oily and fatty stools [1].

In clinical trials of Orlistat, those taking Orlistat capsules lost 4.65kg, or 10.25lb, in comparison to 2.5kg, or 5.5lb, in the placebo group and had more significant reductions in BMI, waist circumference and cholesterol levels [2].

What are the side effects of Orlistat?

Like all medications, Orlistat has some side effects, with the most common side effects being changes in bowel movements. But, these generally occur within the first few weeks of being prescribed the medication dose.

The most common side effects and symptoms of Orlistat include [3]:

• Gas with oily spotting
• Urgent need to have bowel movements
• Oily spotting on underwear
• Loose and oily or fatty stools
• Increased frequency and difficulties controlling bowel movements
• Stomach pain
• Irregular menstrual periods

There are also some other serious side effects including [3]:

• Hives, rashes and itching
• Difficulties with breathing or swallowing
• Continuous and severe pain in the stomach
• Fatigue and weakness
• Nausea and vomiting
• Loss of appetite
• Yellowing of the eyes or skin
• Dark coloured urine
• Light coloured stools

It's important to contact your doctor or healthcare professional if you experience any serious side effects as soon as possible.

What is Saxenda?

Saxenda is a prescription medication used for weight loss and is generally used as a treatment for those who are overweight or obese. Saxenda is typically prescribed to people who have a body mass index (BMI) of 30 or higher.

In some cases, it can be prescribed to those with a BMI of 27 or higher if they also have a weight-related medical condition such as high cholesterol, high blood pressure or sleep apnoea [4].

But, unlike Orlistat, Saxenda is administered as a daily injection subcutaneously (under the skin) in the upper arm, thigh or stomach. The prescription medication belongs to a group of weight loss medications that mimic the glucagon-like peptide 1 (GLP-1) hormone and contains the active ingredient liraglutide.

The GLP-1 hormone regulates appetite, controls blood sugar levels and slows down gastric emptying, which helps people eat fewer calories [4].

When Saxenda is combined with increased exercise and a balanced and healthy diet, patients can achieve a healthy weight.

In clinical trials, Saxedna showed that 60% of people who took the medication lost 5% of their body weight, and 30% of people lost 10% of their body weight. In comparison, only 34% of people in the placebo group lost more than 5% of their body weight and only 15% of people in the placebo group lost more than 10% of their body weight [5].

What are the side effects of Saxenda?

There are some side effects of Saxenda to keep in mind, but the good news is that they're generally mild and tend to ease over time once the body adjusts to the medication.

The most common side effects and symptoms of Saxenda include [6]:

• Nausea
• Diarrhoea
• Constipation
• Vomiting
• Injection site reaction
• Low blood sugar (hypoglycemia)
• Headache
• Fatigue
• Dizziness
• Stomach pain
• Change in enzyme (lipase) levels in your blood.

There are also some more serious side effects of Saxenda, but in most cases, they are rare. For those with a history of pancreatitis, liver problems can occur.

In animal studies of Saxenda and other similar weight loss medications, the results showed the possible development of thyroid tumours, including thyroid cancer. Although this hasn't occurred in people, it is advised not to take Saxenda if you have a family history of thyroid cancer [6].

Can you take Orlistat and Saxenda together?

When deciding whether to take Orlistat and Saxenda it's important to speak to your doctor to decide what is the best course of action for your weight loss journey. While there are no direct contradictions between Orlistat and Saxenda there are moderate drug interactions between the two medications [7].

Taking both these medications at the same time won't result in faster weight loss, and it's essential to consult your doctor about whether you can and should take Orlistat capsules with the Saxenda injection.

What to avoid when taking Orlistat and Saxenda?

When taking any medications, it's important to follow the guidance from your doctor or healthcare professional and read the medication's instructions. But, some general considerations about these two medications include:

Orlistat

• Orlistat capsules can interfere with the absorption of fat-soluble vitamins, including Vitamin A, D, E and K and beta-carotene. Your doctor may suggest taking supplements that contain these vitamins to ensure you're meeting all your nutritional needs when taking this medication [8].
• Orlistat works best when you're following a low-fat diet in order to minimise gastrointestinal side effects such as oily and fatty stools and abdominal discomfort [1].

Saxenda

• When taking Saxenda, it's generally advised you avoid other medications in the same class that also contain GLP-1 receptors, as this can increase the risk of side effects [6].
• Saxenda can also affect your blood sugar levels. Remember to talk to your doctor about any insulin medications you're taking, as they may adjust your dosage to prevent hypoglycemia (low blood sugar) [9].

What's the best way to holistically approach weight loss

When approaching weight loss, it's important to look beyond medications and view losing weight through a holistic lens. Juniper's Weight Reset Programme takes a holistic approach to weight loss, backed by health coaching, lifestyle changes and actionable diet and exercise advice.

Kickstart your weight loss journey with Wegovy or Mounjaro, two groundbreaking weight loss injections that mimic the GLP-1 and GIP hormone respectively to help control cravings, delay stomach emptying, and keep you feeling fuller for longer.

Plus, we have a team of expert dietitians and health coaches you can consult with, to help you work through any challenges you're experiencing during your weight management journey.

Our health coaches guide you with practical and actionable tips and tricks to help you implement important lifestyle changes like reducing your calorie intake and increasing your physical activity levels.

Ultimately, Orlistat and Saxenda are both effective weight loss medications but work in 2 different ways and contain different active ingredients. It's important to consult your doctor or healthcare professional to figure out which weight loss medication is right for you and your weight loss journey.