Orlistat (Xenical®) Healthy Eating Guide

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This dietary advice sheet has been provided by Norfolk and Norwich University Hospitals and gives some general information to help you make the recommended changes to your diet. If you need more detailed advice or if you are following a special diet that makes it difficult to make these changes, please ask your doctor to refer you to a registered dietitian.

If you are overweight you are at greater risk of developing health problems such as type 2 diabetes, raised cholesterol, raised blood pressure, coronary heart disease, osteoarthritis, obesity-related cancers and joint pain.

Making small but positive changes to your diet and lifestyle can help you to lose weight and reduce the risk of developing these health problems.

If you eat more calories than you need, your body stores the extra, resulting in weight gain. One way to aid weight loss is to reduce the amount of fat in your diet.

Xenical works in your digestive system by preventing about one third of dietary fat from being digested and absorbed. It does this by attaching itself to enzymes called lipases (found in your gut) that breakdown dietary fat - meaning any undigested fat cannot be absorbed and is passed in your stools.

It is recommended that you reduce your fat intake to 30% of your total calorie intake whilst taking Xenical. Reported side effects of eating too much fat include: flatulence, oily spotting on underwear, and increased urgency and loose bowel movements.

Tips on how to reduce your fat intake

  • Change from butter or regular spreads to a low-fat spread such as Flora Light®, Bertolli Light® or supermarket versions.
  • Choose lean cuts of meat and trim visible fat. Avoid skin on chicken and crackling on pork.
  • Avoid added fat/oil when cooking, (or use a spray oil) - grill, poach, bake or microwave instead.
  • Choose low-fat dairy foods such as semi-skimmed or skimmed milk, low-calorie yoghurts, reduced-fat cheeses and low-fat spreads.
  • Choose lower-fat cook-in sauces with less than 5 g fat per 100 g sauce.

Fibre is needed in the diet to help maintain a healthy digestive system, fill you up and it can also help to reduce raised cholesterol levels.

To increase your fibre intake

  • Choose high-fibre breakfast cereals such as Weetabix®, Shreddies® or Branflakes®.
  • Choose wholemeal bread, wholewheat pasta and brown rice.
  • Include pulses, peas, beans and lentils.

Aim to have five or more portions of fruit and vegetables each day, fresh, frozen or tinned. They are both low in calories and provide essential nutrients to promote healthy skin, immune function and general well-being.

One portion is:

  • 1 medium fruit, such as apple, small banana, pear.
  • 2 small fruits, such as 2 plums, 2 apricots, 2 kiwis.
  • A handful of berries/grapes.
  • 3 tablespoons cooked fruit or vegetables.
  • A small mixed salad.
  • A small glass of fruit juice (limit to one small glass per day as fruit juices are high in sugar).

Sugar provides ‘empty calories’. 1 teaspoon provides approximately 20 calories. Aim to reduce the amount of sugar in your diet as much as possible.  Try to:

  • Have hot drinks without sugar or use a sweetener.
  • Choose ‘no added sugar’ squashes, diet/slimline/zero fizzy drinks or flavoured water.
  • Choose desserts, such as sugar-free jelly and low-calorie yoghurts (less than 100 calories per 125 g pot).
  • Choose tinned fruit in natural juice rather than in syrup.

You can have snacks between meals but try to choose healthy types. Remember to stock up on these healthy items to prevent you being tempted by other things. Try the following: 

  • Chopped vegetables such as carrots, celery and peppers. Try a low-fat dip such as salsa (tomato with onion, chilli, lime and coriander) or tzatziki (yoghurt with cucumber, garlic and mint).
  • Fresh fruit (with sugar-free jelly or low-calorie yoghurt).

There are many not so healthy snacks available that are less than 100 calories per portion. Examples are: 

  • 2 Jaffa® cakes.
  • 1 bag Ryvita® minibites.
  • 1 thin slice of malt loaf.
  • 1 small (multipack) of Quavers®.
  • 1 funsize Twix®/Milkyway®.
  • 1 Cadbury Highlight® mousse.

Check for other ideas by checking the nutrition labels or look online for "100-calorie snacks".

Limit this type of snack to a maximum of 1-2 per day, less if you find you are not losing weight.

  • Try to eat three regular meals each day.
  • Eat some starchy carbohydrate such as bread, potato, rice and pasta at each meal. These are low in fat and will help to make you feel full.
  • Fill at least half your plate with vegetables and salad and eat smaller portions of meat and starchy food. This will reduce your calories but keep you feeling full.
  • If you need to eat smaller portions, then try using a smaller plate. Eat slowly!
  • Try not to buy tempting foods - if it’s not in the cupboard, you can’t eat it!
  • Stay motivated. It is easier to achieve results if you have a clear goal of weight loss or a clothing size to work towards.
  • Don’t give up. Your weight loss may stop and start but keep going and the outcome will be worth it!
BreakfastLunchEvening meal
25-40 g (1 to 1½ oz) cereal
with low-fat milk.
1 portion fruit or a small glass of fruit juice.
Sandwiches (2-3 slices of bread).
1 slice lean meat and salad.
1 portion fruit.
Shepherd’s pie, spaghetti bolognese or chilli con carne and rice.
Large helping of vegetables or salad.
Fresh fruit salad.
2 slices toast with a thin spread of low-fat spread and jam or marmalade.
1 portion fruit.
Sandwiches (2-3 slices of bread).
1-2 boiled eggs and salad.
Low-calorie yoghurt, such as Müllerlight®, Weight Watchers® or Onken Lite®.
Smoked haddock - poached.
Jacket potato.
Large helping of vegetables.
Sugar-free jelly and fruit, tinned in natural juice.
2 slices toast with a thin spread of low-fat spread.
1 boiled egg.
Non-cream soup with 2-3 slices bread or toast.
Or jacket potato with a little low-fat cheese and pickle or tuna and low-fat dressing.
Salad.
1 portion fruit.
Lean meat - grilled such as gammon, steak, chicken, bacon.
Or lean meat - casseroled.
Jacket or boiled potatoes.
Large helping of vegetables.
Fresh fruit salad.
2 slices toast with a thin spread of low-fat spread.
1 poached egg and grilled tomatoes.
Roast dinner with lean meat, 2-3 slices.
Boiled potatoes, 2-3 medium.
Large helping of vegetables.
Baked or stewed apple (with cinnamon and sultanas) and custard made with low-fat milk or natural yoghurt.
Large mixed salad.
Lean meat or tinned fish or 1-2 boiled eggs.
2 slices bread.
Low-calorie yoghurt (as before)

Content used with permission from Norfolk and Norwich University Hospitals website: Your guide to healthy eating whilst taking Orlistat (Xenical) (review date November 2016). Copyright for this leaflet is with Norfolk and Norwich University Hospitals.

Original Author:
Norfolk NHS
Current Version:
Peer Reviewer:
Norfolk NHS
Document ID:
28972 (v1)
Last Checked:
09/01/2015
Next Review:
08/01/2018
Now read about Obesity in Adults

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