Still Life with Ace of Hearts

One Fourth Less Heart Health Risk with Orlistat?

Bariatric surgery provides a benefit for reducing risks to heart health. This has been pretty clear for years now. Still, utilization remains low because the procedure seems daunting to many who need it. But a recent study suggests that an anti-obesity medicine – orlistat – might also reduce risks to heart health.

In the European Heart Journal – Cardiovascular Pharmacotherapy, researchers report a finding of 26 percent less risk of major CV events in patients who took orlistat. The comparison group was a propensity-matched cohort of patients who did not get the drug.


Orlistat is a something of a forgotten option in the world of anti-obesity meds. It’s modestly effective, but extremely safe because it works in the gut without ever being absorbed. In fact, it is so safe that FDA approved it for use without a prescription in 2007. The OTC brand name is alli. As a prescription drug, the name was Xenical. ConscienHealth founder Ted Kyle worked on the effort to secure OTC approval for alli, so it happens that we are very familiar with this drug.

Which brings us to the other distinguishing feature of this drug – oily stools. When a person eats a high fat meal while taking orlistat, they can expect to see significant amounts of fat in their stools afterward. This results from the mechanism of action, but for some people it can be quite daunting. Others have no problem.

Nonetheless, orlistat continues to be useful for some patients. In fact, it enjoys surprisingly wide use in the VA medical system.

An Observational Study

We must note that this study was observational and thus, the results don’t necessarily prove that orlistat is entirely responsible for the lower heart health risk the researchers found. They explain:

“Due to the retrospective nature of the study, it is difficult to say with certainty that the observed association is causal.”

With all that said, the finding is noteworthy. A 26 percent reduction in cardiovascular risk is less than the reduction seen in some studies of bariatric surgery. But it’s not nothing. On top of that, the researchers found 61 percent less mortality in the orlistat group. So we suggest you pay attention to the conclusion of the study authors:

“This study adds to current evidence on the known improvements in cardiovascular risk factor profiles of orlistat treatment by suggesting a potential role in primary prevention.”

Click here for the study and here for further reporting on it.

Still Life with Ace of Hearts, artwork by Georges Braque / WikiArt

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August 4, 2021