The November 2009 issue of the Drug and Therapeutics Bulletin (DTB) features a review of OTC orlistat (alli®), which is available in the UK for purchase from pharmacies by adults who are overweight or obese (BMI ≥28kg/m2), at a cost of around £55 per month (for up to 6 months).

The review covers how it is being sold, practice guidance/training for pharmacists, efficacy data, unwanted effects and its cautions and contra-indications.  The authors conclude that OTC orlistat ‘provides a reasonable choice for motivated individuals who can afford it’.  They note that those who choose to buy it should receive full counselling about gastrointestinal side effects and how these relate to diet.  Individuals should be advised to discuss long-term weight management with an appropriate healthcare professional at an early stage of treatment, as weight gain is likely to be a problem when the drug is stopped.