Orlistat And Keto: A Weight Loss Power Couple?

The ketogenic diet is a low-carbohydrate, high-fat diet that has been shown to be effective for weight loss and improving blood lipids. Orlistat is a prescription drug designed to treat obesity by blocking fat absorption in the body, which can lead to weight loss. While both the keto diet and orlistat can lead to weight loss, combining the two may not be a good idea. This is because orlistat can cause unpleasant side effects, including uncontrollable diarrhoea, when paired with a high-fat diet like keto. There is also a concern that combining the two may not provide any additional weight loss benefits compared to following the keto diet alone.

Orlistat and keto may lead to comparable weight loss

The ketogenic diet is a popular weight-loss method that involves a low-carbohydrate, high-fat approach. Orlistat, also known as Xenical or Alli, is a prescription drug designed to treat obesity by blocking fat absorption. So, what happens when you combine the two? Is it a match made in weight-loss heaven, or a recipe for disaster? Let's explore the evidence and opinions on this intriguing combination.

The Science Behind It

Interestingly, some research suggests that a low-carbohydrate ketogenic diet and the use of orlistat with a low-fat diet can lead to comparable weight loss. A study by Christopher D. Gardner found that both approaches resulted in similar improvements in weight and blood lipids. However, the ketogenic diet had an additional benefit of being more favourable for blood pressure. This indicates that while orlistat and keto may lead to similar weight loss, there may be other health factors to consider when choosing a weight-loss method.

Real-World Experiences

Now, let's hear from some individuals who have bravely ventured into the world of combining orlistat and keto. The experiences shared online range from hesitant curiosity to outright horror stories. Some people are intrigued by the idea, wondering if orlistat could be a solution to the constipation that keto dieters sometimes experience. However, the majority of first-hand accounts strongly advise against this combination.

One key concern is the infamous side effect of orlistat: unpleasant and uncontrollable digestive issues. When combined with a high-fat keto diet, the risk of these side effects increases significantly. As one individual colourfully described it, "If you take a fat blocker and still eat that level of fat, it has to go somewhere. You might as well run cable to the bathroom." Another person shared a second-hand account of a customer at their furniture store who had an embarrassing "orange poo" incident while taking orlistat.

Expert Advice

Health professionals and experts in online forums overwhelmingly advise against combining orlistat with a keto diet. The fundamental issue is that orlistat blocks fat absorption, which directly contradicts the principle of a high-fat keto diet. As one expert put it, "Trying to do a pescatarian Keto with low fat is a recipe for disaster. You’ll be eating fish, eggs, and a controlled portion of veggies. This is far too restrictive to be sustainable." Another expert emphasised the importance of seeking professional advice: "You really should be asking your doctor if it is ok to go on keto with orlistat. I have concerns... that the medicine and keto will work against each other."

While the ketogenic diet and orlistat may lead to comparable weight loss when used separately, combining them is not recommended. The high-fat nature of the keto diet conflicts with orlistat's fat-blocking mechanism, potentially resulting in unpleasant and unpredictable digestive issues. Additionally, the restrictive nature of a pescatarian keto diet paired with orlistat may be challenging to sustain. As always, it is crucial to consult a healthcare professional before starting any new diet or medication to ensure a safe and effective approach to weight loss.

Orlistat is a fat-blocker

Orlistat is a weight-loss drug designed to treat obesity. Marketed as a prescription drug under the trade name Xenical by Roche in most countries, it is also sold over the counter as Alli by GlaxoSmithKline in the UK and the US. It is a fat-blocker that works by blocking fat absorption, thus lowering the calories the body processes from fat and leading to weight loss.

However, combining Orlistat with a high-fat diet like Keto is not recommended. This is because Orlistat can cause some nasty side effects like uncontrolled fatty diarrhea if you consume too much fat. Since Keto is a high-fat diet, taking Orlistat while on Keto could lead to these unpleasant side effects. In fact, some people have shared their experiences combining Orlistat with a high-fat diet, and the results were not pretty. One person shared that they had to end their low-carb diet because the likelihood of orange explosive diarrhea became astronomical. Another person shared that they had to rush to the bathroom immediately after taking Orlistat with a high-fat meal.

Therefore, it is generally advised to take Orlistat with a reduced-calorie, low-fat diet to avoid these side effects. This is because Orlistat blocks fat absorption, so there is no benefit to eating a high-fat diet while taking this drug. In fact, it could be dangerous as your body will not be able to absorb any nutrients if you cut out entire macros and flush the body of the fat you are eating.

While Orlistat can be effective for weight loss when combined with a low-fat diet, it is important to carefully consider the potential side effects and speak to a doctor or health professional before taking this drug, especially if you are also following a high-fat diet like Keto.

Keto is a high-fat diet

The keto diet is a low-carb, high-fat diet that shares similarities with the Atkins and low-carb diets. It involves drastically reducing carbohydrate intake and replacing it with fat. This reduction in carbs puts your body into a metabolic state called ketosis, where your body becomes very efficient at burning fat for energy.

There are several types of keto diets, but the standard ketogenic diet (SKD) is the most researched and most recommended. It typically contains 70% fat, 20% protein, and only 10% carbs. The cyclical ketogenic diet (CKD) involves periods of higher-carb refeeds, such as five ketogenic days followed by two high-carb days. The targeted ketogenic diet (TKD) allows you to add carbs around workouts. The high-protein ketogenic diet is similar to the SKD but includes more protein, with a ratio of 60% fat, 35% protein, and 5% carbs.

On the keto diet, you should base your meals on meat, fish, eggs, butter, nuts, healthy oils, avocados, and low-carb vegetables. It's important to note that not all fats are equal, and even on a high-fat diet, it's crucial to choose healthy fat sources. While saturated fats are considered keto-friendly, unsaturated fats are still recommended over saturated fats as they can help lower cholesterol levels.

The keto diet has been shown to have many health benefits, including weight loss, improved insulin sensitivity, and reduced risk factors for heart disease. However, it also has some risks, including high levels of saturated fat, nutrient deficiency, liver and kidney problems, constipation, and fuzzy thinking and mood swings. Therefore, it's important to consult a doctor and a registered dietitian before starting a ketogenic diet.

Potential side effects of combining orlistat and keto

Combining Orlistat and a keto diet can lead to some unpleasant side effects. Orlistat is a fat binder, meaning it binds to the fat in food so that the body can dispose of it. This reduces the body's daily fat and calorie intake, making it easier to lose weight. However, the keto diet is a high-fat, low-carb diet, which is incompatible with Orlistat. When taking Orlistat, one should consume no more than 19 grams of fat per meal, which does not align with the keto diet.

Some people have reported attempting this combination and experiencing unpleasant side effects. One person shared that they had tried Orlistat with a low-carb, not keto, diet and that the result was "not pretty". They explained that Orlistat can cause "orange explosive diarrhea" if your fat intake is too high. Another person shared that their husband had been prescribed Orlistat and that the side effects after eating even a small amount of oil or fat were "explosive and messy". They described the experience as "indignity, shame and embarrassment".

The potential side effects of Orlistat are serious and include symptoms of a severe allergic reaction, bleeding from the back passage, symptoms of inflammation of the large intestine, symptoms of inflammation of the pancreas, symptoms of hepatitis, and a build-up of calcium oxalate which may lead to kidney stones.

LCKD is more beneficial for blood pressure

A low-carbohydrate ketogenic diet (LCKD) is more beneficial for blood pressure than a combination of orlistat with a low-fat diet. This is despite the fact that both diets lead to comparable improvements in weight and blood lipids.

Evidence from Randomized Controlled Trials

Randomized controlled trials (RCTs) are considered the gold standard for evaluating the effectiveness of interventions in healthcare. In one RCT, overweight or obese outpatients were randomized to either an LCKD group or a group that received orlistat therapy combined with a low-fat diet (O + LFD). The LCKD group was instructed to initially consume less than 20 grams of carbohydrates daily, while the O + LFD group was instructed to consume less than 30% of energy from fat and create a calorie deficit of 500-1000 kcal/day.

Results of the RCT

At 48 weeks, weight loss was similar between the two groups, with a mean change of -9.5% in the LCKD group and -8.5% in the O + LFD group. However, the LCKD group had a more beneficial impact on blood pressure, with greater reductions in both systolic and diastolic blood pressure compared to the O + LFD group. Specifically, the LCKD group had a reduction of 5.9 mm Hg in systolic blood pressure and 4.5 mm Hg in diastolic blood pressure, compared to 1.5 mm Hg and 0.4 mm Hg in the O + LFD group, respectively.

While both diets led to similar weight loss, the LCKD was more effective in lowering blood pressure. This provides evidence that LCKD may be a preferable option for individuals looking to improve their blood pressure while also achieving weight loss. However, it is important to note that more research is needed to fully understand the long-term effects of these diets.

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