Management of obesity

Obesity is a growing problem, particularly in the western world, with a large proportion of the total population expected to be overweight in the near future (Davies, 2023). Despite the effectiveness of behavioural and lifestyle changes, there is growing scope for pharmacological and even surgical interventions. The mainstay of pharmacological intervention in the UK is orlistat which is a drug that prevents fat absorption in the intestine and thus reduces the proportion of dietary calories absorbed. Although patients are able to buy 60 mg orlistat (GlaxoSmithKline Consumer Healthcare, 2017) over the counter from pharmacies, they may also be able to receive a higher strength preparation on prescription if they have a body mass index (BMI) ≥30 kg/m² or ≥28 kg/m² with associated risk factors (National Institute for Health and Care Excellence (NICE), 2014).

Consider a patient who has approached you for a prescription for orlistat who is keen to lose weight and has the following anthropometrics: male, 44 years old, 185 cm tall, 113 kg. He has no other medical conditions or medications.