Key takeaways
Orlistat (Alli, Xenical) and semaglutide (Ozempic) are both used to help with weight management, but they belong to different medication classes and different primary uses. Orlistat is a lipase inhibitor that helps with weight loss by blocking the absorption of fats from your diet. It is available both over-the-counter (as Alli) and by prescription (as Xenical). Semaglutide, on the other hand, is a glucagon-like peptide-1 (GLP-1) agonist primarily used to treat Type 2 diabetes and reduce the risk of heart problems in people with diabetes. Another form of semaglutide, Wegovy, is approved for weight management, similar to orlistat. Semaglutide is administered as a weekly injection. While orlistat is taken three times a day with meals, semaglutide is injected once a week. Orlistat can cause side effects like oily stools and gas, while semaglutide may cause nausea, vomiting, and diarrhea. Orlistat can interact with medications like levothyroxine (Synthroid, Levoxyl, Tirosint) and warfarin (Coumadin, Jantoven), whereas semaglutide can cause low blood sugar if taken with other diabetes medications. Orlistat is not recommended for those with chronic malabsorption syndrome, while semaglutide should be avoided if you have a history of certain thyroid cancers.
