. Author manuscript; available in PMC: 2017 Aug 8.

Published in final edited form as: Int J Eat Disord. 2010 Jul;43(5):472–479. doi: 10.1002/eat.20829

TABLE 1.

Prior literature on orlistat use by patients with eating disorders

Authors	Diagnosis, Current (C) and Historical (Hx) Compensatory Methods	Age, Gender BMI (kg/m²)	Description of Orlistat Use	Comment
Fernandez-Aranda et al.¹¹	BN-P, C: orlistat, Hx: vomiting, laxatives, food restriction	26 yo, 22 kg/m²	Orlistat taken after bingeing, once to twice daily, totaling 120–240 mg/day	Patient experienced soft stools as the only adverse effect of orlistat.
	BN-P, C: orlistat, Hx: vomiting, laxatives, diuretics, food restriction	34 yo, 23.8 kg/m²	Orlistat taken two-three times daily following binge episodes, totaling 240–360 mg/day	No adverse effects were reported.
Cochrane and Malcolm¹²	BN-P, C: orlistat, phentermine, ephedrine, vomiting, herbal teas, fiber supplements, excessive coffee as a laxative, diuretics, food restriction, Hx: amphetamines, methamphetamine, cocaine, cigarrettes	35 yo, “normal weight”	Orlistat taken after eating, 240–480 mg each episode up to two-three times per week for 12 months. In the past 6 months, frequency of use has decreased to once/week and prn for high fat binges.	Patient had bouts of diarrhea after taking orlistat, but never had fecal incontinence. Patient used orlistat at work when it is too difficult to vomit or use laxatives.
Malhotra and McElroy¹³	BN-P, C: orlistat, Hx: occassional use of laxatives to “relieve fullness”	49 yo, 45 kg/m²	Orlistat was taken prn with binge eating	Patient was considered to have BED prior to orlistat use. Patient experienced 4–8 bowel movements per day along with fecal urgency, oily rectal spotting, and flatulence. Treatment providers felt orlistat reinforced binge eating behavior and encouraged patient to discontinue use.
Hagler-Robinson¹⁴	BED	45 yo, BMI < 27 kg/m²	Orlistat was taken in double the indicated dosage and more frequently than recommended. Patient did not limit fat intake, often purposefully binge eating high fat foods after taking orlistat.	Patient experienced adverse effects including oily spotting which made her “feel less guilty” about binge eating. She also experienced cramping and soreness during excretion. During treatment with cognitive-behavioral therapy, patient discontinued orlistat use. Authors discuss the similarity of this orlistat use to BN.

Notes: BED, binge eating disorder; BMI, body mass index; BN, bulimia nervosa; BN-P, bulimia nervosa, purging subtype; C, currently using; Hx, history of use; prn, only taken “as needed”; yo, year-old.