Which adverse effects are commonly associated with orlistat and should be discussed with families?

• A. Gastrointestinal effects including frequent oily stools and steatorrhea
• B. Increased appetite and rapid weight regain
• C. Hypertension and tachycardia
• D. Insomnia and mood changes

Answer: (A)

Orlistat causes fat malabsorption because it inhibits pancreatic lipase in the gut. The most recognizable and important adverse effects are gastrointestinal, stemming from undigested fat passing into the stool. Families should be prepared for symptoms like oily stools and steatorrhea, which can be accompanied by gas or stool leakage and may vary with fat intake. This is why counseling focuses on dietary fat management (spreading fat across meals and choosing lower-fat options) and on taking a fat-containing meal with the medication only when present. It’s also useful to note that because fat absorption is reduced, some fat-soluble vitamins can be less well absorbed, so a multivitamin taken separately from orlistat may be recommended. Other potential effects listed are not the typical or primary concerns with orlistat.