3 Commonly Used Over The Counter Weight Loss Pills

OTC Weight Loss Pills

Over the counter weight loss pills are being increasingly used because of the high prevalence of obesity especially in teenagers.

A recent study showed that young girls are more likely to use over-the-counter (non-prescription weight loss pills)

OTC weight loss pills are not as effective as prescription weight loss pills. In addition, they are not 100% safe.

Over The Counter Weight Loss Pills: Key points:

  • In the US, a large number of people struggle to control their weight, and the proportion has increased from 30.5% to 41.9% in just 3 years (2017 – 2020).


  • Restricting calories causes compensatory changes that make it difficult to lose weight over the long term. As a result, many people look into other options like taking supplements and medications.


  • Alli is a non-prescription medicine that helps with weight loss by blocking some fat in our food. However, it may not be suitable for everyone and may cause side effects, so use it cautiously.


  • Some claim that the natural supplement Garcinia cambogia aids in weight loss by reducing appetite and preventing the body from storing more fat.
  • However, not everyone will experience the same level of benefit, and there are concerns regarding potential liver issues.


  • Another weight-loss supplement that some people use is bitter orange, but it can quicken your heartbeat. It might not be suitable for you if you have heart issues or are sensitive to things like that.
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Why do people try non-prescription weight loss pills?

A person may wish to reduce their body weight for a variety of reasons, such as managing symptoms associated with a disease, lowering their risk of developing an illness, and enhancing their general quality of life.

According to data from 2017-2020, obesity prevalence in the United States increased from 30.5% to 41.9% [ref].

Even though weight loss can improve health, it’s not always easy to lose excess body fat and maintain that weight loss over time.

Calorie restriction causes compensatory changes in the body, such as increased appetite and decreased energy expenditure, making long-term weight loss difficult.

As a result, many people turn to alternative weight loss methods, such as medications and supplements.

Many overweight people think that by using “self-help” techniques, they can overcome their weight issues on their own.

Their focus shifts towards over-the-counter weight loss medications rather than going out for a hike or exercise or practicing dietary restriction methods such as calorie restriction, low-carb diet, or intermittent fasting.

Non-prescription weight loss medicines can cause transient weight loss, but, they are not helpful in the long run and may be harmful.


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Commonly Used Over The Counter Weight Loss Pills:

1.   Alli (Orlistat)

Alli is an over-the-counter weight-loss medication containing the active ingredient orlistat.

It is a non-prescription weight loss pill approved by the FDA to help people lose weight.

It inhibits the absorption of dietary fats and hence may cause some degree of weight loss, especially in patients who have lots of oils and fat in their diet.

Alli is a low-dose formulation of Orlistat and is available over the counter. The higher dose orlistat is a prescription drug.

Are there any worries regarding Orlistat?

The FDA issued a safety review of Orlistat in 2010 because of rare reports of severe liver injury in people using it.

The FDA was unable to find any proof that the liver injuries reported were caused by orlistat.

Nonetheless, the reports led to the revising of the labels for Xenical and Alli. If you experience any of the following warning signs or symptoms of liver damage, consult your doctor straight away:

  • Itching
  • Appetite loss
  • yellow eyes or skin
  • Brown urine and light-colored stools

How does Alli work?

Orlistat (the active ingredient in Alli) helps you lose weight by reducing the amount of dietary fat absorbed in your intestines.

The digestive tract enzyme lipase aids in the breakdown of dietary fat into smaller pieces so that it can be utilized or stored for energy.

Orlistat blocks the work of lipase. About 25% of the fat in your diet is not broken down when you take the medication with a meal. The fat is passed through bowel movements [ref].

Side effects of Alli:

The active component in Alli, orlistat, induces digestive side effects linked to the passage of undigested fats through the digestive system.

These effects typically decrease over time and with correct usage of the medication. Such side effects encompass:

  • Abdominal pain or discomfort
  • Discharge of oily substances from the anus
  • Gas accompanied by oily anal discharge
  • Presence of oily stools
  • Increased frequency of bowel movements
  • Urgent or challenging-to-control bowel movements

Other potential side effects may include:

  • Headaches
  • Back pain
  • Symptoms resembling a common cold
  • Changes in menstrual patterns

Contraindications for Alli:

Certain people may not be good candidates for Alli, and specific contraindications must be considered.

Alli should not be used by people with certain medical conditions, such as gallbladder or malabsorption problems.

Before using this weight loss tool, women who are nursing or pregnant, as well as those taking medications that prevent fat absorption, should speak with a healthcare provider.

Furthermore, heed medical advice and proceed with caution if you have a history of kidney stones or pancreatitis.


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2.   Garcinia Cambogia Extract:

Garcinia cambogia extract is a popular dietary supplement derived from the rind of the Garcinia cambogia fruit, which is native to Southeast Asia.

This substance, marketed as a natural weight loss aid, has received attention due to its capacity to impact weight management.

How Garcinia Cambogia Extract Works:

Garcinia Cambogia appears to aid weight loss in two key ways.

Firstly, it may reduce appetite based on studies in rats and humans. Rats given Garcinia Cambogia ate less, and human studies revealed a potential feeling of fullness, reducing overall food intake [ref].

The active ingredient is thought to boost serotonin levels in the brain, which is known to suppress appetite. However, individual results can vary [ref].

Secondly, Garcinia Cambogia may inhibit fat production and reduce belly fat [ref].

Several studies in humans and animals suggest it lowers blood fats and hinders the creation of new fatty acids.

This process is linked to inhibiting an enzyme called citrate lyase, which is crucial in fat production [ref].

Daily intake may lead to improved cholesterol levels and reduced risk of weight gain, addressing critical factors related to various diseases.

Effectiveness of Garcinia Cambogia Extract:

The effectiveness of Garcinia cambogia extract for weight loss remains a topic of debate within the scientific community.

Some studies suggest a modest reduction in body weight, while others find no significant impact.

It’s essential to note that results may vary among individuals, and the supplement is most effective when used in conjunction with a healthy diet and regular exercise.

Side Effects of Garcinia Cambogia Extract:

No participants have frequently experienced severe adverse reactions in the clinical trials conducted on garcinia cambogia.

The most common garcinia cambogia side effects include [ref]:

  • Discomfort
  • Nausea
  • Headaches
  • Diarrhea or upset stomach

However, more severe adverse effects associated with garcinia cambogia use in the general public have been documented outside of controlled studies.

There have been multiple reports of liver damage following the consumption of herbal supplements containing garcinia cambogia, leading to reports of the fruit’s possible hepatotoxicity.

Most cases were related to one particular supplement available in the USA, which was reformulated in 2004 and again in 2009 [ref].

Contraindications for Garcinia Cambogia Extract:

Garcinia cambogia extract may not be suitable for everyone, and there are specific contraindications to consider.

Individuals with pre-existing medical conditions, such as diabetes or those taking certain medications, should exercise caution.

Pregnant or breastfeeding women are typically advised to avoid the supplement.


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3.   Bitter orange Supplement:

Bitter orange, scientifically known as Citrus aurantium, is a popular supplement for weight loss and energy enhancement.

It is derived from the peel of the bitter orange fruit; this supplement contains active compounds believed to influence various physiological processes [ref].

How Bitter Orange Works:

Bitter orange contain p-synephrine as well as other naturally occurring chemicals.

While p-synephrine and ephedrine, the active ingredient in ephedra, share a structural similarity, p-synephrine exhibits distinct pharmacologic properties.

Because ephedra is associated with an increased risk of heart attack and stroke and raises blood pressure, the U.S. Food and Drug Administration has prohibited its use in dietary supplements. 

In nutritional supplements, bitter orange is frequently used instead of ephedra.

Effectiveness of Bitter Orange Supplement:

Bitter orange is often promoted as an energy enhancer and helps with weight loss. According to some research, it might have little impact on energy expenditure and metabolic rate, which could help people lose weight.

However, overall effectiveness varies between individuals, and more research is required to establish consistent results.

Side Effects of Bitter Orange Supplement:

While bitter orange is generally considered safe when used appropriately, it can cause side effects due to its stimulant properties.

Common side effects may include [ref]

  • Increased heart rate
  • Elevated blood pressure, and
  • Jitteriness
  • Headache
  • Anxiety

Contraindications for Bitter Orange Supplement:

Bitter orange supplements may not be appropriate for everyone.

Individuals with pre-existing heart conditions, high blood pressure, or sensitivity to stimulants should avoid or use caution with this supplement [ref].

It is crucial to consult with a healthcare professional before incorporating bitter oranges into one’s routine, especially if there are concerns about potential drug interactions or existing health conditions.



Losing weight can be challenging; some try non-prescription options like Alli, Garcinia Cambogia, and Bitter Orange.

Alli helps to prevent fat absorption, but it may cause side effects. Garcinia Cambogia may reduce appetite, but its effectiveness varies, and there are concerns about liver damage.

Bitter Orange may cause the heart to beat faster, especially in people who have heart problems.  Before pursuing these options, it is critical to exercise caution and consult a doctor.

Overall, the safest ways to lose weight are to eat a well-balanced diet, exercise, and seek professional advice.

What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

I love my family, my profession, my blog, nature, hiking, and simple life. Read more about me, my family, and my qualifications

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