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The evidence that they directly cause weight loss is weak

Step 1: The Titration Down Strategy Never stop cold turkey

Because the medication remains in the body for several days, symptoms may last longer and should be monitored closely

Orlistat (Xenical, Alli) reduces fat absorption in the gut and is the only effective over-the-counter weight loss pill available, says Johnson-Rabbett, though it can have significant gastrointestinal side effects

An intermediate level of 4 mg per week demonstrated enhanced weight loss compared to the starting dose while maintaining acceptable safety margins

Both methods serve different, complementary purposes