Journal of Health Psychology 2016, Vol. 21(5) 590–598 © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1359105314532153 hpq.sagepub.com Introduction Orlistat is currently the only available prescribed form of pharmacological management for obe- sity and functions by reducing the amount of fat absorbed from food eaten (National Institute for Health and Clinical Excellence, 2001; Royal College of Physicians of London, 2003). There can therefore be unpleasant consequences, such as oily stools and anal leakage, if fat is con- sumed. Although frequently prescribed by doc- tors (Srishanmuganathan et al., 2007), there is marked variability in patient outcomes with many patients either not losing weight or regain- ing any lost weight by follow-up (Rucker et al., 2007). To date, research addressing this variabil- ity has focused on measures of effectiveness and adherence concluding that the average addi- tional weight loss from orlistat is about 2.9 kg, with attrition rate estimates ranging from 33–77 percent (Padwal et al., 2003; Rucker et al., 2007; Vray et al., 2005). One study used interviews to explore the possible mechanisms involved in promoting successful weight-loss maintenance after being prescribed orlistat (Ogden and Sidhu, 2006). The results indicated that successful weight loss was related to participants’ model of the causes of their obesity, their motivations for weight loss and the ‘side effects’ of taking orlistat in terms of both how they managed the side effects Gaining weight after taking orlistat: A qualitative study of patients at 18-months follow-up Amelia Hollywood and Jane Ogden Abstract Orlistat is currently the only prescribed form of pharmacological management for obesity and functions by reducing the amount of fat absorbed from food eaten. Although frequently prescribed, there is marked variability in outcomes. A total of 10 participants’ experiences of gaining weight after taking orlistat were analysed using thematic analysis. Participants attributed their failed weight loss to mechanisms of the medication, emphasised a medical model of obesity with barriers to their weight loss and other weight-loss methods which had also failed. Overall, their weight gain was considered an inevitable part of their self- identity, reflecting their self-fulfilling prophecy of being a perpetual dieter. Keywords adherence, diet, medication, obesity, self-identity University of Surrey, UK Corresponding author: Jane Ogden, School of Psychology, University of Surrey, Guildford, Surrey GU2 7XH, UK. Email: J.Ogden@surrey.ac.uk 532153HPQ 0 0 10.1177/1359105314532153Journal of Health PsychologyHollywood and Ogden research-article 2014 Article at University of Surrey on May 10, 2016 hpq.sagepub.com Downloaded from