There is good evidence from RCTs that Orlistat promotes weight reduction for some people in the short term. However, the published results do not coincide with the licensed indication and so their relevance is limited. The Committee noted that discontinuation of Orlistat treatment (in conjunction with a switch to a eucaloric diet) resulted in a weight regain. In addition, while the trials provide two-year outcome information, there is no evidence of the longer term benefits or disbenefits of continued treatment with Orlistat and treatment beyond two years is currently unlicensed. It was also noted that the base-case utility estimates seemed to be based on a generous assumption about the QALY gain associated with a 10% loss in initial body weight. The proposal for the use of Orlistat, and therefore the cost calculations, were based on the assumption that it would be prescribed in secondary care. The costs would vary if it were prescribed and monitored in a primary care setting.