Side effects and practical notes Orlistat causes loose stools, urgency, and oily spotting, especially after fatty meals
Metabolic changes But muscle loss isn't the only thing people losing weight need to worry about
Proc Natl Acad Sci USA 92 : 10281032 Girnita A, Girnita L, Prete Fd F, Bartolazzi A, Larsson O, Axelson M (2004) Cyclolignans as inhibitors of the insulin-like growth factor-1 receptor and malignant cell growth

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PMID 7759932
Many factors can make pills harder to swallow, from mouth size to bad experiences with swallowing medication in the past