Should Orlistat be considered in the management of hypertriglyceridemia?

While there are no controlled trials addressing this issue, it is certainly a reasonable option which I have used in some patients with Familial Chylomicronemia Syndrome. It will help to reduce the generation of chylomicrons and therefore the subsequent risk for hypertriglyceridemic pancreatitis. May also help reinforce dietary fat restriction due to steatorrhea. The main problem has been getting Insurance to cover this as most patients are not obese, and so often patients have to buy OTC lower strength Orlistat.