Healthy food swaps are one of the simplest ways to cut calories without overhauling your diet. Losing weight comes down to eating fewer calories than your body uses, and the NHS says weight loss medicines are usually prescribed alongside diet and lifestyle changes.1 NICE says all weight management medicines should be used alongside a reduced-calorie diet and increased physical activity.2
Whether you're taking orlistat, a weight loss injection or tablet, or no treatment at all, these five swaps are practical and easy to keep up. If you take orlistat, there's one extra point to know. The licence says your diet should get about 30% of its calories from fat, spread across three main meals.3
Crash diets aren't the answer. NICE advises against restrictive diets that are nutritionally unbalanced, because they're ineffective in the long term and can be harmful.2
You don't need to cut out whole food groups. A few small swaps you can stick with is a good place to start.
Swap 1: Replace full-fat dairy with lower-fat alternatives
Butter, hard cheese and cream are high in saturated fat, according to the NHS.4 Dairy is a good place to start because most staples come in a lower-fat version.
Choose lower-fat milk, low-fat plain yoghurt and reduced-fat cheese, and use the cheese in small amounts.5,6 When you cook, swap butter for a small amount of unsaturated oil, such as rapeseed or olive oil.5 That trades some saturated fat for unsaturated fat, which is what the NHS advises.4
Taking orlistat? It can reduce how well you absorb the fat-soluble vitamins A, D, E and K. If a multivitamin is recommended, take it at bedtime or at least 2 hours after your orlistat dose.3 Ask your pharmacist whether you need one.
Start with the milk, yoghurt and cheese you use most. Small changes there add up quickly.
Swap 2: Replace fried foods with grilled, baked or steamed versions
How you cook can matter as much as what you cook. The NHS suggests you grill, bake, poach or steam food rather than frying or roasting it.7
That could mean grilled chicken instead of fried, oven-baked chips instead of deep-fried, or a poached egg instead of a fried one. When you do need oil, measure it with a teaspoon or use an oil spray.7 Each tablespoon of fat adds around 100 calories, so cutting a tablespoon down to a teaspoon makes a real difference.5
If you take orlistat, lighter cooking makes it easier to keep your fat in check. Stomach and bowel side effects can be more likely with a high-fat diet.3 On a 2,000 calorie day, more than 30% of calories from fat means more than 67g of fat.3
A teaspoon of oil, not a free pour. It's one of the easiest ways to trim calories at the pan.
Swap 3: Replace white refined carbohydrates with wholegrains
This swap is about keeping you fuller. We digest wholegrain foods more slowly than refined grains, so they can help you feel full for longer.8 Fibre also helps keep your bowels healthy.8
Try wholemeal or granary bread, wholewheat pasta, brown rice and porridge oats.9 If you prefer white bread, look for a higher-fibre version.8 The NHS says adults should aim for 30g of fibre a day.9
“Healthy food swaps work best as small habits you can keep up. Start with one or two, compare labels using the per 100g figure, and spread your fat evenly across three main meals if you take orlistat. If you're thinking about weight loss treatment, a pharmacist or prescriber can talk it through with you.
Ana Carolina GoncalvesSuperintendent Pharmacist
Go easy on what you add, too. Butter, oil and rich sauces raise the calorie content of starchy foods, so use a lower-fat spread or a small amount of unsaturated oil on your potatoes instead.8
Change one staple first, such as your bread or rice, rather than everything at once.
Swap 4: Replace high-fat sauces and dressings with lower-fat options
Labels are the most reliable way to spot higher-fat products. For solid foods, low fat means 3g of fat or less per 100g, and high fat means more than 17.5g per 100g.4 Compare the per 100g figure when you shop.6
Watch for labels that say lower fat, reduced fat or light. These only mean at least 30% less fat than a similar product, so a lower fat mayonnaise can still be high in fat.4
For flavour, use herbs, spices and lemon juice, and look for reduced-salt or reduced-sugar sauces.6 Try low-fat Greek yoghurt instead of cream or sour cream in soups, chilli and curry.5 When you eat out, asking for sauces and dressings on the side lets you decide how much to use.
Lower fat doesn't always mean low fat. Check the per 100g figure before you trust the label.
Swap 5: Replace high-calorie snacks with fruit, vegetables or lower-fat options
Snacks are where good intentions often slip. The NHS suggests swapping crisps, biscuits and chocolate for fruit, plain popcorn, plain rice cakes, crackers with lower-fat cheese, or chopped vegetables with lower-fat hummus.6
If you take orlistat, remember that it goes with main meals. The capsule is taken immediately before, during or up to an hour after each main meal, and the NHS says to leave it out if a meal has no fat in it.3,10
Do not take orlistat at snack time or with a fat-free meal. The capsule is for main meals that contain fat.
Healthy food swaps are a good foundation, and some people add treatment on top. Which medicine suits you depends on the treatment. The Wegovy licence includes a BMI of 27 to 29.9 with a weight-related health condition, while prescription orlistat is licensed from a BMI of 28 with associated risk factors.11,3 A prescriber has to assess whether treatment is suitable for you.
Pharmica assesses orlistat and GLP-1 treatments through different routes. Through Pharmica, orlistat treatment must stop once your BMI falls below 28, and GLP-1 treatment involves separate previous-prescription checks.
You can read more about orlistat, Wegovy pens, Wegovy tablets and Mounjaro, or see how they compare in our Wegovy vs Mounjaro vs orlistat guide.
Frequently asked questions
What should I eat on a balanced diet for weight loss?
Build meals around vegetables, fruit and higher-fibre starchy foods such as wholewheat pasta or brown rice. Aim for at least 5 portions of fruit and vegetables a day, choose lower-fat milk and dairy, and add some protein. If you take orlistat, your diet should get about 30% of its calories from fat, spread across three main meals.
How much fat can I eat per meal when taking orlistat?
The licence doesn't set a fixed amount per meal. It says about 30% of your calories should come from fat, spread across three main meals. On a 2,000 calorie day, that's roughly 67g of fat in total. A high-fat diet makes stomach and bowel side effects more likely, so check your leaflet and ask a pharmacist if you're unsure.
Are healthy food swaps enough to lose weight without medication?
Swaps can support weight loss without medication, especially alongside more activity. NICE says weight loss medicines should be used alongside a reduced-calorie diet and more physical activity. Whether treatment is an option depends on the medicine: Wegovy is licensed from BMI 27 with a weight-related condition, and prescription orlistat from 28 with risk factors. Through Pharmica, orlistat must stop below BMI 28, and GLP-1 treatment has previous-prescription checks. A prescriber decides.
What vitamins should I take with orlistat?
Orlistat can reduce how well you absorb vitamins A, D, E and K, so a multivitamin may be worth considering. If one is recommended, take it at bedtime or at least 2 hours after your orlistat dose. Ask your pharmacist or prescriber whether you need one and which type suits you.
What foods should I avoid when taking orlistat?
You don't need to cut out fat completely, but go easy on high-fat foods such as fried food, processed or fatty meats, biscuits and cakes. A very high-fat meal is more likely to cause oily stools and wind. Check labels as you shop, because more than 17.5g of fat per 100g counts as high fat.
References
- NHS. Obesity: treatment. NHS website; 2026. nhs.uk
- National Institute for Health and Care Excellence. Overweight and obesity management. NICE guideline NG246. NICE; 2026. nice.org.uk
- Neon Healthcare Ltd. Xenical 120 mg hard capsules: Summary of Product Characteristics. Electronic Medicines Compendium; 2023. medicines.org.uk/emc
- NHS. Different fats in food. NHS website; 2023. nhs.uk
- British Heart Foundation. Healthy food swaps. British Heart Foundation; 2023. bhf.org.uk
- NHS. Healthier food swaps. NHS website; 2026. nhs.uk
- NHS. How to eat less saturated fat. NHS website; 2023. nhs.uk
- NHS. Starchy foods and carbohydrates. NHS website; 2023. nhs.uk
- NHS. How to get more fibre into your diet. NHS website; 2026. nhs.uk
- NHS. Orlistat. NHS website; 2026. nhs.uk
- Novo Nordisk Limited. Wegovy 2.4 mg FlexTouch solution for injection in pre-filled pen: Summary of Product Characteristics. Electronic Medicines Compendium; 2026. medicines.org.uk/emc
This article is intended for informational purposes only and does not replace professional medical advice. Always read the patient information leaflet supplied with your medication and speak to a healthcare professional if you have specific concerns.