Orlistat can, to some extent, improve fatty liver, but orlistat also has relatively obvious side effects. It is not recommended for mild and moderate fatty liver, and can be applied with caution for those who are obese, with severe fatty liver. Orlistat is a lipase inhibitor in the gastrointestinal tract, which inhibits the absorption of triglycerides and reduces caloric intake. Orlistat can inhibit the absorption of vitamin D, vitamin E and carotenoids, which can lead to various vitamin deficiencies and the corresponding symptoms. Orlistat is more suitable for obese patients with hyperlipidemia and hyperglycemia, but because of its side effects, it should be applied on a balance of pros and cons. The treatment of fatty liver patients is mainly based on exercise and diet control, and the application of drugs should be weighed against the pros and cons because any drug has side effects.