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Head-to-head evidence comparison — which supplement is right for you?
Nicotinamide Riboside vs Orlistat: Orlistat has the stronger overall evidence (6 vs 5.5/10); they're alternatives for metabolic health — the best pick depends on your goals. Take the 60-second quiz for a pick tailored to your goals.
Orlistat wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Too few graded studies
Top outcomes
Verdict
Mostly mechanism / observational
Top outcomes
1000 mg daily (the dose used in most outcome trials; lower doses raise blood NAD+ but have not been tested for clinical effects)
Morning with breakfast, Split dosing (morning and midday) for doses above 500 mg
Nicotinamide Riboside Chloride capsules or powder
Prescription Xenical: 120 mg three times daily (360 mg/day), taken with or up to 1 hour after each main fat-containing meal. Over-the-counter Alli: 60 mg three times daily (180 mg/day). Skip the dose if a meal is missed or contains no fat. Used alongside a reduced-calorie diet in which fat supplies roughly 30% of energy — a higher-fat meal makes the gastrointestinal side effects markedly worse, not the weight loss better.
With meals
Xenical 120 mg capsule three times daily with meals (prescription)
and 1 more not shown
and 2 more not shown
1–2 weeks
4–8 weeks
8–16 weeks
4–8 weeks
4–12 weeks to onset; maximal by 6–12 months
Year 2 of continuous use
Years
3–12 months
NAD⁺ supplementation for anti-aging and wellness: A PRISMA-guided systematic review of preclinical and clinical evidence.
Ageing Research Reviews (2026) · Systematic review
Reviewed 113 intervention studies published from 2010 to October 2025: 33 in humans (28 of them randomised) and 80 in rodents, covering NR, NMN and injected NAD+.
The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis.
Journal of Cachexia, Sarcopenia and Muscle (2025) · Meta analysis
Systematic review and meta-analysis of placebo-controlled RCTs of NMN or NR in adults with a mean age of 60.9 to 83 years, looking at muscle mass, grip strength, gait speed and other physical performance tests.
Effects of NAD+ precursor supplementation on glucose and lipid metabolism in humans: a meta-analysis.
Nutrition & Metabolism (2022) · Meta analysis · n=14750
Meta-analysis of 40 clinical studies (14,750 participants) of four NAD+ precursors: nicotinamide riboside, nicotinamide mononucleotide, nicotinic acid (niacin) and nicotinamide.
XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients.
Diabetes Care (2004) · Rct · n=3305
4-year double-blind trial randomising 3,305 obese patients (BMI ≥30) to lifestyle changes plus orlistat 120 mg or placebo three times daily
Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group.
Lancet (1998) · Rct · n=688
743 obese patients (BMI 28–47) entered a 4-week placebo lead-in at 15 European centres; 688 were randomised double-blind to orlistat 120 mg three times a day or placebo for 1 year on a 600 kcal/day-deficit diet, then reassigned for a second 52-week weight-maintenance period
Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial.
JAMA (1999) · Rct · n=892
2-year randomised, double-blind, placebo-controlled trial at 18 US research centres; 1,187 obese adults (BMI 30–43) entered and 892 were randomised, with 223 placebo- and 657 orlistat-treated subjects in the intent-to-treat analysis
The points come from one 8-week RCT in overweight adults, where 100, 300 and 1,000 mg a day raised whole-blood NAD+ by 22%, 51% and 142%, with no difference in adverse events versus placebo or between doses (PMID 31278280). Other trials at 1 g a day found similar rises, 2.6-fold in older adults with mild cognitive impairment (PMID 37994989). No trial compared doses above 1,000 mg, so no optimal dose is plotted. The ceiling is the 2,000 mg a day that a 12-week RCT in obese men found safe (PMID 29992272). The NR-SAFE trial also found 3,000 mg a day well tolerated over 4 weeks in 10 people with Parkinson's disease (PMID 38016950).
AI-estimated from published studies. Interpret as directional guidance.
Orlistat has a higher evidence score (6/10 vs 5.5/10) and wins in 2 of 3 categories.
For metabolic health, Orlistat has a higher relevance score (58 vs 30).
No documented interaction was found in the data searched. This does not establish that this exact combination is safe.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.