Background: Obesity is fast becoming a worldwide epidemic. Orlistat has widely been used in the US for the management of obesity since being approved by the FDA in 1999. Recent studies indicated that Orlistat has been associated with hepatic dysfunction. Consequently in May 2010, the FDA approved a revised label for Xenical to include new safety information about cases of severe liver injury with its use. More recently, reports have suggested oxalate nephropathy and acute kidney injury associated with Orlistat use. To date, there have been no large studies in the US, demonstrating an association between Orlistat and renal dysfunction.