Coconut oil has gained popularity as a purported natural remedy for obesity, but does the evidence support its use? Extracted from mature coconuts, this saturated fat contains medium-chain triglycerides (MCTs) that some claim boost metabolism and aid weight loss. However, coconut oil remains exceptionally calorie-dense and approximately 90% saturated fat—identical in energy content to other fats. UK guidance from the NHS and NICE does not recommend coconut oil for obesity management, and high-quality research shows no significant weight loss benefit. This article examines the evidence, risks, and NHS-recommended alternatives for effective, safe weight management.

What Is Coconut Oil and How Might It Affect Weight?

Coconut oil is a saturated fat extracted from the flesh of mature coconuts (Cocos nucifera). It has gained popularity in recent years as a purported natural remedy for various health conditions, including obesity. The oil is composed predominantly of medium-chain triglycerides (MCTs), particularly lauric acid (approximately 50%), alongside caprylic and capric acids. These MCTs differ structurally from the long-chain triglycerides found in most dietary fats.

The proposed mechanism by which coconut oil might influence body weight centres on the unique metabolic pathway of some MCTs. Unlike long-chain fatty acids, shorter-chain MCTs (caprylic and capric acids) are absorbed directly into the portal circulation and transported to the liver, where they undergo rapid beta-oxidation. This process theoretically increases energy expenditure through a phenomenon called diet-induced thermogenesis—the energy required to digest, absorb, and process nutrients. However, lauric acid, which makes up approximately half of coconut oil's fatty acid content, behaves metabolically more like a long-chain fatty acid despite its classification as an MCT. This means coconut oil does not have the same metabolic effects as purified MCT oils containing predominantly shorter-chain fatty acids.

Some short-term studies have suggested that MCTs may increase satiety (feelings of fullness) more effectively than other fats, potentially leading to reduced caloric intake. However, evidence for this effect with coconut oil specifically is limited and inconsistent, and any modest short-term changes have not been shown to produce clinically meaningful weight loss. It is crucial to note that coconut oil remains a calorie-dense food, providing approximately 900 kilocalories per 100 grams—identical to other fats—and contains approximately 90% saturated fat.

Key considerations:

• Coconut oil contains approximately 900 kcal per 100 g and is approximately 90% saturated fat

• Lauric acid, whilst classified as an MCT, behaves metabolically more like a long-chain fatty acid

• The thermogenic effect of shorter-chain MCTs is modest and does not translate to clinically significant weight loss with coconut oil

• Coconut oil is not equivalent to purified MCT oil and should not be expected to have the same metabolic effects

Evidence for Coconut Oil in Obesity Management

The scientific evidence supporting coconut oil as an effective treatment for obesity remains limited and does not support its use for weight management. Systematic reviews and meta-analyses examining the relationship between coconut oil consumption and weight have produced consistently negative or neutral results, with high-quality studies showing no significant benefit for weight reduction.

A 2020 systematic review and meta-analysis published in Circulation examined the effects of coconut oil on cardiovascular risk factors, including body weight. The analysis found no statistically significant reduction in body weight or body mass index (BMI) compared to other dietary oils. In fact, coconut oil was associated with significantly higher LDL cholesterol levels compared to unsaturated oils such as olive or sunflower oil. Similarly, other systematic reviews comparing coconut oil to other fat sources have consistently failed to demonstrate superior weight loss outcomes. Where modest benefits have been observed in small studies, they are often attributed to the MCT content rather than coconut oil specifically—and pure MCT oil contains a higher proportion of the shorter-chain fatty acids (C8 and C10) thought to be most metabolically active.

Some small-scale studies have reported reductions in waist circumference with coconut oil supplementation, particularly in populations with abdominal obesity. However, these studies often have significant methodological limitations, including small sample sizes, short duration (typically 12 weeks or less), lack of adequate control groups, and potential conflicts of interest from industry funding. The clinical significance of any observed changes remains highly questionable.

Evidence limitations:

• Most studies are short-term (12 weeks or less) and do not assess sustained weight loss

• Heterogeneous study designs make comparison difficult

• Publication bias may favour positive results

• Many studies are industry-funded, raising potential conflict-of-interest concerns

• High-quality evidence shows adverse effects on LDL cholesterol compared to unsaturated oils

NICE guidance on obesity management (CG189) does not recommend coconut oil as a treatment for obesity. The NHS and other UK regulatory bodies do not support its use as an intervention for weight management. Current evidence does not support coconut oil as a primary or adjunctive treatment for obesity.

How to Use Coconut Oil Safely if Choosing to Include It in Your Diet

If individuals choose to incorporate coconut oil into their diet, it should be done with careful consideration of overall dietary patterns, particularly saturated fat and total caloric intake. Coconut oil should never replace evidence-based obesity treatments. UK dietary guidance from the NHS and British Heart Foundation recommends limiting saturated fat intake and choosing unsaturated oils (such as olive or rapeseed oil) in preference to saturated fats like coconut oil.

Practical guidance for use:

• Stay within saturated fat limits: The NHS recommends no more than 20 g of saturated fat daily for women and 30 g daily for men. Two tablespoons of coconut oil contain approximately 24 g of saturated fat, which would exceed or nearly meet the entire daily limit

• Substitution, not addition: If using coconut oil, replace other dietary fats rather than adding it on top of existing fat intake, and account for the calories (approximately 120 kcal per tablespoon)

• Prefer unsaturated oils: NHS and British Heart Foundation guidance recommends choosing unsaturated oils such as olive, rapeseed, or sunflower oil for cooking and food preparation, as these have beneficial effects on cardiovascular health

• Cooking applications: Refined coconut oil has a higher smoke point (approximately 232°C) than unrefined (approximately 177°C); use accordingly for cooking temperature

It is crucial to maintain awareness of total caloric intake to ensure coconut oil consumption does not lead to an unintended caloric surplus, which would promote weight gain rather than loss. Individuals should be aware that coconut oil's exceptionally high saturated fat content (approximately 90%) may adversely affect cardiovascular health markers, particularly LDL cholesterol levels, compared to unsaturated oils.

When to seek professional advice:

• Before making significant dietary changes, particularly if you have existing health conditions

• If you have cardiovascular disease, hyperlipidaemia, or diabetes

• If you are taking lipid-lowering medications (statins) or other medicines that may be affected by dietary fat intake

• If you experience any adverse effects after introducing coconut oil

Patients should consult their GP or a registered dietitian before using coconut oil as part of a weight management programme, especially if they have co-morbidities that require medical nutrition therapy. A dietitian can provide personalised advice on healthy fat choices within a balanced, calorie-controlled diet.

Risks and Limitations of Coconut Oil for Obesity

Despite its popularity, coconut oil carries several important risks and limitations that must be considered, particularly for individuals with obesity who often have concurrent metabolic and cardiovascular conditions.

Cardiovascular concerns: The most significant concern relates to coconut oil's exceptionally high saturated fat content (approximately 90%). Saturated fats are known to raise low-density lipoprotein (LDL) cholesterol—often termed 'bad cholesterol'—which is a major risk factor for atherosclerotic cardiovascular disease. A 2020 Cochrane review confirmed that replacing saturated fats with polyunsaturated fats reduces the risk of cardiovascular events. High-quality systematic reviews and randomised controlled trials have consistently demonstrated that coconut oil increases LDL cholesterol compared to unsaturated oils such as olive or sunflower oil. The British Heart Foundation and NHS guidance recommend limiting saturated fat intake and choosing unsaturated oils in preference to coconut oil.

Multiple randomised controlled trials have demonstrated that coconut oil increases both LDL and HDL cholesterol compared to unsaturated oils. Whilst some argue that the rise in HDL ('good cholesterol') is protective, the overall effect on cardiovascular risk remains unfavourable compared to unsaturated fat sources, and the increase in LDL cholesterol is a significant concern.

Additional limitations and risks:

• Caloric density: At 9 kcal/g (approximately 900 kcal per 100 g), excessive consumption easily leads to caloric surplus and weight gain

• Displacement of healthier fats: Using coconut oil instead of unsaturated oils means missing the cardiovascular benefits of olive, rapeseed, or other unsaturated oils

• Displacement of nutrient-dense foods: Relying on coconut oil may reduce intake of foods rich in essential nutrients, fibre, and beneficial phytochemicals

• Gastrointestinal effects: Some individuals experience nausea, diarrhoea, or abdominal discomfort, particularly with higher intakes

• Allergic reactions: Though rare, coconut allergy can occur and may cause serious reactions including anaphylaxis

• Drug interactions: High-fat meals can affect the absorption of certain lipophilic medicines; patients taking regular medication should check with their pharmacist or consult the patient information leaflet

When to seek urgent medical help:

• Call 999 or go to A&E immediately if you experience: – Chest pain or tightness – Signs of a severe allergic reaction (difficulty breathing, facial or throat swelling, severe skin reaction)

• Contact NHS 111 or your GP for: – Persistent gastrointestinal symptoms – Significant unexplained weight gain despite dietary efforts – Concerns about medication interactions

Reporting side effects: If you suspect you have experienced a side effect from a medicine or medical device, you can report it via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk or by searching for 'MHRA Yellow Card' in the Google Play or Apple App Store.

NHS-Recommended Approaches to Obesity Treatment

The NHS and NICE provide comprehensive, evidence-based guidance for obesity management that does not include coconut oil as a recommended intervention. Effective obesity treatment requires a multimodal approach addressing diet, physical activity, behavioural factors, and, where appropriate, pharmacological or surgical interventions.

NICE-aligned obesity management strategies:

Dietary modification: NICE recommends a balanced, calorie-deficit diet tailored to individual needs, typically reducing daily intake by 500–600 kcal. The emphasis is on whole foods, including fruits, vegetables, whole grains, lean proteins, and unsaturated fats such as those found in olive oil, rapeseed oil, nuts, seeds, and oily fish. The NHS Eatwell Guide provides a visual representation of healthy eating patterns. Referral to a registered dietitian may be appropriate for personalised nutrition advice and support.

Physical activity: Adults should aim for at least 150 minutes of moderate-intensity aerobic activity weekly, plus strength training on two or more days. For weight loss, greater volumes of activity (up to 300 minutes weekly) may be necessary. Activity should be gradually increased and tailored to individual capability, preferences, and any existing health conditions.

Behavioural interventions: Structured weight management programmes, such as the NHS Digital Weight Management Programme, provide behavioural support including goal-setting, self-monitoring, stimulus control, and relapse prevention strategies. These programmes have demonstrated effectiveness in achieving and maintaining weight loss. The NHS Weight Loss Plan app and online resources provide free, evidence-based support.

Pharmacological treatment: For adults with a BMI of 30 kg/m² or more, or 28 kg/m² or more with risk factors such as type 2 diabetes or hypertension, NICE recommends considering orlistat (a lipase inhibitor) if lifestyle interventions alone have not achieved adequate weight loss. Orlistat is available on prescription (Xenical 120 mg) or over the counter at lower strength (alli 60 mg) for adults with BMI 28 kg/m² or more. Newer agents including GLP-1 receptor agonists may be prescribed in specialist weight management services for eligible patients:

• Semaglutide 2.4 mg (Wegovy): NICE TA875 recommends it as an option for weight management in adults with at least one weight-related comorbidity and a BMI of 35 kg/m² or more (or 30 kg/m² or more for some groups), within specialist weight management services and for a defined duration

• Liraglutide 3 mg (Saxenda): NICE TA664 recommends it for eligible adults with specific BMI and comorbidity criteria, within specialist services

These medicines are used alongside a reduced-calorie diet and increased physical activity, and treatment is reviewed regularly.

Bariatric surgery: Surgical interventions (gastric bypass, sleeve gastrectomy, adjustable gastric banding) may be considered for adults with:

• BMI of 40 kg/m² or more, or

• BMI of 35–39.9 kg/m² with significant weight-related comorbidities that could be improved with weight loss, or

• BMI of 30–34.9 kg/m² with recent-onset type 2 diabetes

Surgery is considered after non-surgical measures have been tried, and following comprehensive assessment in a specialist weight management service.

Accessing NHS support:

• Speak with your GP about weight management options and referral to specialist services or structured programmes

• Access free NHS weight loss resources online at nhs.uk, including the NHS Weight Loss Plan

• Use NHS-approved apps such as the NHS Weight Loss Plan app

• Ask your GP or local authority about local weight management services and programmes

Effective obesity treatment requires long-term commitment and professional support. Patients should be wary of unproven remedies and focus on evidence-based interventions that address the complex, multifactorial nature of obesity. NICE guidance (CG189) provides the framework for safe, effective obesity management in the UK.

Frequently Asked Questions