Orlistat works for some people. There are side effects, which are related to bathroom patterns. Also, the amount of weight loss expected on this drug and other anti-obesity drugs averages 22 pounds total. It is always recommended as an adjunct to incorporate diet modifications, exercise, and behavior change for permanent weight loss. I feel I have a very low metabolism.
Weight training builds muscle, which has a positive effect.
Aerobic exercise also helps the body burn calories at a faster rate during exercise. Intense aerobics, like running, can also raise metabolism for several hours after the exercise is finished. As far as I know, there's no direct relationship. However, some medications used for bowel diseases are steroid-based. These can facilitate weight gain in some people.