Background/Aim: Fatty acid synthase (FASN) provides palmitate for cell membrane formation in colorectal cancer (CRC) cells, however, palmitate is also available in the blood of CRC patients. The aim of this study was to examine whether orlistat, a FASN inhibitor, is able to attenuate CRC cell growth despite the availability of extracellular palmitate. Materials and Methods: Palmitate concentrations were measured in serum from CRC patients and healthy controls. HT-29 CRC cells were treated with orlistat and palmitate. Results: Treatment of CRC cells with orlistat caused a dose-dependent inhibition of cell proliferation. In turn, delivery of extracellular palmitate at doses lower than those found in the serum of CRC patients reversed inhibition by orlistat concentrations of up to 10 μM. Conclusion: Inhibition of CRC cell proliferation by orlistat is reversed by palmitate which is present at high levels in the serum. Therefore, orlistat may be effective in vivo only at high concentrations.Colorectal cancer (CRC) is one of the leading causes of mortality among cancer patients, and the search for new therapies is still underway. Due to advances in screening techniques and improvements in treatments, the death rate from colorectal cancer has been decreasing in the United States and Europe. However, a trend of increasing incidence of the disease has been observed in recently developed countries (1). This cancer tends to affect men and women equally, but men tend to develop it at a younger age (2). CRC can often be sporadic; however, hereditary forms are also common in this entity (2). Recent evidence shows that CRC is associated with considerable changes in lipid composition and metabolism in cancer cells (3, 4). One of the alterations characteristic of many cancers is enhanced lipogenesis, a process that provides lipids for cell membrane formation in rapidly proliferating cancer cells (5). Some authors have reported overexpression of fatty acid synthase (FASN), the major enzyme which produces palmitic acid, in CRC tissue (6-8). Furthermore, FASN levels in the serum of colorectal cancer patients are significantly higher than that in healthy individuals; thus, this enzyme may be a potential tumor marker (9). FASN knockdown has been associated with the inhibition of CRC cell proliferation (10). Moreover, FASN expression increases with tumor progression in certain tumor types, including colorectal cancer and is associated with increased disease aggressiveness and diminished survival and response to classical chemotherapeutic agents (11)(12)(13). Thus, research on inhibitors of FASN as potential anticancer therapies is underway (5). Orlistat (tetrahydrolipstatin) is a drug used for the treatment of obesity. Orlistat is an inhibitor of pancreatic and gastric lipase, and its action leads to decreased absorption of dietary fat (14). This agent, which is administered by the oral route, is minimally absorbed by the gastrointestinal tract and reduces the lipid supply from outside sources. However, orlistat is also an inhibitor...