Everybody knows we are in the middle of the diabetes and obesity epidemic. One third of Americans are overweight and a further one third are obese. In 2012, 29.1 million Americans, or 9.3% of the population, had diabetes and 86 million Americans age 20 and older had prediabetes. 1.4 million Americans are diagnosed with diabetes every year.
Forty-five percent of overweight Americans and 67% of those who are obese are trying to lose weight and more than a third of them have reported using a dietary supplement. Weight-loss supplements remain a booming industry in the United States, with overall retail sales of 26.9 billion in 2009.
A lot of people use over-the-counter, hyped-up internet products that are marketed as "natural," thinking that they are safe. Furthermore, patients often do not share with their doctors the fact that they are using such supplements. However, product quality remains variable and uncertain, with some products containing undeclared laxatives, diuretics or thyroid hormones that could be dangerous to your health, if used unsupervised.
There are natural supplements that do show promise for weight loss and weight maintenance.
Supplements That Increase Energy Expenditure:
Ephedra sinica (Ma Huang)
Has been banned by FDA in 2004 due to adverse health effects, including heart, psychiatric, and neurological consequences.
Shown to increase metabolic rate, help to burn fat and enhance stamina in sports performance. It is also a mild appetite suppressant. It causes mild weight loss for period up to 12 weeks, but not sustained with long term use. It can cause an elevation in heart rate and blood pressure and can worsen anxiety.
Caffeine (as caffeine, or from herbs like guarana, kola nut, yerba mate, and others)
Works thru the brain and as a diuretic with beneficial effects on weight loss with eventual tolerance development. However, adverse events are more frequently seen at high doses, including the commonly reported side effects of tremors, insomnia, and dizziness.
Capsaicin (from chili pepper)
Can maintain moderate weight loss for up to 2 years. But you need to take up to 2 mg/day, that is difficult to tolerate due to pungent taste.
Supplements That Modulate Carbohydrate Metabolism:
It potentiates the action of insulin, reduces food cravings, increases the metabolic rate and lean muscle mass. It can help people to lose up to 2.2 lbs/year. Possible side effects are headaches, watery stools, constipation, weakness, vertigo, nausea, vomiting, and hives.
Common (white kidney) bean
Works as a "starch blocker," suppresses appetite and mobilizes body fat. In addition to diet, helps to lose and maintain up to 6.6 lbs of weight lost in 24 weeks. Possible side effects are headaches, soft stools, flatulence, and constipation.
Supplements That Increase Fat Melting or Reduce Fat Synthesis:
Conjugated linoleic acid
Can help to lose up to 3 lbs in 6 months. Possible side effects are abdominal discomfort, constipation, diarrhea, loose stools, and adverse effects on blood lipid profiles.
Decreases fat absorption and has multiple other health benefits, but weight loss is very modest. Possible side effects are mild, including stomach upset, constipation, nausea, and increased blood pressure.
Garcinia (hydroxycitric acid)
Mildly suppresses appetite. Weight loss up to 8 lbs in combination with low calorie diet in 12 weeks. Possible side effects are headache, nausea, stomach upset, and upper respiratory tract symptoms.
Supplements That Increase Satiety:
Devil's backbone (Cissus quadrangularis)
In combination with a low calorie diet, it can help to lose up to 18 lbs in 8 weeks. No evidence of adverse effects has been reported.
Helps with gut microbiota as a prebiotic. Minimal effect on weight loss. Possible side effects are abdominal pain, flatulence, diarrhea, nausea, and cramps.
Supplements That Block Dietary Fat Absorption:
Glucomannan and Chitosan
Decrease cholesterol absorption. Weight loss is up to 3.5 lbs in 4 weeks without dieting. Possible side effects are abdominal pain, diarrhea, and constipation.
Supplements That Suppress Appetite:
A published, controlled, randomized trial showed no effect on weight lose without staying on a low calorie diet. Possible side effects are an increased heart rate and blood pressure, headaches, dizziness, nausea, and vomiting.
Human chorionic gonadotropin (hCG)
Studies have disproven the notion that hCG, administered orally or via injection, has any effect on appetite, fat mobilization, or satiety. In addition, it has been associated with serious adverse effects, including ovarian hyperstimulation, hypercoagulability, and multiple pregnancies. The FDA has issued warnings to manufacturers and consumers noting that these products are unapproved for use. There is no human evidence supporting the use of hCG for weight management.
As you can see, the evidence supporting the use of dietary supplements to reduce body weight is inconclusive and unconvincing, and the cost of these products can be considerable.
Most of these supplements are not risk-free!
If you are serious about your weight, you need a comprehensive, physician-supervised approach that includes a detailed evaluation of your health, sometimes even a genetic assessment, with specific recommendations on your diet, exercise program, possible medications and supplements, and even weight reduction surgery.
For more information please schedule an appointment with Dr. Koganski at 215-750-7000,
2. National Institutes of Health, Office of Dietary Supplements. Dietary supplements for weight loss.
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4. Blom WA, et al. Effects of 15-d repeated consumption of Hoodia gordonii purified extract on safety, ad libitum energy intake, and body weight in healthy, overweight women: a randomized controlled trial. Am J Clin Nutr 2011;94:1171-81.
5. Heymsfield SB, et al. Garcinia cambogia (hydroxycitric acid) as a potential antiobesity agent: a randomized controlled trial. JAMA 1998;280:1596-600
6. Birmingham CL, Smith KC. Human chorionic gonadotropin is of no value in the management of obesity. Can Med Assoc J. 1983;128:1156-1157.