A lot of diet pills and weight-loss supplements have become popular. They promise weight loss with minimum effort. They also claim to have no side effects since most of them are “natural”. But is there any truth to their claims?
BY KARLA SILVERIO-FERNANDO, MD
With the advent of fastfoods and modern technology, wherein almost everything can be done with the “push” of a touch screen, it is not surprising that obesity has now become an epidemic. Eating calorie-rich food and upsized servings have become the norm, coupled with sedentary lifestyle encouraged by modern gadgets.
When it comes to losing weight, most people want shortcuts and instant results as well. Hence, diet pills and weight loss supplements have become popular. Are supplements and herbs really as effective and safe as they say? Let us take a look at some of the common weight loss supplements available in the market today.
We see this incorporated even in some drinks that are being promoted for weight loss. L-carnitine is a molecule that allows the cells to break down fat and get energy from the stored fat reserves. Because of this action, it has been proposed as a treatment for weight loss. Available studies however show that L-carnitine does not seem to have a significant effect.
In a small study done by RG Villani and colleagues in 2000 on the effect of L-carnitine supplementation in obese women, there were no differences in the total body mass as well as fat mass between subjects who took 2 grams of L-carnitine per day and those who did not. Furthermore, some subjects who took L-carnitine experienced nausea or diarrhea.
This is an essential trace element that seems to enhance the effects of insulin and lower glucose levels in some patients, especially those with chromium deficiency. It is often seen as part of supplements being promoted to help diabetes. Some say that taking chromium picolinate for two to three months may also produce a small weight loss of about 1.1 kg, but most clinical studies show no significant effect. The proposed mechanism of weight loss is decrease in appetite and increase in calories burned. However, there is a lack of good scientific evidence to support this. Uncommon adverse effects of chromium include headache, insomnia, irritability, mood changes and cognitive dysfunction.
3. Bitter orange (citrus aurantium)
Bitter orange peel is used to improve appetite, and ironically, it is also used for weight loss. The proposed mechanism for this is an increase in metabolism, thus increasing calories burned. It was thought to be a safer alternative to Ephedra, a weight loss supplement that was banned due to its cardiovascular adverse effects.
While some evidence for weight loss is promising, it doesn’t seem any better than Ephedra with regards to safety. This supplement can increase your heart rate and blood pressure and is therefore not recommended especially for those with hypertension and/or heart problems.
The combination of bitter orange and caffeine is frequently seen in weight loss and bodybuilding products, and this can cause high blood pressure and increased heart rate even in healthy adults with otherwise normal blood pressure.
Fiber helps you lose weight by making you feel full, thus making it easier to control the amount of food that you eat. It does this by delaying gastric emptying and staying in the stomach longer. Although taking an appropriate amount of fiber can be good for you, taking too much can cause constipation and even gastrointestinal obstruction. When taking fiber supplements, be sure to add fiber to your diet slowly and to drink plenty of water. In general, evidence for the effectivity of fiber in weight loss is still lacking.
Some of the weight loss supplements that act as fiber are discussed below:
This is a fiber that comes from chitin, the main component in the shells of insects and crustaceans. It has been promoted as a type of dietary fiber that may help reduce absorption of fats.
b. Whey protein
This supplement is commonly found in health stores, used mainly for building muscles. However, it is also found to suppress appetite and is thus promoted for weight loss.
c.. Beta glucan
This is a soluble fiber derived from yeasts, mushrooms, and algae. It is said to lower cholesterol and promote weight loss probably by reducing fat absorption.
This fiber is derived from an Asian plant called Konjac, and is said to be effective for sugar control and weight loss. It helps absorb water in the digestive tract, reducing cholesterol and carbohydrate absorption.
5. Conjugated linoleic acid (CLA)
CLA occurs naturally in small amounts in dairy products and red meat. It was proposed to be beneficial for obesity, diabetes, and cholesterol problems. A small study by MA Belury et al showed that CLA is inversely correlated with weight.However, subsequent larger studies on the role of CLA on obesity and metabolism showed conflicting results.
In several studies, administration of CLA for 12 weeks has been reported to decrease body fat mass, but with no changes in body weight, cholesterol, or glucose metabolism.
Furthermore, there were several human studies that showed detrimental effects of CLA on lipids and glucose metabolism. Based on the available data, the use of CLA for the management of obesity or diabetes is not recommended.
6. Green tea extract
This is said to decrease appetite while increasing calorie and fat metabolism, thus increasing the use of energy. However, current evidence to support this is still lacking. The components in green tea extract that have shown some effect on lowering body weight are catechins, caffeine and theanine. Adverse effects include dizziness, insomnia, agitation, nausea, vomiting, bloatedness and diarrhea.
7. Meal Replacements
This is probably the weight loss supplement with the best scientific evidence. Choosing a low-calorie, nutritious diet in our current environment that offers a surplus of palatable, energy-dense, nutrient-poor food choices can easily push anyone to obesity.
Meal replacements are a good option since they contain a known energy and macronutrient content. They are therefore a good strategy to eliminate problematic food choices or complex meal planning. Several studies have shown equivalent or greater weight loss with structured meal replacement plans compared to low-calorie diet treatments.
The American Dietetic Association recommends substituting one or two daily meals or snacks as a successful weight loss and weight maintenance strategy. Meal replacements are sold in most pharmacies and health stores in the form of bars and shakes.
8. Human chorionic gonadotropin (HCG)
Human chorionic gonadotropin is a hormone produced by humans. Approved indications for the use of HCG include treatment of select cases of female infertility and hormone treatment in men.
FDA-approved HCG products are only available in injection-form and require a prescription. Currently, there are no FDA-approved HCG drug products for weight loss since there is no substantial evidence that HCG increases weight loss. Additionally, the labeling for the “homeopathic” HCG products states that each product should be taken in conjunction with a very low calorie diet (VLCD) thus putting consumers at increased risk for side effects including gallstone formation, electrolyte imbalance, and heart arrhythmias.
A VLCD should only be used under proper medical supervision.
9. Bangkok Pills, EmagreceSim, and Herbathin
We should also be careful about weight loss supplements that are actually a concoction of several substances, some of which might be unsafe. Some of these substances are actually prescription or restricted drugs. An example is the Bangkok Pills that became very popular several years ago. These pills contain bisacodyl (a laxative), furosemide (a diuretic), phentermine (raises levels of the hormone leptin, causing appetite suppression), and fenfluramine (an appetite suppressant that acts by increasing the blood levels of serotonin and catecholamine).
Adverse effects of Bangkok Pills include increased heart rate, palpitation, irregular heart rhythm, chest pain, tremors, anxiety, insomnia, fatigue, drowsiness, dehydration, nausea, vomiting, seizures, stroke, or even death. The US FDA banned this anti-obesity drug in September 15, 1997.
There are two supplements from Brazil that also gained popularity especially in the United States, namely EmagreceSim (or Brazilian diet pill) and Herbathin dietary supplement. These, however, have been shown to contain prescription drugs such as Chlordiazepoxide (antianxiety), Fluoxetine (anti-depressant), and Fenproporex (a stimulant that is converted in the body to amphetamine, the family of shabu). In 2006, the US FDA issued a warning to consumers not to take these diet pills.
This review of weight loss supplements shows us that over-the-counter doesn’t mean risk-free. Most aren’t supported by good scientific evidence, and some may even be dangerous. Dietary supplements aren’t subject to the same rigorous standards as are prescription drugs. They can therefore be sold with limited proof of effectiveness or safety. So the next time you walk into a health store or search online for the perfect diet supplement, you might want to check out the label and do a little research. And while you’re at it, you might want to do a little dieting and exercising as well… you might just find your perfect solution to weight loss.
“Over-the-counter weight loss supplements aren’t necessarily risk-free. Most aren’t supported by good scientific evidence, and some may even be dangerous”
September 2017 Health and Lifestyle