Weight-Loss Supplements: Do They Work?
SATURDAY, Jan. 15 (HealthDayNews) -- Now that the holiday cookies are history, you've resolved to get fit and trim. Perhaps you've even considered taking over-the-counter dietary supplements to help you reach your weight-loss goals.

Drugstores, nutrition shops and Web sites offer a plethora of supplements and combination products that claim to help burn fat, block fat absorption, modulate carbohydrate metabolism, boost energy expenditure, suppress appetite, flush out excess water weight and control cravings -- all good outcomes to an eager dieter.

So what's the harm in grabbing a bottle?

"There's a tremendous appeal for a magic pill to help lose weight -- manufacturers of weight-loss pills appeal to that, I think," said Dr. Robert Saper, director of integrative medicine in the Department of Family Medicine at Boston University Medical Center.

But in a review of the scientific evidence, published in the Nov. 1, 2004, issue of American Family Physician, Saper suggested there's no miracle pill on the market. In fact, some of the supplements out there may be dangerous or might interact with prescription medications that people are taking, he said.

"There's very few of them that show benefit for what people are taking them for," agreed Dr. Gary A. Green, a clinical professor in the Division of Sports Medicine at the University of California, Los Angeles.

Steven Dentali, vice president of scientific and technical affairs at the American Herbal Products Association, offers a somewhat more upbeat assessment: "I would say there is some preliminary evidence that some of these ingredients can be useful in combination with diet and exercise."

Dietary supplements have quite a following among many Americans. Overall, 7 percent of adults use over-the-counter weight-loss supplements, according to a five-state survey reported in 2001 in the Journal of the American Medical Association. The use of nonprescription weight-loss products is particularly common among young obese women -- 28.4 percent reported taking them.

One recent success story is that of former Playboy "Playmate of the Year" Anna Nicole Smith. The 37-year-old actress and model dropped 69 pounds in eight months using a formulation of TRIMSPA, a popular brand-name product, the supplement maker's Web site claims.

But do you know what you're getting when you buy brand-name dietary supplements, including TRIMSPA, Xenedrine, and Hydroxycut, or individual herbal products?

The Natural Medicines Comprehensive Database, a source for evidence-based information on natural brand-name products and ingredients, lists more than 50 individual supplements and 125 proprietary products, according to Saper, who examined individual ingredients found in several commercial products.

Chromium, for example, is a popular weight-loss supplement found in many products, but its efficacy and long-term safety are uncertain, he said. Guar gum, derived from the Indian cluster bean, appears to be ineffective for weight loss. Chitosan, derived from shellfish, is another one to avoid, Saper said. "I discount chitosan because, although it's safe, its role as a 'fat blocker' is not well-substantiated," he explained.

Glucomannan, a plant fiber, may be helpful for modest weight loss, he said, but the data are insufficient to support a definitive conclusion.

Overall, the amount of well-designed research to substantiate the effectiveness of many individual herbs for weight loss is sparse, Saper said. Even greater questions exist as to the safety and effectiveness of combination products and the potential for harmful interactions among different ingredients, he noted.

Dietary aids containing the herbal supplement ephedra were extremely popular until the U.S. Food and Drug Administration banned their sale in April 2004 due to reports of deaths. Ephedrine, the active ingredient, is a stimulant known to increase metabolic rate, heat production and the risk of heatstroke.

Dangerous supplements still remain available on store shelves and Web sites, Consumers Union warns. The public advocacy group's Consumer Reports magazine last May published a list of the "dirty dozen" -- 12 supplement ingredients that have been linked either to serious adverse effects or to a strong theoretical risk. The list included bitter orange, a common dietary supplement that contains a compound called synerphrine, which carries risks similar to ephedrine, Saper said.

Critics of the dietary supplement industry want Congress to put some teeth into federal regulations. Under the Dietary Supplement Health and Education Act of 1994, manufacturers of dietary supplements are not required to provide evidence of safety or effectiveness. The burden rests on the FDA to prove that a product is either unsafe or ineffective.

"As long as they don't claim to treat any specific disease or condition they can basically make any claims that they want," Green said.

For its part, the herbal products association has expressed support for a mandatory adverse-events reporting system for dietary supplements.

Until there's better data, motivated dieters would be better off talking to their physicians about proven weight-loss strategies, such as diet and exercise, according to Saper.

But Dentali believes herbal products can play a role in a sensible weight-loss strategy. Switching from soda to green tea, for example, may provide some health benefits, "and you're not sucking down those sodas."

More information

To learn more about dietary supplements, visit the National Center for Complementary and Alternative Medicine.

SOURCES: Robert Saper, M.D., director, integrative medicine, Department of Family Medicine, Boston University Medical Center; Gary A. Green, M.D., clinical professor, Division of Sports Medicine, University of California, Los Angeles, and Pacific Palisades Medical Group, Pacific Palisades, Calif.; Steven Dentali, Ph.D., vice president, scientific and technical affairs, American Herbal Products Association, Silver Spring, Md.; Nov. 1, 2004, American Family Physician; Aug. 22, 2001, Journal of the American Medical Association ~WEIG~~NSUP~~DLOS~

http://www.rednova.com/news/display/?id=119324

I've fallen for a few "magic pills" in my time. Isn't it funny how so many of us are victims of the wishful thinking syndrome? Anna Nicole found her success in pharmaceuticals, but I doubt it was TrimSpa! <sniffsniff>

If you read the fine print in a lot of the ads, they really don't promise anything... the promises are in bold, but it's all taken back in the stuff you need a magnifying glass to read.

It makes me sad to see someone else fall for the latest supplement miracle on the block, so it's good to see articles that show the other side.

What has always amazed me about most diet pills (the most notable being the myriad of old pills with ephedra) have the back of the bottle full of warnings about who shouldn't take them (basically anyone with a family history of anything!). If you take the warnings literally, they are telling you that almost no one should be taking their product! And yet so many of us have taken the chance instead of merely being patient with our diet program.

At best, even the supplements that "work" make a barely perceptible change in metabolism, yet there are people who jump in and claim miracles from one right after another.

A common theme in every advertisement... "In conjunction with a diet and exercise program" and under the pictures of those miracle losses "Results not typical".

It really ought to say "Caveat Emptor" and "Placebo Effect"....

i've heard that eating a great amount of pineapples will make you lose weight fast! im not sure how much pineapples youre supposed to eat but i've heard it can make you lose up to 20 lbs. in 2 wks. if anybody has any more info on this please tell me thx

Sounds like another binge and purge diet, sometimes known as starvation.

Not recommended. Better to go on a high-protein/reasonable fat no-carb fast. Drink ludicrous quantities of water to flush out everything/prevent acidosis effects.

I did that a few times, but never for more than 4 days eating little more than smoked turkey with salt and a little pepper. Lotsa water.

It always works. Especially good for re-starting the diet when it seems to be getting somewhat unproductive.

an alternative to doing lots more physical exercise in terms of getting the fat loss in a relatively short time. I don't recommend doing this Stillman-type diet AND more exercise at the same time! [You probably cannot drink enough water you would need, etc.]

Also, an "antidote" to having just cheated is either of the above.

cjl (been there)

I learned my lesson, after taking fen-phen and dropping 35 pounds back in the late 90's. I do think I'm lucky in that I could never remember to take the evening pill which turned out to be the one that was banned... but still, the worry never really goes away. Every pound I'd lost returned eventually.

Fast forward... I found Atkins, and I'm now where I was after I'd dropped that 35 and this time I'm doing it worry-free, the right way.....and I'm doing it all on my own.

Ah...the "Pineapple Diet". Perhaps the reason that people lose weight on this is that their mouths become too sore to eat anything from all the acid in the pineapple.
Seriously...that IS a fad diet and is lacking in a whole lot of important things that your body needs such as essential amino acids, essential fatty acids and many vitamins and minerals. It also does nothing to teach you how to change your eating habits to keep the weight you lose off.
Forget the Pineapple diet and find something you can stick with long term.

Maybe it's just ME, but eating nothing but meat for days on end is no less crazy than eating pineapple or taking a weird pill...neither are healthy and sustainable, just degrees of desperation.

I had two reactions to this story. First the "magic pill" thinking about diet pills. It is crazy to think one pill a day will make you thin. There is one on TV that is only for "seriously overweight" people because it is so expensive. $153 a month or something like that. What a waste of money. What a wild marketing scheme.

The second thought is that supplements work. I am a huge supporter of fish oil and Essential Fatty Acids as supplements.(well they are good in your diet also) The American Heart Association even supports this supplement. I know my skin is greatly improved and I think my joints are better also. Research would suggest that my heart is happier also. I also take a mega daily and a few other supplements that I think are worthwhile.

So on the one hand. A pill won't make you thin. But on the other hand there are a few that may help. Or at least help with overall health which can't hurt a weight loss effort.

I agree. When a supplement is providing you with something that's essential to health, like essential fatty acids, that's different from diet-scam-of-the-month. What Dr Atkins called nutra-ceuticals get a bad rap because natural substances can't be patented, therefore they are of no use to the big pharmaceutical companies, therefore there's hardly any money put into researching them. They don't WANT you to solve your health problems with herbs and vitamins. That, I find very unfair and unfortunate.

I agree that they're both extreme and and protein/fat option isn't likely to be sustainable for the long term for most folks (although the Inuit didn't seem to have a problem living that way), but at least with a protein/fat fast you're getting essential fatty acids and essential amino acids (as well as vitamin B-12) that your body can't function without long-term whereas with the pineapple diet you're not even getting that (and with the protein/fat regime you're getting a lot more vitamins than with the pineapple deal). When it comes down to it, a person would fare far better eating nothing but meat and a reasonable amount of fat long-term than a person eating nothing but pineapple.

I don't think anyone trying the meat/fat fast or the pineapple diet are doing it because they think it promotes optimal health... they want to lose weight NOW.

In that sense, they are crash diets, and IMO, while one may be less detrimantal to health than the other they are in the same category.

[shrug] Along those lines of thinking, ANY plan can be used as a crash diet, even Atkins induction (and I've seen it used that way many times), South Beach or other low carb plans and nearly everyone who starts a weight loss plan wants weight loss now. It doesn't make the plans bad, it just shows that there's a potential for abuse in nearly every weight loss plan. Perhaps that's why the Atkins people wrote an article titled "The Uses and Abuses of Induction"? OTOH, I've often seen a meat/fat fast used by members to break a stall or get cravings back in line again, not just as a means to drop a few quick pounds and then go back to their pre-diet menu so, IMO, it has its valid uses.
Personally, if I were going to crash diet (which I don't recommend, BTW), I'd at least choose one that didn't promote a high amount of muscle loss (like that Pineapple diet) and I'd think seriously about what I was going to do to maintain my loss when the crash diet was over (think long-term changes).
Bottom line is...there are no 'magic pills' and there are no 'magic diets'. Weight loss takes a serious long-term commitment as well as a commitment to permanent changes in the way a person eats/lifestyle change. Anything else is...well...a diet.

The Stillman plan is to eat moderately reduced fat or even lower than that if you can, and otherwise only protein, and as much water as you can stand without drowning. It works really well and is essentially a protein fast.

This is NOT recommended for days on end, just as a short-term kick-start when the Atkins regimen isn't really working right for a variety of transient reasons.

Some people go totally off the diet, gain fat, re-induce, hoping that this will also kick-start the diet, and it might even work. But the Stillman plan is far more effective and has the added advantage of avoiding weight gain entirely, not to mention it is instantly cancellable, as it does not require re-induction, etc. The water recommendation is not as far-fetched as it sounds, as this is a regimen that REALLY gets dark-purple ketostix results!

cjl