Meghan Stoops, R.D./L.D.N.

About Weight Loss Supplements

Counting calories, counting “macros,” going “Keto,” or simply chugging celery juice, what if there was another way? We know overweight and obesity is a problem in the United States, but let’s face it, dropping pounds is hard.

Diet and exercise is still the number one recommended way to lose weight and keep it off but what if there was something else that could help? We have all seen the commercials for the next best diet pill but do they really work?

New weight loss supplements are entering the market daily, making it hard to know which ones are actually safe and give us the results we are looking for. Before considering taking a weight loss supplement, there are a few things you should know.

First and foremost, you can’t have your cake and eat it too. We all want an easier solution but weight loss supplements should not be used as a way to avoid making lifestyle changes. These supplements provide best results when done along with a healthy diet and exercise.

Second, you will most likely have rebound weight gain once you stop taking those supplements. Seems a little counterintuitive, right? This is why working on those lifestyle changes is so important.

Lastly, sometimes the risks for taking these supplements outweigh the rewards. It is essential, whether taking a prescription or an over-the-counter weight loss supplement, to talk to your doctor and make sure you have all the facts. Some ingredients in the supplements could have a negative reaction to a medication you are taking or effect a condition you have. You know what they say, it’s better to be safe than sorry.

How Safe Are They?

To give you a little more insight into supplements, let’s talk over the counter. The Dietary Supplement Health and Education Act of 1994 placed herbal remedies in the same category as dietary supplements. Why does this matter? There is a lot of research that has been done on the use of different vitamins and minerals in that multivitamin you take but the research on these popular herbs and extracts being thrown into the mix is scarce.1

Don’t you want to know exactly what is in that fancy, all-natural mixture that promises to annihilate 10lbs of body fat in one week? I know I do.

The Food and Drug Administration (FDA) does not regulate supplements like they do for prescription medications. Supplements are actually regulated just like food products. This means they don’t require safety or even proof that it works to be given by the manufacturer. Basically they can do whatever they want to try and encourage you to purchase their product. Scary huh?

To add insult to injury, the FDA will not remove any of these items off the shelves until there is a severe reaction reported. Someone actually needs to be harmed by these products and report their experience before they can be removed from the market.

The FDA has approved a small handful of weight loss supplements as medications but, in most cases, you have to qualify to get a prescription which is not always an easy feat. Let’s take a look at some of the FDA-approved weight loss supplements on the market.

Alli (Orlistat)

Alli, a lower dose version of the prescription Orlistat, is the only FDA approved weight loss supplement you can buy over the counter at your local drug store. This supplement works by preventing your body from absorbing fat. Sounds great right? Except this means you will most likely want to follow a low-fat diet while taking Alli or you might experience some pretty unpleasant side effects such as upset stomach, bloating, diarrhea and gas. 2

You also need to watch out for vitamin deficiencies. Since Alli rids your body of the fat you ate, you can become deficient in some of those important fat-soluble vitamins. But not to worry, this can be resolved by taking a fat-soluble vitamin supplement. 2

Alli has been proven to assist with weight loss when combined with those lifestyle changes we discussed earlier. It has also shown to have other benefits such as improvement in blood pressure and blood sugar control. 3,4 Because of it’s unpleasant side effects, some people struggle with taking Alli but the good news is it has been proven to be safe with a low chance of serious reactions. 2

Although not ideal for everyone, Alli can be a good option to help with weight loss because it’s proven to be safe and is more accessible than prescription supplements.

Qsymia (Phentermine Topiramate)

Qsymia, another FDA approved weight loss supplement is actually the combination of two different medications- Phentermine, which can help lower your appetite, and Topiramate, an anti-seizure and anti-headache drug that can cause you to feel full more quickly during meals.

The exact way either of these drugs work is not well known but the combination of the two has shown greater weight loss results at lower doses than either of them taken alone. Taking less of these drugs means less chance of a severe reaction, a win-win. 5

The most common side effects of Qsymia are pretty mild and include constipation and dry mouth. 5 Although effective, there are risks with taking this medication since we don’t really know how it works or how it could affect us when using it long term so, let’s move on.

Saxenda (Liraglutide)

Saxenda, a glucagon-like-peptide-1 (GLP-1) receptor agonist, is an FDA approved weight loss supplements that slows down how quickly your stomach empties food. This means your stomach feels full for longer. It is also marketed in lower doses as the Type 2 Diabetes medication, Victoza, because it can also help lower blood sugar levels. 6

Sounds great! Let’s just hope you don’t hate needles because this medication is available by injection only. As far as side effects go, nausea, vomiting, diarrhea, constipation, abdominal pain and headaches are all on the table. 6

Studies show that Saxenda can provide significant, sustained weight loss when done along with a healthy lifestyle. Unfortunately, it is more expensive than other prescription weight loss supplements on the market, such as Orlistat, which is relatively inexpensive in comparison. Getting insurance coverage for these medications can be tricky so you always want to pay attention to price. 6

But what if we don’t qualify to take prescription weight loss supplements? We seek alternative routes of course. Let’s take a look at some of the over-the-counter weight loss supplements on the market.

Hydroxycut

You can find Hydroxycut, one of the most popular over-the-counter weight loss supplements, on Amazon or in stores such as CVS or Walmart. Hydroxycut’s formula is based on a blend of caffeine and plant extracts including Lady’s Mantle, wild olive, wild mint and Komijn extract, ooh la la!

Don’t be fooled. Despite it’s popularity, Hydroxycut has a relatively checkered past. Having undergone two separate reformulations for safety concerns from their fancy ingredients, including the now FDA banned stimulant Ephedra, Hydroxycut remains on the market but with some safety concerns. 7

Although they have different formulations of Hydroxycut, including “stimulant-free” options, caffeine appears to be the main star of the show and it’s most potent ingredient. Unfortunately, caffeine on it’s own does not have any strong research to support it’s role in weight loss. As far as the plant extracts go, there are not enough studies involving humans to prove if they are safe or actually work. 7

A study that was conducted by Hydroxycut themselves showed an average of 16.5lbs lost in 8 weeks compared to only 2.1lbs from the placebo group. Overall, it appears effective for weight loss based on the small number of studies available, but safety is still a big concern. 8 Some of the most common side effects associated with Hydroxycut are typically related to sensitivity to caffeine and include anxiety, insomnia and jitteriness. Next!

Burn-XT Thermogenic Fat Burner

Rated a number one best seller in fat burning supplements, you can find Burn-XT Thermogenic Fat Burner by Jacked Factory on Amazon or other online retail sites. It is marketed as a weight loss and appetite suppressant along with an energy booster, touting ingredients such as acetyl l-carnitine, green tea extract, caffeine, cayenne pepper extract and black pepper fruit extract.

Burn-XT is marketed as all natural and safe for long term use but should we believe them? There is research available for some of these substances supporting weight loss claims, such as green tea extract and acetyl l-carnitine however, research on this combination of ingredients has not been done which is a red flag for safety. Pass!

Substances That May Promote Weight Loss

Known as a complimentary alternative to medicine (CAM), herbs and extracts have been used to treat many different conditions and promote health and wellbeing but do they help us lose weight? Marketed as a natural and safe alternative to traditional drugs, these herbs and extracts have finagled their way into our over-the-counter supplements. Let’s see if they are actually worth the hype.

Caffeine

Caffeine, the main ingredient in our morning cup of joe, is one of the most common ingredients found in over-the-counter weight loss supplements like Hydroxycut. Caffeine is appealing because it can enhance mood, increase alertness and improve exercise performance yet too much can lead to some unpleasant side effects. You might experience anxiety, insomnia and jitteriness and high amounts of caffeine can be dangerous for those with heart conditions. Like a lot of supplements, we are also in the dark when it comes to the long term affects high caffiene intake can have on us. 11

The idea behind caffeine for weight loss is based off of thermogenesis. This is a fancy word for how our body burns energy. Caffeine is believed to make us more efficient at this as well as increase metabolism and fat oxidation which is why it is a popular ingredient in weight loss supplements as a “fat burner.” 11

Much to our dismay, studies on caffeine did not show any promising results for weight loss but there was some improvement when it was combined with the catechins in green tea. 10

Probiotics

Probiotics, which are the live organisms (good bacteria and yeast) that reside in our body naturally and help to keep us healthy are another substance linked to possible weight loss effects. Further long-term studies are required but based on some meta-analysis, short term (<12 weeks) probiotic supplementation did show improvement in weight loss, BMI and fat percentage but the effects were small. 14 Similar to fiber, probiotics are a highly encouraged addition for a balanced diet which can promote a healthy weight overall.

Green Tea Extract

Tea is the most widely used herbal CAM around, and for good reason. Tea has been proven to have high antioxidant and anticancer properties but our most favored is the Green tea which contains the highest levels of catechins, the compound responsible for the majority of it’s health benefits. 9

The most renowned catechin in green tea is Epigallocatechin Gallate (EGCG) which is said to help increase thermogenesis and fat oxidation similar to caffeine, acting as a “fat burner.” 9 Sadly, results for weight loss are mixed and it’s true effects are still undetermined. The good news is, there are no known adverse effects to using green tea for weight loss so you can sip away this magnificent green liquid without any worries. 9

Acetyl L-Carnitine

Acetyl l-carnitine is a partial protein that is naturally occurring in our body and animal products. It is often used as a supplement for it’s fat-burning effects yet it’s not well proven. 12 I’m sensing a theme here.

There are some studies linked to possible neurologic benefits of Acetyl l-carnitine however, there is limited research on weight loss. 12

Glucomannan & Guar Gum

Glucomannan and guar gum are both types of soluble fiber that help to make you feel full by absorbing water in your gut. Like any other form of soluble fiber, this also helps to improve constipation as well as blood sugar and cholesterol levels but evidence on supplementation for weight loss is not what we hoped. 13 Although it can assist with feelings of satiety, fiber overall is not a good supplement for weight loss but rather a healthy addition to a balanced diet that can promote a healthy weight overall. 11

Chitosan

Chitosan, which is derived from certain shellfish such as lobster, crab and shrimp, works similarly to Alli by blocking fat absorption. Sadly, the amount commonly present in supplements is too low to be effective and when larger amounts we studied, there was no significant change. Similar to Alli, taking Chitosan can also result in unfavorable stomach discomfort. 9 To sum it up, it doesn’t really work and causes stomach upset. I think it’s safe to nix this one, don’t you?

Chromium Picolinate

Chromium Picolinate, a supplemental form of the mineral chromium, works by altering the metabolism of carbohydrates. There were some studies that show a reduction in body weight compared to placebo groups however, it was a minute .5kg (1.1lb) increase, not a huge help. Side effects to taking this substance include diarrhea, vertigo, headaches and hives. Again, probably safe to nix. 9

Conjugated linoleic acid

Conjugated linoleic acid, found in meat and dairy products, is believed to help burn fat but, here we go again, human trials on this showed little to no evidence to support this claim. There are also some safety concerns. When taking conjugated linoleic acid, which is a component of the poly-unsaturated fatty acid, linoleic acid you will have an increase of circulating free fatty acids in your blood stream. If not utilized by activity, this can put you at risk for developing certain health conditions such as hyperlipidemia, hyperglycemia and lipodystrophy. In short, we need more research before we know that this is truly safe for us to be taking. 9,11 Starting to notice a trend here?

Hoodia

Hoodia is a succulent found in south Africa that can assist with suppressing appetite. There are currently no known side effects however, the majority of studies were done on animal subjects so there is not enough evidence on the dose or the safety of using this for weight loss in humans. 9

There are some safety concerns as well. because Hoodia works on the part of the brain that is responsible for thirst, as well as appetite, there is a risk for severe dehydration if this thirst response is suppressed. This is also a very rare and often protected plant which raises concerns for manufacturers advertising false claims for Hoodia in their products, yikes! 9

Ephedra Sinica

Ephedra Sinica, also known as Ma Huang, is a Chinese herbal medicine used to treat headaches, asthma and allergies. This substance is believed to help stimulate the central nervous system and aid in weight loss by decreasing your appetite. 11

The effects of Ephedra Sinica can be enhanced with the use of other chemicals such as caffeine. There are numerous studies that show positive effects for weight loss when combined with caffeine but there were strong adverse reactions reported which resulted in a ban by the FDA in 2004. 11 If you recall, this was one of the ingredients originally in Hydroxycut products prior to their ban.

The Importance of Diet and Exercise

One thing that all of these weight loss supplements have in common is they are best used along with lifestyle modification, including a healthy diet and exercise. Weight loss supplements used alone provide nothing more than a Band-Aid to a growing infection.

Diet and exercise, although often judged by its slow process, is not only the healthiest option for weight loss but when done properly, creates sustainable changes that provide a more significant impact on your overall health and wellbeing.

Consider some of the substances above that have been researched for their potential weight loss effects: caffeine, green tea, soluble fibers, probiotics, minerals, etc., these are substances we can get in healthy amounts through a balanced diet. Others, such as Hoodia and Ephedra Sinica, are substances not normally found in the diet therefore safety with use of these supplements is a concern.

If you are struggling to find success in weight loss with diet and exercise alone, you should speak with your doctor to consider your options before picking up an over-the-counter supplement. These medications have research and multiple clinical trials to back them up whereas over the counter, “natural” supplements do not.

If looking to find a natural way to progress with your weight loss, focus on the natural foods that contain these substances instead, such as drinking a cup of green tea or black coffee every morning, choosing more high fiber foods and foods high in probiotics, vitamins and minerals.

How to Choose a Safe Supplement Source

If you do decide to take a natural supplement, first ensure you have taken these precautions to make sure it is a reputable manufacturer and a legitimate product. When searching online for supplement information, ensure you are choosing a reliable source such as the National Institute of Health, FDA or United States Department of Agriculture (USDA) instead of the retail site to make certain their claims are accurate and free from bias.

Natural does not always mean safe, even certain vitamins and minerals in high doses can be toxic. Always speak to your doctor before taking a supplement and if it sounds too good to be true, it likely is. I know it’s hard to hear but there are no supplements on the market that are able to cure diseases or that are known to work better than prescription medications. 15

Vegetarian and Vegan Considerations

If you are vegetarian or vegan, choosing over the counter or medications for weight loss can be difficult as gelatin is a common ingredient in pill capsules. Some of these ingredients also come from animal products, such as acetyl l-carnitine, chitosan and conjugated linoleic acid so opting more towards green tea extract, or simply consuming green tea daily, is a safer option for these individuals.

Takeaway

Although diet and exercise is still the number one recommended way to lose weight and keep it off, that does not make it any easier. If you are struggling to find success in losing weight with diet and exercise alone, over the counter or prescription weight loss supplements are an option but it is important that you consider the benefits and the risks.

A lot of over-the-counter supplements do not provide adequate research on safety and effectiveness of their use and some prescription medications are not safe for those with certain conditions or provide unfavorable side effects.

There are some weight loss supplements that are proven to be better options than others however, if not used in along with diet and lifestyle changes, these supplements will not prove to be very effective long term.

It is important to tread cautiously when choosing over the counter supplements, even when marketed as “natural” because there is a lack of regulation that puts you at risk for potential adverse reactions and giving into false claims.

Instead of reaching for supplements, choose a healthy, balanced diet, rich in vitamins and minerals to ensure you are getting the most from your foods to help fuel you towards your weight loss goals without the risk of the unknown. If you do decide to choose over-the-counter weight loss supplements, ensure you are doing your research on the product as well as the manufacturer.

References

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