According to the Journal of Clinical Psychology, weight loss continues to be the number one New Year’s resolution every year, as two-thirds of Americans are overweight or obese.
Sure, you can start with changing your eating habits and increasing your physical activity, but who doesn’t want a little help reaching the ultimate weight loss goal?
Weight Loss Drugs vs. Supplements
While weight loss drugs are often used successfully to treat obesity, they must be prescribed by your doctor and can often be cost-prohibitive. They also come with a number of risk factors:
– Side Effects – Though usually mild, weight loss drugs can have unpleasant side effects, including elevated heart rate and blood pressure, insomnia, dizziness or lightheadedness, headache, anxiety, excessive perspiration, gas, oily stools, and/or constipation. Some individuals may experience more severe symptoms that affect their daily lives.
– Tolerance – Many physicians and scientists worry that the body may be able to build a tolerance to weight loss drugs, as many patients who use them reach a weight loss plateau and stop losing weight after a few months of use.
– Addiction – As with any medication, many prescription weight loss drugs also run the risk of dependence, leading to additional health dangers.
It comes as no surprise that weight loss supplements are increasing in both popularity and number. But with all the different products currently available and new ones being developed each year, how do you know which one is right for you? Which ones work and which don’t? And most importantly, which are safe?
Most weight loss supplements can be classified based on their mode of action: thermogenic, fat-burning, appetite suppressant, carbohydrate regulation or some combination. Below we review each of these categories and give you the skinny on what supplements are best to lose those extra pounds you may have gained over the holidays. Lastly, we review an emerging area of research which explores the relationship between probiotics and weight loss.
Thermogenic Weight Loss Supplements
These supplements cite weight loss through thermogenesis, increased heat in the body, by increasing metabolism and turning stored calories into energy.
7-Keto. A naturally occurring metabolite (breakdown product) of the hormone dehydroepiandrosterone, 7-KETO (3-acetyl-7-oxo-dehydroepiandrosterone) is better known as DHEA. While 7-Keto is naturally found in the body, levels decline dramatically with age – by age 40, levels drop to about half. It is found in a number of high-end weight loss supplements and is said to perform essential functions that assist with the weight loss process. It can boost metabolism, allowing for more efficient fat burning. It can also increase energy levels, which can help people stick to a diet and exercise program until results can be seen. This ingredient appears to offer many of the benefits of DHEA without any of the potentially dangerous side effects, but studies have not yet shown what effects long-term use of 7-Keto might have.
Piperine/Bioperine®. Piperine, also known by its trademarked name Bioperine®, has been used for hundreds of years by Eastern medicine practitioners to treat gastrointestinal distress, inflammation, and pain. An extract from the fruit of the black pepper or long pepper plant, it’s what gives pepper its distinctive taste and heat. Studies show that it may enhance the body’s natural thermogenic activity and possibly block the formation of new fat cells. While piperine is considered safe for most people, one potential side effect is that it may inhibit liver metabolism of drugs and cause medical drugs in the bloodstream to be absorbed at higher-than-normal levels.
Bitter Orange/Synephrine (Citrus aurantium). The dried fruit, peel, and sometimes flowers and leaves of the bitter orange tree are often found in popular weight loss supplements and claims to stimulate thermogenesis and weight loss, improve lean muscle mass, suppress appetite, and increase energy. Concentrated bitter orange contains a chemical known as synephrine that, in pharmaceutical form, is commonly used to treat low blood pressure and nasal congestion. Synephrine is chemically similar to the main chemical in ephedra, and there is concern that it may have similar effects, particularly when used in conjunction with caffeine. Conclusive evidence on its safety as a dietary supplement is yet to be established, and individuals with heart problems and the elderly should avoid this product.
Caffeine. One of the few ingredients you’re probably quite familiar with, caffeine is a stimulant that can cause in slight increase in metabolic effect for about three hours. It may also help suppress appetite, but it is unlikely to result in significant weight loss. Used in moderation, caffeine is safe for most healthy adults. This means about 200-300 milligrams, the equivalent of about two to four cups of coffee, every day. Side-effects may include dehydration, upset stomach, elevated heart rate, anxiety, restlessness, and trouble sleeping. Those with gastrointestinal issues, heart conditions, anxiety disorders, sleep disorders, or chronic headaches should minimize or avoid caffeine consumption.
Cayenne/Capsaicin. Capsaicin is the substance in cayenne pepper that gives it its spice, and it may curb appetite and help your body burn more fat, according to recent studies. It is generally safe for most healthy adults, but capsules may cause stomach irritation so those with ulcers or gastric conditions should consult their physicians. It may also cause an adverse reaction in those with allergies to latex, bananas, kiwi, chestnuts, and avocado.
Green tea (Camellia sinensis)/EGCG. Green tea extract and the most abundant antioxidant found in green tea – epigallocatechin gallate (EGCG) – have been shown in multiple studies to increase metabolism and fat oxidation beyond levels associated with caffeine and decrease appetite, but there is not enough evidence to fully evaluate its effectiveness. This ingredient is generally safe in moderation for most healthy adults, but excessive levels may cause dizziness, nausea, restlessness, and abdominal pain.
Ephedrine/Ephedra Sinica/Ma Huang. Banned in the United States since April 2004, this ingredient is a stimulant that raises heart rate and blood pressure and has been linked to heart attacks and stroke. Technically speaking, the FDA banned alkaloids of ephedrine, found mainly in the stem of the ephedra sinica species. So, if you find ephedra-containing supplements on the internet, most likely the product contains extracts from species of ephedra that contain little or no ephedrine.
Guarana. This supplement is a stimulant that may help with weight loss, improve energy levels, and make you more alert. Synthesized from the seeds of the guarana plant found in the Amazon, its effects come courtesy of its caffeine content and the chemicals theophylline and theobromine, which are similar to caffeine. Its effectiveness is inconclusive, and it most often comes in a formula that also contains other ingredients.
Yerba mate (Ilex paraguariensis). A stimulant similar to caffeine, yerba mate, or maté, contains xanthines, alkaloids in the same family as caffeine, theophylline, and theobromine. It comes from a species of holly native to subtropical South America, and it is often consumed as a tea-like hot beverage. Many users note that while it does make one more alert and focused, it lacks the “jitteriness” associated with caffeine and other similar stimulants. Its effectiveness as a weight-loss ingredient is inconclusive, and its safety is uncertain in large amounts or if combined with caffeine or bitter orange.
Yohimbine/Yohimbe (Pausinystalia yohimbe). This stimulant, an extract from the bark of the West African yohimbe tree, may suppress appetite by blocking brain receptors. It is not to be confused with yohimbine hydrochloride, a prescription medication. Its efficacy as a weight-loss supplement is inconclusive, and side-effects may include dizziness, nausea, increased heart rate, and elevated blood pressure.
Lipolysis Weight Loss Supplements
Lipolysis is simply defined as fat-burning. During this process, body fat is broken down for use as an energy source. As the name implies, lipolysis weight loss supplements are designed to increase fat burning or reduce fat synthesis.
Carnitine/L-Carnitine. L-carnitine is promoted as a weight loss aid that decreases BMI and body fat content. It comes from an amino acid and is found in nearly all cells of the body. Carnitine transports long-chain fatty acids into the mitochondria so they can be burned to produce energy. However, there is insufficient evidence to back these claims.
Coleus forskhlii. Coleus is a member of the mint family and is native to India and indigenous to its Ayurvedic medince. The standardized extract from the plant source forskohlin is marketed as ForsLean® by Sabinsa. The root extract may help to increase lean body mass and optimize body composition.
Conjugated Linoleic Acid (CLA). CLA, found in dairy products and safflower oil, is a fat-burning compound. It aids in getting glucose to the cells so that it can be burned for energy instead of stored as fat. It also encourages fat-burning in muscles. While it would not be possible to take it in amounts that would produce a drastic reduction in fat, studies have shown it may result in modest body fat loss. Coupled with healthy lifestyle changes, it is likely an effective way to provide a small boost to your metabolism.
Fucoxanthin (Undaria pinnatifida). Fucoxanthin is a carotenoid which is found in brown algae and brown seaweed, giving them a brown or olive-green color. Studies done on animals have shown that fucoxanthin promotes fat burning within fat cells in white adipose tissue (WAT). This type of fat accounts for roughly a quarter of body weight found around the internal organs.
Hydroxycitric acid or HCA (Garcinia cambogia). Also known as malabar tamarind and brindle berry, garcinia cambogia is a relatively small, purple fruit that contains a chemical compound called Hydroxycitric acid (HCA) that is very similar to the citric acid found in many other citrus fruits. HCA may suppress an enzyme called citrate lyase that helps turn excess carbohydrates into fat; by doing so, it is supposed to increase carbohydrate oxidation. While some studies claim that HCA suppresses appetite and enhances fat-burning, other studies have been less clear. It is also important to note that a popular product with HCA as the active ingredient was recalled in 2009 over reports of seizures, liver problems, and muscle damage; while HCA was not established as a conclusive link to these effects, the manufacturers removed it from the product completely.
Omega-3 Fatty Acids. Omega-3s help weight loss by activating enzymes that promote fat-burning in cells. They may also develop leptin signaling in the brain, causing the brain to increase fat burning and decrease appetite. While studies seem to suggest weight loss potential, omega-3s also have many other benefits that may aid in weight loss indirectly.
Appetite Suppressant/Satiety Weight Loss Supplements
Appetite supplements work by “tricking” the brain into thinking that the body is not hungry. Satiety supplements, on the other hand, create a feeling of fullness. Both result in eating less, leading to weight loss.
Caralluma fimbriata Extract. Caralluma fimbriata is a succulent plant in the family Apocynaceae. It has been eaten in rural India for centuries, raw, as a vegetable with spices, or preserved in chutneys and pickles, and is often found as a roadside shrub or boundary marker. It may help suppress hunger and appetite and enhance stamina by affecting the appetite control centre of the brain. Studies have shown that use in conjunction with dietary management and exercise may result in a reduction in waist circumference, but additional research is needed to provide conclusive evidence of weight loss promotion.
Hoodia (Hoodia gordonii). Hoodia is a succulent that grows primarily in the semi-deserts of South Africa, Botswana, Namibia, and Angola that claims to ward off hunger. While there are over 13 types of hoodia, the only active ingredient identified so far is a steroidal glycoside dubbed “p57” which may have appetite-suppressing effects, and only hoodia gordonii is thought to contain p57. Still, there are too few studies and no conclusive evidence of its efficacy.
Fiber. In its various forms, fiber can help make you feel full and reduce the amount of food you consume. Studies have shown that taking just 14 grams per day for more than two days can lead to eating 10% less and losing more than four pounds over about four months. When supplementing with fiber, it should be added to the diet gradually, and fluid consumption should be increased to prevent constipation.
Whey Protein. Long-touted for its muscle-building properties, whey protein, which comes from the protein-rich liquid left over after cheese making, is now being promoted as a weight loss supplement that suppresses the appetite. It is easy to digest and has high levels of cysteine, an amino acid. More lean muscle means more calories burned, and studies seem to show that this supplement shows potential.
Carbohydrate Regulating Weight Loss Supplements
One of the first foods that most nutritionists recommend that dieters reduce in their diet is carbohydrates. That doesn’t mean that all carbs are bad – but simple sugars – like the kind found in sodas, desserts, baked goods and even condiments are believed to contribute to our nation’s obesity crisis.
Supplements that regulate carbohydrate metabolism work in a number of ways from managing blood sugar levels to reducing the absorption of carbs.
GlucoFit®. A branded ingredient from OptiPure that contains corosolic acid derived from the banaba plant. Based on the company’s research, GlucoFit has been clinically proven to help balance blood glucose levels.
Glucomannan. Derived from the Asian plant Konjac, glucomannan is a fiber considered extremely effective for diabetes and blood sugar control. The fiber helps absorb water in the intestinal tract, reducing cholesterol and carbohydrate absorption.
Loquoro®. Derived from the leaves of the loquat (Eriobotrya japonica), Loquoro is another branded ingredient offered by OptiPure. According to the company’s research, Loquoro is used for balancing low blood sugar.
Phase2®. This branded ingredient from Pharmachem is made from the extract of white bean. The carb controller reduces the absorption of starch calories and can lower the glycemic index of starchy foods.
Probiotic Weight Loss Supplements
A growing body of evidence suggests that naturally occurring bacteria and other microbes in the body can influence weight.
Numerous studies done on animals and humans are underway looking at the role of microbes in the intestines, with a focus on how they extract energy from food and how this affects weight loss or weight gain. Researchers believe that the microbiome may contribute to obesity in several ways including increasing energy harvest (more calories are extracted from food ingested) and promotion of fat deposition (more fat calories are stored versus used up).
Indeed in human studies, researchers found that obese individuals had fewer of a group of bacteria known as Bacteroidetes and more of another group of bacteria called Firmicutes than their lean counterparts. Interestingly, when the obese participants were placed on a fat-restricted or carbohydrate-restricted diet for over a year, the proportion of Bacteroidetes increased while the Firmicutes decreased. In the not too distant future, managing the microbial community in our intestines may be one of the tools of helping us manage obesity.
Before you begin a supplement to help with weight loss, always do your homework and make sure you choose a high-quality product. Read labels, and consult your physician or pharmacist for dosage information and to make sure the supplement will not interact with any medications you may already be taking. And check out the FDA’s safety alert website to make sure the product is safe and not being recalled.
As you work on keeping your weight loss resolution, it’s important to acknowledge that weight loss and maintenance are processes that require a lifestyle change. There is no magic potion or pill that will make you lose weight and keep it off. Still, armed with new knowledge on supplements that can help you reach your goal, you can add them to your repertoire and make 2014 your year for weight loss success!
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.