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Weight Loss Supplements: Not Always Safe or Effective

By Marisa Weiss, M.D. on January 20th, 2016 Categories: Uncategorized

Those eye-catching ads for weight loss products always have a great “after” photo. The photos make the person’s weight loss claims seem so easy and convincing.

These ads for supplements appeal to any of us who want to lose a few (or more) pounds. Besides looking our best, maintaining a healthy weight reduces our risk of a number of diseases, including breast cancer. Still, some of these “tricks” to lose weight don’t work — and they may be harmful. And while we all know that exercise and following a healthy diet is hard work and nothing “new,” these tried-and-true strategies remain the safest paths to a healthy weight.

In part one of this series looking at weight loss products, we’ll focus on popular supplements claiming to aid weight loss.

We’ve all seen weight loss supplements in pharmacies, grocery stores, specialty shops, and online. Supplements may contain:

  • vitamins
  • minerals
  • herbs or other plants
  • amino acids (the building blocks of proteins)
  • enzymes (proteins that help make substances your body needs)
  • metabolites (the nutrients that come from the digestion of food)
  • glands or tissues from animal organs (organs carry out important body functions and include the liver, kidneys, ovaries, and pancreas)

Most supplements claim to work by doing one or more of the following:

  • increasing your energy
  • making you feel full faster
  • breaking down fat into energy your body can use
  • blocking fat absorption
  • speeding up your metabolism
  • reducing water retention
  • enhancing your mood

Supplements are available without a prescription and are often labeled as “natural,” which makes many people think they are safe. Most people who take supplements don’t tell their doctors. About half of people surveyed think that supplements are tested to make sure they work as advertised and are safe, but that’s not true. In fact, supplements are only loosely regulated and no regulatory agency tests supplements to check whether they work as advertised.

Federal regulation of supplements is excluded from the Dietary Supplement Health and Education Act, or DSHEA, of 1994. That’s why the U.S. Food and Drug Administration (FDA) does not have to test and approve supplements before they are sold to the public.

Instead, manufacturers and distributors are responsible for making sure that supplements are safe and that the claims made are true. But the manufacturers’ main goal is profit, so most supplement companies don’t spend a lot of time or money on testing. A weight loss supplement may say it’s “clinically proven,” but that doesn’t mean the product was thoroughly tested. For example, raspberry ketone supplements are marketed as clinically proven, natural weight-loss products, but the Mayo Clinic could find only one 8-week clinical trial. That’s not enough evidence to prove the claims scientifically.

In fact, weight loss supplements have been linked to a number of health problems, including diarrhea, constipation, high blood pressure, rapid heart rate or heart attack, stroke, and liver problems.

Some supplement ingredients may be legal but still can cause health problems:

  • Bitter orange is derived from the peel of an orange commonly grown in Seville, Spain. Its active ingredient is synephrine, a stimulant similar to the banned ingredient ephedra. There is little evidence that bitter orange actually helps us lose weight. Bitter orange may cause anxiety, increased heart rate and blood pressure, irregular heartbeat, heart attack, and stroke.
  • Green coffee extract comes from raw, unroasted coffee beans. It contains a higher amount of the chemical chlorogenic acid than roasted beans. The supplement is sold under names including Svetol and CoffeeSlender. It may have a modest weight-loss benefit. But it also causes anxiety, agitation, trouble sleeping, nausea, and an irregular heartbeat.
  • Guar gum comes from the guar bean. The husks are taken off the beans and ground up into a powder. Guar gum acts as a laxative or a filler, helping us feel full faster. Still, studies haven’t found that guar gum boosts weight loss. Also, it’s hard to digest, so it may cause abdominal pain, gas, and diarrhea.
  • Chitosan is made from the shells of crustaceans like shrimp and crab, which are treated with lye. Chitosan is supposed to limit fat absorption and increase the feeling of fullness. No scientific evidence so far shows that it helps with weight loss. Chitosan may cause upset stomach, nausea, gas, increased stool bulk, and constipation.
  • Chromium is a mineral found in many foods and hard water. Chromium supplements claim to burn fat, build muscle, and help the body use carbohydrates. But there is no solid evidence to support these claims. High doses of chromium (1,000 mcg per day) may cause kidney failure.

Why deal with these possible side effects when there’s no sure benefit? Studies done at the Mayo Clinic show no strong evidence that these ingredients help you lose weight. So it’s best to avoid them.

Plus, many supplements contain hidden ingredients not listed on the label. These ingredients may be untested in people or drugs that have been taken off the market. Even if you read the labels to avoid ineffective or unhealthy ingredients in weight loss supplements, you still might have health problems from taking them.

Here are two examples: Some bee pollen products were found to contain the prescription drug sibutramine. This drug was taken off the market in 2010 because it was associated with heart problems and strokes. Other bee pollen products contained phenolphthalein, a laxative and suspected cancer-causing compound that is not approved for use in the United States. Neither of these ingredients were listed on the label.

A recent study found an amphetamine-like drug (a stimulant) called beta-methylphenethylamine (BMPEA) in more than half of supplements labeled as containing “Acacia rigidula.” It’s common for manufacturers to hide such chemicals under plant names because it gives the impression that they are “all natural” and therefore safe. In the case of BMPEA, Canadian health authorities have called it “a serious health risk” and pulled it from stores.

Other supplements were found to have active ingredients from seizure medications, blood pressure medications, and antidepressants.

Because supplements are unregulated, any health issues they cause are usually only discovered after many people take them and report problems.

The FDA is putting together a database of supplements that contain drug ingredients that aren’t on the label and a webpage of tainted weight loss products. But remember: the FDA only tests a small fraction of supplements on the market. Just because a product is not on these lists doesn’t mean it’s safe.

The best advice I can give you about supplements is to question the claims on the product. As the saying goes, “If it sounds too good to be true, it probably is.” If a supplement promises a quick fix, such as “lose 10 pounds in a week” or uses phrases such as “scientific breakthrough” or claims to be an herbal alternative to a prescription drug, watch out. Even if it says “totally safe,” question it — or better yet, ask your doctor.

For sure, effective weight loss is hard work. Promises of “fast” or “a celebrity’s secret method” are likely to be untrue. Regular exercise and a healthy diet are the only strategies that are scientifically proven to work. Eating well and exercising are also much cheaper than some of the alternatives above. Walking daily and eating a diet rich in vegetables and low in processed food doesn’t require a lot of effort. Plus, your overall health, not just your waistline, benefits. Below are some links to some of my other Think Pink, Live Green columns that offer more information on getting to and maintaining a healthy weight in a healthy way.

Losing Weight and Eating a Low-Fat Diet May Help You Live Longer
Getting to a Healthy Weight, One Good Choice at a Time
Dieting vs. Rethinking How You Eat
The Ins and Outs of Insulin Resistance
Sleep Tight, Slim Down

In part two of this column, we’ll talk about procedures that promise weight loss, such as CoolSculpting and low-level laser therapy.

Marisa Weiss, M.D.

Marisa Weiss, M.D. is the founder, president, and chief medical officer of Breastcancer.org, the world's most trafficked online resource for medically reviewed breast health and breast cancer information, reaching over 14 million visitors per year. A breast cancer oncologist with over twenty years of active practice in the Philadelphia region, Dr. Weiss is regarded as a visionary advocate for her innovative and steadfast approach to informing, empowering, and treating patients with breast cancer.

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