Do Weight Loss Pills, Powders, Products Really Work? Don't Bet on It

With Scott Kahan, MD, MPH, and Caroline Apovian, MD

With overweight and obesity a constant struggle for many adults in the United States, it's a given that weight loss efforts occupy our minds much of the time.

On some level, we know there is no quick fix, no product that will melt away our fat while we sleep, simply no effortless answer to rid us of those excess pounds. Despite our best instincts, it’s hard not to be drawn to the latest, newly promising methods that say you don’t have to spend another day fighting to lose weight. Yes—The appealing and very insistent promotions are nearly impossible to resist.

Just google weight loss and up pop 1,340,000,000 hits that suggest ways to help you lose your belly fat, and slim down fast. And no question about it, most of the info that comes up on your screen calls to you to believe, if only you could lose 21 pounds lost in just as many days, pop a pill to cure your constant hunger and cravings, and the promises of fast, effortless weight loss goes on and on.

Pills, powders, & products promising weight loss are gimmicks, buyer beware.Trying to lose weight with unproven weight loss products and supplements may land you in the emergency room. Photo: 123rf

Want Easy Weight Loss—Save Your Money, and Shut Out the Noise

So what to believe, especially if the method comes in the form of dietary supplements, treatments like hypnosis or acupuncture, detox cleanses, or special diets?

Probably none of the above, say a team of obesity experts who combed through thousands of studies published in medical journals to weed out the science from the snake oil.1

One of the leaders in this effort to sort out the facts from the fakes is Scott Kahan, MD, MPH, FTOS, director of the National Center for Weight and Wellness and medical director of the George Washington University's Strategies to Overcome and Prevent (STOP) Obesity Alliance in Washington, DC. As a member of the Obesity Society Clinical Committee that undertook this examination of weight loss products, pills, and promises, he presented their findings at the 2018 ObesityWeek meeting in Nashville, Tennessee.1

"We found there is virtually no scientifically rigorous data to support the use of essentially all of these products that are have not been received [Food and Drug Adminstration] approval for weight loss," he tells EndocrineWeb.

That conclusion matters not just to protect you with regard to your weight loss efforts but also for the sake of your health safety. About 23,000 emergency department visits and more than 2,000 hospitalizations a year have been traced back to the use of dietary supplements, and weight loss pills, which are most commonly involved.2

Evaluating Popular Weight Loss Products, Pills, and Programs

Members of the Obesity Society Clinical Committee decided to look more closely at weight loss products, anti-obesity treatments, and similarly promoted weight reducing supplements and services that are widely used.2

"The vast majority of the products we identified were dietary supplements and herbal preparations," Dr. Kahan says. In particular, the most common include—B12 injections, green coffee bean extract, bitter orange, DMAA and similar pills that contain amphetamines, as well as hypnosis, detox cleanses, and acupuncture.2

To compose the list of the weight loss remedies out there, the researchers looked through studies in the medical literature from 1960 to the present, applying standards of evidence-based in assessing the research findings.2 Patients, for instance, had to be adults, age 18 and older, and diagnosed as overweight or with obese. Ideally, a sound study included a control group and a treatment group to better evaluate how well the method worked. The study results had to demonstrate significant weight loss, either by lowering body mass index, waist circumference, or overall body fat (adipose tissue) loss.

The initial list of 21,000 studies was whittled down to some 14,000 after the review panel excluded research that did not meet the established requirements.2 When they applied even more criteria, such as excluding those studies that were conducted on animals, were duplicates on the list, or those that looked at bariatric surgery, the final list was 313.2

Among the products and services that made the final cut were ones on acupuncture, calcium and vitamin D, chitosan, chromium, ephedra/caffeine, garcinia, green tea, linoleic acid, mind-body and Phaseolus (a bean).

Evidence Is Completely Lacking Across the Entire Weight Loss Category 

Much as we keep hoping for just one good product to solve this vexing problem, there’s only one good answer: lifestyle. The conclusions arrived at by this esteemed group of nutrition experts, was echoed a few months back by none other than Dr. Oz, who doesn’t recommend any supplement to promote weight loss. He says the best way to lose weight is to sleep more.3

Even the few studies that managed to meet the scientific criteria still fell short, Dr. Kahan tells EndocrineWeb, mostly because they had too few participants to justify any favorable conclusions. More importantly, the trials that do have conclusive data often found no weight loss effect, or no improvement in weight measurements when compared to a group that got no treatment.2

While the review panel looked at a variety of weight loss products and approaches, ''the lion's share of the advertising and claims out there are for weight loss supplements," he says.

And he makes a point of needed to take the consequences of using these products seriously—as everyone should. "Some of these products and programs are extremely expensive, and ultimately they don't seem to offer anything to patients except false hope and empty promises." Not to mention, as statistics suggest, the risk of a trip to the emergency room or a hospital stay, and at the very least, a big waste of money.

Ask Your Doctor Before Trying Any Over-the-Counter Weight Loss Product

If your doctor reacts negatively or offers feedback suggesting you are better off avoiding the pill or product you were hoping would help when you ask about weight loss supplements or other heavily-advertised diet methods, you’ll know that it’s because they are aware of this new research showing that their skepticism is well-founded, Dr. Kahan says. We are urging doctors to become more vocal in warning patients away from these potentially harmful products.

Patients need to first realize that obesity is a chronic disease, says Caroline Apovian, MD, FACP, FACN, FTOS, professor of medicine and pediatrics at Boston University School of Medicine and immediate past president of The Obesity Society who reviewed the study findings. “As such, patients must accept that addressing their excess weight needs to become a long-term commitment requiring ongoing efforts. And, it’s important to understand that obesity for the vast majority of you will be relapsing, meaning you can expect that any lost weight is likely to creep back up.

Just as high blood pressure and diabetes, for instance, need to be continually treated to be well managed, so does obesity, Dr. Apovian tells EndocrineWeb. "These snake oil therapies [reviewed by Dr. Kahan and the TOC research committee] will go away as soon as the public recognizes that obesity must be handled with a commitment to lifestyle changes, and possibly helped along with medication or surgery," she says.

"The only FDA-approved medication that you can get over the counter (OTC) for obesity is orlistat (brand names: Alli, Xenical). I consider orlistat similar to Zantac (ranitidine) for gastric [acid] reflux." That's the condition in which there is a burning sensation in your throat or mouth. "But when the reflux doesn’t respond to the medication and becomes an ulcer, you need to work with your doctor to get a prescription treatment to properly care for the problem."

After all, anyone who successfully reduces fat weight with surgery or medications and now has BMI of 23 kg/m2, which is considered a healthy weight,  still has obesity, just as a person with blood cholesterol levels in the normal ranges while taking a statin still has heart disease but is on medications.

As frustrating as it may be, says Dr. Apovian, “patients with obesity who are willing to commit to a  lifelong effort, even after they shed the weight, can take off and keep off enough weight to reduce serious risks like diabetes and heart disease. " 

In the future, doctors and patients will hopefully have better information about how to navigate the avalanche of data around weight loss methods, says Dr. Kahan. That is due to research to be carried out with a grant from Google. "The grant was given to the National Academy of Medicine," he says. "It will be an ongoing project to address misinformation online in key subject areas, including obesity/weight loss."

Meanwhile….In conjunction with the American Heart Association and the American College of Cardiology, the Obesity Society has published guidelines to guide doctors in helping people manage overweight and obesity with safe and proven methods.5 Alas, there are no magic pills or powders or diets involved, but there is strong evidence that the recommended strategies work.

Among them: aiming to lose just 5% of your starting weight to be healthier in terms of blood pressure and other barometers by making some lifelong lifestyle changes with regard to your food choices, following a reduced-calorie diet (individualized for your size and weight) and engaging in daily physical activity even if its just walking.

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