• Overweight and obesity: What's behind the growing trend?
  • Why people become overweight
  • Genetic influences
  • Environmental influences
  • Other causes of obesity
• How excess weight affects your health
  • More disability... and a shorter life?
  • Health benefits of weight loss
• When to seek professional help
  • Medical evaluation for weight loss
  • Screening tests
  • Designing a treatment program
• Weight-loss basics
  • Counting calories: How many do you need?
  • Physical activity: How much is enough?
• Choosing the diet that fits you best
  • The diet studies
• What to eat: A week of daily menus
• SPECIAL BONUS SECTION: 10 habits to help you lose weight
• Weight-loss programs
  • Commercial programs
  • Self-help programs
  • Clinical programs
• Weight-loss medications
  • Who should take them?
  • How should they be taken?
• Weight-loss surgery
  • Bypasses, bands, and sleeves: How they work
  • Criteria for weight-loss surgery
  • Choosing a surgeon, and other considerations
  • After surgery
• Keeping the weight off
  • Keys to lasting weight loss
• Resources
• Glossary

Over-the-counter weight loss supplements: Not worth the risk

Have you been tempted by the vast array of dietary supplements available without prescription that promise to burn fat, curb your appetite, and help you melt away the pounds? After all, they’re made from herbs and other natural ingredients, and they’re readily available in local stores or via the Internet, so there’s no harm in trying one, right? Wrong.

Most popular weight-loss supplements are inadequately tested for safety. Unlike the studies done on prescription drugs to gain approval by the FDA , studies on supplements typically include small numbers of volunteers and don’t last very long. And supplements are far less closely regulated than approved medications. Yet dozens contain undisclosed prescription drugs — some of which are not approved for use in this country, and many of which have serious, sometimes life-threatening side effects, as reported by the FDA ’s Initiative Against Contaminated Weight Loss Products.

Weight-loss aids fall into a gray area in FDA regulation. They’re classified as dietary supplements, a category regulated more like food than drugs, created in response to public pressure to loosen the FDA ’s tight control over a variety of products. As a result, individual nutrients, herbs, and “phytomedicinals” (plants supposed to have medicinal value) can be sold without being tested for effectiveness or safety, so long as they do not make direct health or therapeutic claims. Within these limits, manufacturers cannot say that their weight-loss aids will cure obesity or make you lose weight, but they can make indirect claims—and this has led to a wide array of unfounded assertions on labels and in advertisements.

But the FDA cannot take a product off the market unless it is found to be unsafe. Because the agency cannot test every one of the thousands of supplements on the market, most face no danger of being removed. In 2004, however, the FDA banned the sale of ephedra (ma huang in Chinese) after the compound was linked to a number of deaths and very serious side effects, including heart attacks, strokes, and seizures. In 2001, ephedra products constituted fewer than 1% of all dietary supplement sales, yet they were responsible for 64% of all herb-related complications reported to the U.S. Poison Control Centers during the same year. Despite the fact that ephedra-containing supplements are the only dietary supplements shown to help people lose weight (at least for up to six months), the potential risks far outweigh the benefits.

Despite the ban on ephedra itself, supplements containing ephedra-like compounds (which include ephedrine, norephedrine, and methylephedrine) are widely available over the Internet and in stores. They are often found in combination with caffeine or plant sources of caffeine, such as guarana and yerba mate, in weight-loss supplements. Note that two other ingredients found in some supplements, bitter orange and country mallow, contain chemicals related to ephedra and should also be avoided.

In 2009, the FDA warned people to stop using Hydroxy Cut products, which contain a variety of ingredients and were marketed in various forms, including caplets and drink packets. The agency received 23 reports of serious liver injuries, including one death, in people who took Hydroxycut products. Other reported health issues included heart problems, seizures, and serious muscle damage.

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This report was interesting but the menus left me cold. I am a single person who hates to cook. I do not carry a good share of the ingredients required and probably only used once. Why can't simple, easy recipes be used and for one person. thank you

From the table of contents this appears to be another "Count Calories and Exercise" epistle. Counting calories means not eating to satiety and the history of "semi-starvation" diets is absolutely dismal. (The Women's Health Initialtive showed that "undereating" by 360 calories per DAY for eight YEARS! caused 55,000 women to lose two pounds on average. That is four ounces per YEAR.) Exercise, while perhaps good in its own right, is not going to cause many people to lose weight. From the 2007 report by ten AHA and ACSM experts "It is reasonable to assume that persons... [who exercise]... would be less likely to gain weight over time... So far, the data to support this hypothesis are not particularly compelling." And they are not even talking about weight LOSS.