Do Supplements in Diets for Weight Loss Really Work?

The Centers for Disease Control and Prevention (CDC) works with the National Center for Health Statistics Data (NCHS) each year to conduct the National Health and Nutrition Examination Survey (NHANES), which provides us with data on the prevalence of obesity in the United States. For the years 2013-2014, it is noted that more than 2 in 3 adults (70.2 percent) were considered to be overweight or have obesity. Numbers since then have been on the rise. With such high prevalence of obesity, over half of us report being on a diet. The Council for Responsible Nutrition (CRN) states that the majority of those who report being on a diet – 68 percent – take dietary supplements and that this percentage has remained consistent over the past five years. Consumer surveys conducted by the CRN show that most supplement users aged 18-34 – 66 percent – anticipate their supplement use will increase over the next five years. According to the Office of Dietary Supplements at the National Institutes of Health, Americans spend over $25 billion per year on more than 50,000 products containing vitamins and minerals, herbs and botanicals, and other ingredients such as glucosamine, fish oils, and probiotics. Should Americans be using these supplements for weight loss? Do they really help us lose weight and are they safe to use?

FDA REGULATION

Dietary supplements are available in a variety of different forms from pills, capsules, and gel tablets, to powders, extracts, and liquids. There are hundreds of herbal supplements and over-the-counter drugs that don't require a prescription from a healthcare provider. Most Americans believe that what they find on the shelves of their local convenience store or pharmacy is trustworthy, effective, and safe to use. The scary truth is that many over-the-counter drugs and herbal supplements are not regulated by the Food and Drug Administration (FDA). Without FDA regulation, a lot of what we know about the drug or supplement is unknown including facts on its effectiveness, measurements of the active ingredient(s), and if any harmful substances are used or included. In fact, recent FDA investigations have found that nearly 70 kinds of diet pills were spiked, laced, and flooded with dangerous drugs. The only drugs that promise FDA regulation are prescription medications, drugs prescribed by a physician. There are over a dozen different prescription weight loss drugs on the pharmaceutical market and even though they are FDA regulated, doctors are still leery to prescribe them. This is because failure to follow a physician's exact instructions or taking too much of a weight loss prescription medication has been proven to lead to sleep problems, palpitations, an increased heart rate, stroke, and even heart attacks. Because of this risk, physicians will only prescribe weight loss medications to those who have a body mass index (BMI) greater than 30 or those who have a BMI of 27 and a comorbidity such as hypertension, high cholesterol, or diabetes.

CLINICALLY MEANINGFUL

During a 2016 study of 28 long-term trials of prescription drugs used for the treatment of obesity, researchers confessed that a person taking a prescription weight-loss drug while making appropriate lifestyle changes, only increases their likelihood of achieving clinically meaningful weight loss within a year. In research, clinically meaningful weight loss is generally defined as 5 percent or more of body weight, meaning only enough weight has been lost to lower one's risk of heart disease, diabetes, or other weight related health diseases.

THE FACTS

Ann Thurn, director of the Office of Dietary Supplements communications program at the National Institutes of Health (NIH), says that People may not know that many manufacturers of weight-loss supplements don't conduct studies in humans to find out whether their product works and is safe. For example, the ingredient chromium, may help people lose a very small amount of weight and body fat, and is safe; but another ingredient, raspberry ketones, haven't been studied enough to know whether they're safe or effective. Consumers should keep in mind that many supplements contain more than one ingredient, and these combinations often have not been studied for their safety or effectiveness. We encourage people to talk with their health care providers to get advice about dietary supplements and to visit the ODS website to learn valuable information about these products. The NIH assembles fact sheets on the ingredients in exercise supplements and dietary supplements that manufacturers have claimed produce increased performance and/or increased weight loss. These fact sheets list everything that is known about a supplement's safety and effectiveness and are available to the public.

HERBAL SUPPLEMENTS

Hoodia is an herbal supplement, plant-derived, and available in pill, liquid, and lollipop forms. It's grown naturally in Botswana, South Africa and Namibia and was originally used by African leaders when going on long journeys to hunt or wage war. The substance tricks your body into believing you have enough fuel and do not need to eat any more food by increasing the amount of energy in the brain. The herbal supplement has been sold in the United States – and in the last year – more than it has ever been grown in African countries. It's become so popular that one manufacturer, which made the drug available in milk chocolate chews, claims to have acquired $20 million in a year. A 30-day supply found in health food stores often costs consumers around $35. Despite its popularity and soaring internet sales, the South African appetite suppressant has few to almost none published, scientific studies that support the promise of weight loss. In fact, only one laboratory study has been used as evidence. This evidence, produced by David MacLean, MD, an adjunct associate professor at Brown University and a former researcher at Pfizer – a pharmaceutical company – reported, that a molecule in hoodia, called P57, likely has an effect on the brain's hypothalamus, which helps regulate appetite. He goes on to state that his study was done and tested strictly in animals.

Another herbal supplement that has gained popularity in the United States over the years is bitter orange. Its effects are similar to synephrine, an increase in energy and a reduction in appetite. But what most claims fail to note is that synephrine is a natural chemical that is released when we need to run from real, imminent danger. This type of chemical is not appropriate or safe to put freely into our bodies due to its side effects of increasingly high blood pressure – enough to cause a stroke.

OVER-THE-COUNTER DRUGS

Over-the-counter drugs can also mislead us into believing they are safe and effective to use for weight loss. For example, orlistat, the only product that is FDA approved, stops our bodies from absorbing calories. It does so by coating our intestines with enzymes that disable our bodies from absorbing fat. Therefore, no fat absorption means no calories can be absorbed. So, what's the catch? Let's say you eat a plate of cheese fries, or nachos, doing so will overload the enzyme-stopping system, resulting in bloating, gas and oily, loose, and frequent stools. The only way to avoid this messy complication is to keep your total fat intake under 30% or less. High-fiber supplements and psyllium husks are also recommended to aid in the digestive process and avoid the complication. The worst part? Orlistat inhibits our body's ability to absorb essential vitamins – vitamin A, D, and E – so multivitamins must also be taken (in addition to high-fiber supplements, psyllium husks, and a total fat intake of less than 30%) if you choose to use this over-the-counter drug.

VITAMINS FOR THE WIN

Authors, Arielle Levitan, MD, and Romy Block, MD, state in their book The Vitamin Solution: Two Doctors Clear the Confusion About Vitamins and Your Health, As part of a healthy living plan that includes clean eating, exercise, and stress management, we find that vitamins and minerals can play a role in weight loss and weight management. Many, if not most of us, have nutrient needs that are unmet by diet alone. When we replenish these deficiencies with the right vitamins and minerals, in proper doses, then we can satisfy our body's nutrient cravings and in turn, reduce our unhealthy eating. They go on say that patient's report better sleeping patterns, increased energy, better exercise habits, less of an appetite, and healthier food choices. So which vitamins are the most effective?

VITAMIN D

The American Journal of Clinical Nutrition published a study that found that overweight and obese adults taking vitamin D supplements in conjunction with calcium lost a significantly more amount of stomach fact versus people who were not taking any supplements. Being vitamin D deficient causes our body to convert sugar to fat, instead of energy, resulting in easy weight gain. Also, overweight and obese individuals – especially those that are physically inactive - have lower vitamin D levels. Failure to correct vitamin D deficiency can lead to metabolic syndrome, a collection of heart disease risk factors that increase the chances of heart disease, stroke, and diabetes. Physicians and other health care providers can test to see if you are vitamin D deficient by checking your blood levels.

IRON

Studies have proven a positive correlation between iron deficiency and obesity. Furthermore, studies have also revealed reductions in BMI, body weight, and waist circumference after successful treatment of iron deficiency. Iron also aids in increasing energy levels, which may help increase exercise and result in effective weight loss. If you want to avoid another pill, iron can be found in red meat and a variety of vegetables. Women experience iron deficiency more often than men due to menstruation and therefore require a higher dosage – men need 8 mg per day; women need 18 mg per day. Vitamin C is recommended in conjunction with iron supplements to aid in absorption.

MAGNESIUM

Dr. Friedman notes a number of benefits from magnesium in his book, Food Sanity: How to Eat in a World of Fads and Fiction, Magnesium is an essential mineral, and research suggests it can relax your muscles, help you feel calm, and improve your sleep – and all of those things can help you lose weight. A lack of sleep is a key contributing factor to weight gain. Sleep deprivation is a leading cause of the obesity epidemic, and plenty of research supports this notion. If you are suffering from insomnia, it could be due to a magnesium deficiency. People with low magnesium often experience restless sleep, waking frequently during the night. Magnesium plays a role in supporting deep, restorative sleep by maintaining healthy levels of GABA, a neurotransmitter. Magnesium increases GABA and can improve sleep quality.

The Women's Hospital in Boston conducted a study that found that poor sleep slows our body's metabolism and raises our blood sugar levels. Recommended magnesium levels for men are 400 to 420 mg; for women – 310 to 320 mg.

THE SAFEST BET

It is of no surprise that the safest way and the most effective way to lose weight, and keep it off, is by eating a healthy low-calorie diet and being more physically active. There is no magic pill for losing weight. Weight-loss pills, whether they are prescription drugs, nonprescription drugs, herbal products, or some other kind of dietary supplement, are all just stepping stones that may or may not help with weight loss. With that being said, if you think you absolutely need something to jump start your diet, caffeine can be a healthy option. It's safe to start your day with two cups of black coffee – no cream and no sugar. This will increase your metabolism. Caffeine releases epinephrine, also known as adrenaline, which helps breakdown fat stored in our body. 100mg of caffeine – about one cup of coffee – boosts thermogenesis, or calorie burning, for a few hours following consumption. While caffeine does give you an extra boost for calorie burning, it can cause elevations in heart rate and blood pressure. Because of this, you should contact your doctor or healthcare provider before starting this weight-loss trick, or before using any weight-loss dietary supplements.

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