Over-the-counter weight-loss pills: Do they work?

Wednesday, October 1, 2008

The temptation of using over-the-counter weight-loss pills to lose weight fast is often irresistible. But are these products safe and effective?

The appeal of losing weight quickly is hard to pass up. But do over-the-counter weight-loss pills and products lighten anything but your wallet? And are they a safe option for weight loss? Here's a look at some non-prescription weight-loss pills and what they will and won't do for you.

Popular weight-loss pills

A number of weight-loss pills are available at your local drugstore, supermarket or health food store. Even more options are available online. Most haven't been proved safe and effective, and some are downright dangerous.

Herbal or dietary supplement	The claims	What you need to know
Bitter orange	Increases the number of calories burned	Touted as an "ephedra substitute" but may cause health problems similar to those of ephedra Long-term effects unknown
Chitosan	Blocks the absorption of dietary fat	Relatively safe, but unlikely to cause weight loss Can cause constipation, bloating and other gastrointestinal complaints Long-term effects unknown
Chromium	Reduces body fat and builds muscle	Relatively safe, but unlikely to cause weight loss Long-term effects unknown
Conjugated linoleic acid (CLA)	Reduces body fat, decreases appetite and builds muscle	Might decrease body fat and increase muscle, but isn't likely to reduce total body weight Can cause diarrhea, indigestion and other gastrointestinal problems
Country mallow (heartleaf)	Decreases appetite and increases the number of calories burned	Contains ephedra, which is dangerous Likely unsafe and should be avoided
Ephedra	Decreases appetite	Can cause high blood pressure, heart rate irregularities, sleeplessness, seizures, heart attacks, strokes and even death Banned from the marketplace because of safety concerns, but may still be legally sold as a tea Despite the ban, many ephedra products are still sold on the Internet
Green tea extract	Increases calorie and fat metabolism and decreases appetite	Limited evidence to support the claim Can cause vomiting, bloating, indigestion and diarrhea May contain a large amount of caffeine
Guar gum	Blocks the absorption of dietary fat and increases the feeling of fullness, which leads to decreased calorie intake	Relatively safe, but unlikely to cause weight loss Can cause diarrhea, flatulence and other gastrointestinal problems May cause intestinal obstruction if not taken with enough water
Hoodia	Decreases appetite	No conclusive evidence to support the weight-loss claim

In addition to these herbal and dietary supplements, the Food and Drug Administration (FDA) has approved Alli — a reduced-strength over-the-counter (nonprescription) version of orlistat, a prescription weight-loss medication for adults age 18 and older. Alli promotes weight loss by decreasing absorption of fat by the intestines. The capsules are taken with meals, up to three times a day.

Alli sounds like a dieter's dream, but there are no shortcuts to permanent weight loss. Alli is intended to be used only with a reduced-calorie, low-fat diet and regular exercise. Side effects, such as diarrhea and gas with oily spotting, can be significant if you don't reduce the amount of fat in your diet.

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• Alli weight-loss pill: Does it work?

The pitfalls of pills

Dietary supplements and weight-loss aids aren't subject to the same rigorous standards as are prescription drugs or medications sold over-the-counter. Thus, they can be marketed with limited proof of effectiveness or safety. Vendors can make health claims about products based on their own review and interpretation of studies without the authorization of the FDA. However, the FDA can pull a product off the market if it's proved dangerous.

For the consumer, it's hard to know what you're getting, or even if the list of ingredients matches what's in the bottle. Many weight-loss pills contain a cocktail of ingredients — some with more than 20 herbs, botanicals, vitamins, minerals or other add-ons, such as caffeine or laxatives. How these ingredients interact individually and collectively with your body is largely unknown. And using them can be a risky venture, especially if you're taking other medications.

Your own scrutiny and curiosity are your best protection. Read labels closely and talk with your doctor or pharmacist about any dietary supplements you're taking or considering taking.

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• Bitter orange weight-loss supplements: Do they work?
• Hoodia: An effective appetite suppressant?

No quick fix

There's no magic bullet for losing weight. The most effective way to lose weight and keep it off is through lifestyle changes: Eat healthy, low-calorie foods, watch portion sizes, and engage in regular physical activity. It's certainly no magic pill, but it works.

Keep in mind that even if you take a weight-loss pill, you still have to eat fewer calories than your body uses in order to lose weight. Even if these products were to help you lose weight initially, you'd have to continue taking them for the weight to stay off, which may not be practical or safe.

If you're concerned about your weight or have a condition that's exacerbated by extra pounds, talk to your doctor. Whether you have 10 pounds or 100 pounds to lose, you need to eat a healthy diet based on a variety of foods and burn calories through physical activity. Time has shown that there truly are no easy solutions to losing weight. And over-the-counter weight-loss pills could cause more harm than good.

MORE ON THIS TOPIC

• Weight-loss drugs: Can a prescription help you lose weight?

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MayoClinic.com Bookstore

• 'The Mayo Clinic Plan: 10 Essential Steps to a Better Body & Healthier Life' (Hardcover)
• 'Mayo Clinic Healthy Weight for EveryBody' (Softcover)