On The Table

A collection of knowledge-based articles to inspire overall wellness.

Diet Pills & How They Actually Work

While supplements can be helpful to patch up some holes in our diets, they can often become a harmful shortcut if relied on.

Diet Pills & How They Actually Work

Halloween’s over, which means that—at least for dieters—we’re heading into the scariest part of the year: holiday season!

From the minute those leftover Halloween candies hit the clearance table, it’s a non-stop onslaught of sweets, treats, desserts and indulgences. So, a lot of consumers decide to call in reinforcements, and head for the weight loss dietary supplement section of their drug or discount store to find them.

If you’re going to use dietary supplements as a component of your weight-control effort, you need to know what you’re up against. There are always new products appearing in the weight loss dietary supplement market, so let’s have a quick overview.

Weight Loss Dietary Supplement - Thermogenic Agents

Thermogenic agents are so-called fat-burning drugs that increase energy expenditure. In the United States, there are no approved thermogenic medications for obesity, but that doesn’t keep manufacturers of unregulated supplements from throwing the term around.

Hence, many of my patients come in asking about “natural” thermogenic enhancers. They see advertisements for supplements that offer “increased fat-burning” with enticing names that evoke healthy images: metabo-this and thermo-that.

But you don’t want to be fooled by these fancy names and marketing ploys. These products are often wolves in sheep’s clothing.

While the really dangerous products containing ephedrine—from the plants known as ma huang or ephedra—were banned from the U.S. last year, many of the remaining products are simply sources of related compounds, such as synephrine. The fact that they’re ephedra-free is often proudly emblazoned across the label.

This is not unlike a food manufacturer claiming a food product is sugar-free, because it’s been sweetened with corn syrup instead of cane sugar. Consumers have to see through the smoke screens.

Like ephedrine, synephrine increases release of norephinephrine in the brain, which could decrease appetite. When mixed with caffeine, the combination can produce an slightly increased thermogenic effect, but it also increases heart rate and blood pressure, which led to so many of the tragic deaths and health crises caused by ephedra-based products.

Watch for products containing extracts of bitter orange or country mallow, which is also known as heartleaf, both related to the banned ephedra. And remember that these “natural” products can interact with your prescription medications or other supplements in some surprising, even dangerous, ways. Always check with your doctor or pharmacist for interactions.

Weight Loss Dietary Supplement - Digestion Inhibitors

Some people are using supplements of psyllium and other fibers like barley and guar gum for weight loss. Like some pharmaceuticals, they can prevent fats from being absorbed.

But instead of inhibiting enzymatic breakdown of fats as drugs like Orlistat do, these fibers prevent absorption by binding to fats in the gut. This lets some portion of fats pass right through the body as harmless passengers on the fiber.

That’s why increasing fiber intake decreases blood lipid levels. But there is a little evidence that these fibers alone actually help decrease weight in heavy patients. Guar gum has been studied the most, but on its own, it does not seem to be working for weight loss.