Mar 08 2012

Weight Loss Supplements Don’t Work

This is something I and others have been saying and writing about for years – there is no current utility to weight loss supplements. Now a systematic review of the literature has come to the same conclusion. From the abstract:

Weight-loss supplements typically fall into 1 of 4 categories depending on their hypothesized mechanism of action: products that block the absorption of fat or carbohydrate, stimulants that increase thermogenesis, products that change metabolism and improve body composition, and products that suppress appetite or give a sense of fullness. Each category is reviewed, and an overview of the current science related to their effectiveness is presented. While some weight-loss supplements produce modest effects (2 kg), especially in the long term. Some foods or supplements such as green tea, fiber, and calcium supplements or dairy products may complement a healthy lifestyle to produce small weight losses or prevent weight gain over time. Weight-loss supplements containing metabolic stimulants (e.g., caffeine, ephedra, synephrine) are most likely to produce adverse side effects and should be avoided.

Definitely the most troubling category are those that contain stimulants. They are added to give the user a sense of increased energy – it’s a cheap way to make it seem like the supplement is doing something. But the long term effects are negative overall. Your body will simply adjust to the constant use of stimulants, and then if you stop you will likely gain back any weight you lost and more. Further frequent use of such stimulants may not be safe. Ephedra itself was banned by the FDA because of cases of sudden death in users.

The other categories of supplements simply don’t work. For those studies that show a modest weight loss effect (2 kg is not a significant weight loss) subjects also engaged in a reduced calorie diet and/or exercise. Therefore we cannot make any statements about the effectiveness of the supplements themselves.

It should also be pointed out that in the US, due to DSHEA (a 1994 act that essentially removed supplements from FDA oversight) supplement manufacturers can put any combination of herbs and nutrients into a pill and make whatever claims they wish about it (as long as they don’t name a specific disease), without any burden of evidence. Right now you could throw darts at a dartboard with various herbs, minerals, and vitamins on it to come up with a random formula, and then spin a wheel of indications (boosts the immune system, improves metabolism, supports cellular function – whatever) and then market your random ingredients for your random indication, all without a lick of evidence. You can even claim your product was “scientifically formulated.” Now all you need are some anecdotes, but they are easy to come by. If you’re ambitious you can find an MD or PhD to endorse your product in exchange for a piece of the company.  Don’t worry, as long as you don’t make a disease claim (directly – that’s what the anecdotes are for) and you put the quack disclaimer on your website, the FDA can’t touch you.

The Federal Trade Commission (FTC) is a different story. They can still go after you for commercial fraud if you make claims that are not true. To its credit, the FTC has been going after false advertising of supplements, but there are so many products and companies you can simply hide in the herd. Many of the cases the FTC goes after lied in their advertising or used deceptive practices other than just making up claims for random ingredients.

This latest study is evidence, in my opinion, for the utter failure of DSHEA. It has not served the interest of the consumer. It has served the interests of the supplement industry, which by an amazing coincidence is centered in Utah, home state of Orrin Hatch – one of the main sponsors of DSHEA. Go figure. Weight loss supplements are a 2.4 billion dollar industry in the US – an industry based entirely on products that do not work, and some of which are not entirely safe. In addition to this financial waste, weight loss supplements distract people from weight loss methods that at least have a chance to be effective (life style changes, regular exercise, calorie control). If anything the weight loss supplement industry contributes to obesity in this country by distracting the public with worthless products and misleading claims. Thank you, Senator Hatch.

The solution is simple – we need to go back to a regulatory system in which companies need to provide some reasonable level of evidence for safety and effectiveness before they put a product on the market and make health claims for it.

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