Question: “Are herbal weight loss supplements safe and effective?”

Answer: This question is important because there are many herbal weight-loss products available to patients over-the-counter without a prescription. Some can even be bought in supermarkets and “health food” stores rather than pharmacies. Products may include single components or combinations of ingredients, such as ephedrine, caffeine, chromium, psyllium, chitosan, L-carnitine, teas and various herbal preparations. They are very attractive to many who struggle with their diet because of the desire for a “magic bullet” which could possibly make them lose weight effortlessly with the daily intake of one or two pills. Many people who take these drugs also have the idea that because these are so-called “natural” products derived from leaves, seeds, or fruits of various plants, they are automatically safe.

In general, none of these herbal weight loss preparations have been demonstrated to be effective in large studies on significant numbers of overweight or obese individuals. Among the gamut of agents, only products derived from the plant Ephedra sinica (or Ma huang in Chinese) appear to have direct benefit in clinical studies for weight loss. Despite its efficacy, it is also the most unsafe among these herbal weight loss supplements. Its use for whatever indication is strongly discouraged because of the high potential for adverse side effects including hypertension, heart attacks, stroke, convulsions and irregularities in the heart beat. There are even reports of death and permanent disability after using this agent. This is true for both ephedra alone, and the combinations of ephedra and caffeine.

Other herbal supplements such as green tea, L-carnitine, psyllium and even chromium show promise in animal studies, but so far the studies in humans are small and inconclusive.

How about safety? What are some of the possible dangers? Since these are supplements rather than traditional drugs, quality control during manufacturing or packaging is not always assured. Worldwide, the dietary supplement industry is not regulated and therefore, product safety is not guaranteed. There may be some contaminants or impurities which could cause allergies. In a study done in the U.S., it was revealed that among 247 agents that were assayed, as much as 16 percent had heavy metal contamination which could be potentially toxic, while another seven percent had bacterial contamination which could lead to gastrointestinal infections and diarrhea.

How about the side effects of these supplements? As mentioned, the most dangerous among these agents are those derived from Ma huang due to their potential for serious problems in the heart which could even lead to death. Slimming teas may cause some diarrhea or increased urination if taken in excessive amounts, leading to dehydration, body weakness and even loss of important ions like potassium.

Some agents have been studied to be at least safe and these include green tea, psyllium, L-carnitine, and chitosan. Their use is not generally discouraged by medical practitioners as they may have some health benefits such as their anti-oxidant effects (green tea), improvement of bowel movements (teas, psyllium), or even slight decreases in blood sugar and cholesterol (psyllium, chromium). However, over¬all, these relatively “safer” herbal supplements have limited benefit for the overweight and obese as there is no strong data showing significant weight loss among humans.

Herbal supplements may also interact with common drugs used by overweight people who frequently have other medical problems like hypertension or diabetes. For example, the intake of tablets containing St. John’s wort, an herbal supplement that is becoming popular for weight loss, can interact with drugs called warfarin, digoxin, or oral contraceptives, increasing the risk for serious side effects or making these drugs more potent.
People who are contemplating on taking these agents or are currently taking them for weight loss should know that there are no adequate data to support their use for weight loss, and the short- and long-term adverse effects of many of these agents are largely unknown.

Lastly, perhaps the greatest danger to using these herbal supplements is that individuals who are overweight or obese may use these agents in lieu of healthful dietary and behavioral changes, such as exercise, smoking cessation and minimal alcohol intake. It is human nature to prefer to swallow a pill rather than exert effort to exercise in the gym or to practice restraint in ordering those tasty dishes in restaurants. There really is no substitute for a consistent diet and regular aerobic exercise to lose weight. Ask your doctor about the appropriate diet and exercise program suited for your age, condition and lifestyle. After all, not everything that is natural is safe.

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