Weight loss pills and supplements

The use of weight-loss supplements is tempting. Who wouldn't want a little help to make the struggle easier? But there are hundreds of diet pills and supplements on the market. It can be confusing to sort through the claims and find a weight-loss supplement that is safe and effective.

Prescription vs. Over-the-Counter Diet Supplements

There are two categories of weight-loss supplements: prescription medications and non-prescription or over-the-counter (OTC) supplements. As a general rule, the use of OTC weight-loss pills is discouraged. In a study in the Journal of the American Dietetic Association researchers made a clear statement about their use. "Dietary supplements are not recommended as part of a weight-loss program due to concerns about efficacy and safety."

The American Dietetic Association (ADA) also addresses the use of prescription weight-loss pills. In a policy statement, they acknowledge that weight-loss medications may help dieters lose a modest amount of weight initially, but the long-term safety and effectiveness of these types of medications have not been established.

The best resource for information regarding the use of any supplement is your healthcare provider. Ask your doctor about current research into the products that have aroused your interest. Your doctor will also be able to discuss how taking a supplement might interact with your other medications and will also be able to provide the best advice regarding the safety of new products.

Prescription Weight-Loss Supplements

• Phentermine. Phentermine is marketed under a long list of names, including Suprenza, Adipex-P, Kraftobese and Teramine. It is prescribed only for short periods and works by decreasing a dieter's appetite. According to the ADA, it is the most widely prescribed weight-loss supplement in the United States. However, the drug can be habit forming; side effects can include insomnia, constipation and dry mouth.
• Xenical (orlistat). This prescription medication has been approved by the U.S. Food and Drug Administration (FDA) since 1999. Xenical is a lipase inhibitor, which means it works by blocking the absorption of fat. While that might seem to be the perfect weight-loss solution, there can be significant side effects, and the drug is meant to be combined with a low-fat, low-calorie diet.
• Meridia (sibutramine). This appetite suppressant product was removed from the market in the United States in 2010. The FDA initially approved the product, but the manufacturer stopped producing it after clinical studies showed that users had an increased risk of heart attack and stroke. The National Institutes of Health (NIH) recommends that anyone still using Meridia contact their physician to discuss alternative treatments.

• OTC Weight-Loss Supplements

• Alli (orlistat). This product has gained attention because it is a lower dose version of the drug orlistat, which is found in prescription Xenical. Alli is the OTC weight-loss product approved by the FDA. It works by blocking the body's absorption of fat. However, Alli is not a cure-all for obesity. For Alli to work properly, dieters still need to limit fat intake and make lifestyle changes. If you try to take the pill without making changes, side effects can be uncomfortable or even intolerable. Eating just one high fat meal may result in an inability to control bowel movements; loose or liquid stool; or oily discharge.
• Ephedra, ephedra-free products and bitter orange. When ephedra was banned from the market in 2004, a number of similar stimulants took its place. Most advertise they are ephedra-free and safe for dieters. They often contain bitter orange (citrus aurantium), synephrine or octopamine. Two of the most popular products, Xenadrine EFX and Advantra Z, were tested by researchers and still found to have unsafe effects on heart rate and blood pressure.
• Chromium. Sometimes marketed as chromium picolinate, products that contain this substance often claim to help you burn extra calories and decrease your appetite. However, the NIH found that chromium has no significant benefits for weight loss. Chromium is generally considered to be safe, but it is likely to drain your wallet without any significant benefit to your waistline.
• Green tea. Green tea can be consumed as a beverage or in pill form. It is often used to aid in weight loss or for improving mental alertness or lowering blood pressure. While green tea is safe when consumed in moderation, there is little evidence to support its use as a weight-loss supplement.
• Hoodia. This herb is sold as a hunger suppressant for dieters. Hoodia is extracted from a flowering plant and can be consumed in tablet, pill or powder form. There is no scientific evidence to support the claims that hoodia is an effective appetite suppressant, and its safety has not been verified.

• _Sources:

  _{Chromium. Office of Dietary Supplements, National Institutes of Health. Accessed: November 28, 2011. http://ods.od.nih.gov/factsheets/chromium}

  _{Heidi Michels Blanck PhD, Mary K. Serdula MD, Cathleen Gillespie MS, Deborah A. Galuska PhD, Patricia A. Sharpe PhD, MPH, Joan M. Conway PhD, RD, Laura Kettel Khan PhD, Barbara E. Ainsworth PhD. "Use of Nonprescription Dietary Supplements for Weight Loss Is Common among Americans." Journal of the American Dietetic Association March 2007, Pages 441-447 .}

  _{EatRight.org Weight Management. American Dietetic Association. Accessed: December 15, 2011. http://www.eatright.org/About/Content.aspx?id=8382}

  _{Sharpe PA, Granner ML, Conway JM, Ainsworth BE, Dobre M. "Availability of weight-loss supplements: Results of an audit of retail outlets in a southeastern city." Journal of the American Dietetic Association. 2006 Dec;106(12):2045-51.}

  _{Haller CA, Benowitz NL, Jacob P 3rd. "Hemodynamic effects of ephedra-free weight-loss supplements in humans." The American Journal of Medicine 2005 Sep;118(9):998-1003.}

  _{Weight Control Information Network. "Choosing a Safe and Successful Weight Loss Program". U.S. Department of Health and Human Services, National Institutes of Health. Accessed: November 28, 2011. http://win.niddk.nih.gov/publications/choosing.htm}

  _{"Weighing the Evidence in Diet Ads". Federal Trade Commission. Accessed: November 28, 2011. Government PDF}

  _{"Dietary Supplements For Weight Loss. Limited Federal Oversight Has Focused More on Marketing than on Safety." Janet Heinrich?Director, Health Care-Public Health Issues. Accessed: November 25, 2011. Government PDF}

  _{Amelia Hollywood and Jane Ogden. " Taking Orlistat: Predicting Weight Loss over 6 Months." Journal of Obesity October 2010 .}

  _{Green Tea. National Institutes of Health, National Center for Complimentary and Alternative Medicine.. Accessed: November 28, 2011. http://nccam.nih.gov/health/greentea/index.htm}

  _{Hoodia. National Institutes of Health, National Center for Complimentary and Alternative Medicine. Accessed: November 25, 2011. http://nccam.nih.gov/health/hoodia/}

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Should You Use Diet Pills?

Losing weight isn't easy and unless you're Super Woman, you're probably going to need a little help along the way. Friends, family, the Web, groups, diet programs, and books are all helpful ways to get support.

But if your idea of getting a leg up on losing weight is popping a pill ... there are a few things you need to consider.

When people refer to "diet pills", these can be two very different things: Weight loss supplements are sold over the counter (OTC). These are as near as your local drugstore, where you'll find an aisle offering everything from pills to teas that promise weight loss. Weight loss medications, however, are available only by prescription from a physician.

The most important thing to remember about weight loss supplements is just because they're available over-the-counter, that doesn't mean they're necessarily safe. Known side effects to OTC weight loss supplements include serious gastrointestinal problems, dermatitis, and sleep disruption. In extreme cases, such as ephedra, OTC products have caused potentially fatal reactions.

OTC supplements can also interact with other medications you may be taking. This can be dangerous if you're using medication to control serious conditions such as high blood pressure or heart disease.

Taking medication without your doctor's knowledge is a risky prospect in and of itself. Remember, the clerk at the health food store who recommends a product doesn't know the first thing about your medical history or the other medications you're taking; but your doctor does.

Then there's the fact that there is little research to prove that OTC weight loss supplements work. Have you ever noticed those ads' small print says, "When used in conjunction with exercise and diet."? If you expect a pill to do what only diet and exercise can, you'll find you've lost more money than weight.

If your efforts to eat right and exercise just don't bring the results you'd hoped for and you're interested in medication to lose weight, discuss your concerns with your physician and find out if it is an option for you.

There are three types of weight loss medication: those that suppress the appetite with amphetamine-like effect; a second type of appetite suppressant called sibutramine; and third, orlistat, which prevents the absorption of some of the fat you eat. All have potential side effects and none should be used indefinitely.

Keep in mind that weight loss medications are intended only for individuals who have a significant amount of weight to lose.

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