Weight loss pills

Can slimming be as easy as popping a pill?
 
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01 .Introduction

weight loss pills

In Australia, the weight-loss industry is worth millions. It is estimated that in 2010-11, Australians will spend $789.6 million in an effort to slim down. Weight-loss pills make big claims – but do they really work?

We took a closer look at a selection of diet pills and the ingredients that reportedly give them their fat-busting properties. What we found were
products that are not rigorously tested and active ingredients with little or no proof they work. Overall, the current evidence for the effectiveness and safety of these products is pretty sketchy. At present, a balanced, kilojoule-controlled diet and exercise plan are still the best way to control your weight.

In 2008, Australia hit a milestone. After years of downing meat pies, snags and pints, we finally did it – we officially became the fattest nation in the world, according to a study by Baker IDI Heart and Diabetes Institute, Australia’s Future Fat Bomb. It reported 26 per cent of adult Australians – almost four million people – are obese. If you include those who fall into the overweight category, that figure jumps to nine million. No wonder we are turning to over-the-counter help.

The spruik

You’ve seen the ads – you know, the ones that say “I lost eight kilograms with this product” or “Yes! I want my body to absorb less fat!” They can be pretty convincing, especially when supported by “scientific evidence” and amazing “testimonials”, complete with before and after shots.

It used to be that such dramatic testimonials came with the fine print that they are “exceptional” and that “individual results may vary”. In 2005, the law changed so that testimonials and photos must be of typical cases. However, in the testimonial pages of some websites many cases still seem exceptional. If you look at the fineprint, it is often explained that their results are due to a lot more than taking product X, such as larger changes in diet and activity levels.

You will typically find that weightloss pills are designed to be used in conjunction with an energy-controlled diet and exercise. But wasn’t that what we were trying to avoid in the first place? The truth of the matter is these products may or may not assist with weight loss, but, whatever their impact, it seems that we can’t escape the hard yards.

 
 

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These products tend to be a mix of herbs and vitamins and, often, stimulants such as caffeine, which can result in high blood pressure and heart palpitations. Herbs contain many chemicals, the presence and concentration of which can vary according to the source and the preparation. And in most of these weight-loss pills, ingredients are only individually tested for safety. They may interact with one another or with other medications.

Amazingly, two products we looked at contained both bitter orange and panax ginseng, which aren’t recommended to be taken together, due to an increased risk of fatal heart arrhythmias.

Hydroxycitric acid (HCA)

What is it? A derivative of the fruit from the plant Garcinia cambogia. May also be listed as brindleberry, Malabar tamarind, Garcinia quaesita, or hydroxycitric acid.
What they say it does Modifies metabolism, reduces fat synthesis and decreases appetite.
Can they prove it? Studies provide contradictory evidence. Some show some positive results, while others show no difference between the group taking HCA and the placebo. More comprehensive studies are needed.
Side effects and interactions None known. It appears to be safe over the short term in the doses studied.
Products: Naturopathica FatBlaster Max, Supprexxa Metabolism Formula.

Bitter orange

What is it? An extract of the Seville orange, it also known as Citrus aurantium. Used in place of ephedra as it contains similar compounds.
What they say it does Increases metabolism and fat burning while decreasing appetite.
Can they prove it? Limited promising evidence; more research is needed on its safety and effectiveness.
Side effects and interactions Has been linked with fainting, heart attack and stroke. It is advised that you avoid bitter orange if you have a heart condition or are taking other medications.
Products: Rapid Burn Dual Action Weight-loss System, FatBlaster and FatBlaster Max, Hershel-Beck Laboratories Xantrax.

Capsicum annum

What is it? Capsaicin from hot peppers.
What they say it does Increases metabolic rate and reduces appetite.
Can they prove it? Studies on capsaicin are interesting but mixed – one shows that having a spicy entrée can reduce your total food intake over the whole meal.
Side effects and interactions Short term burning pain.
Products: Supprexxa Metabolism Formula.

Green coffee extract

What is it? An extract of raw coffee beans – it is believed that chlorogenic acid is the active ingredient.
What they say it does Increases metabolism and glucose control.
Can they prove it? There are some positive results from studies. However, the quality of the studies is poor, so more rigorous trials are needed.
Side effects and interactions None known, however the product safety hasn’t been confirmed in a large analysis. Has the potential to increase heart rate and blood pressure.
Products: Hydroxycut Advanced, Xantrax, FatBlaster Max.

Green tea extract

What is it? The catechins extracted from green tea.
What they say it does Reduces fat synthesis and absoption and increases metabolism.
Can they prove it? Conflicting results. Some studies suggest it needs to be taken with caffeine to be effective.
Side effects and interactions? Deemed safe. when formulated and taken appropriately, There’s some concern that green tea extracts may cause liver toxicity, especially if taken on an empty stomach.
Products: Xantrax, FatBlaster, FatBlaster Max, Rapid Burn.

Chitosan

What is it? Derived from the powdered shells of crustaceans.
What they say it does Binds to dietary fat to stop absorption.
Can they prove it? Studies show varying results, with only minor weight loss shown.
Side effects and interactions If it does work, there could be malabsorption of nutrients and loose, oily stools.
Products: Rapid Burn.

Chromium picolinate

What is it? Chromium is an essential trace element commonly used in the form of chromium picolinate.
What they say it does Enhances insulin sensitivity and fat burning. May increase lean body mass.
Can they prove it? Experts agree there’s insufficient evidence to recommend it as a weight-loss aid.
Side effects and interactions No studies have reported side effects. However, it may cause DNA damage in high doses.
Products: Hydroxycut Advanced, Optislim Max, FatBlaster, FatBlaster Max, Xenadrine Ultra, Rapid Burn, Supprexxa Metabolism Formula.

Sprung!

In the last six months, Australia has seen two recalls that bring into question the regulation around listed weight-loss products.

In October 2010, we saw weight-loss chocolate bars pulled from sale as they contained an unlisted ingredient, the prescription drug, sibutramine. Sibutramine, previously a leading prescription weight-loss medicine, was withdrawn from the Australian market after being associated with cardiac events such as non-fatal heart attack and stroke.

In another worrying event, the heavily advertised Latin Seed was withdrawn for containing the poisonous yellow oleander, instead of candle nut as claimed on the label. It can cause a variety of symptoms from diarrhoea to heart damage.

While these events are unusual, the fact that they do happen makes it difficult to see how the TGA can consider these products “low risk”.

If you think that weight-loss pills are evaluated for safety and efficacy like prescription medicines, think again.

The Therapeutic Goods Administration (TGA) is the body that’s been charged with regulating complementary medicines. In Australia, all complementary and alternative medicines – such as weightloss pills – need to be entered on the Australian Register of Therapeutic Goods. On this register there are two types of products: “registered goods” and “listed goods” – and it’s important to know the difference. Registered goods are medicines that are considered high risk – such as prescription medicines. They are evaluated by the TGA for quality, safety and efficacy before being released onto the market. Listed medicines (identified by an AUST L number) are considered lower risk and must only contain ingredients that have their safety and quality approved for use in listed products, but are not evaluated for efficacy.

Manufacturers can apply for a listing by just filling in an online form and paying a fee. Around 20% of products are randomly audited to make sure they meet standards. Manufacturers also have to hold a file of evidence to prove that their products work. Based on the literature we looked at, we suspect their “proof” is pretty underwhelming.

In 2008, there were about 100 times more listed weight-loss products than registered products – now there are probably more.


The evidence?

So, if the products aren’t evaluated for efficacy, how do you know whether they are worth the money? The short answer is you don’t – unless you do some leg work. We did the hard yards and had a look at the literature around the most common “active” ingredients. Several systematic reviews have concluded that, at best, more research is needed before any conclusions can be drawn.

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