What if there was a pill that you could recommend to your patients that would help them shed unwanted pounds—a kind of “magic bullet” that would miraculously transform their bodies overnight?
It’s a pleasant fantasy—one that supplement manufacturers and Big Pharma alike have pursued relentlessly for decades. New exotic sounding products like green coffee bean extract, Yalkon syrup, saffron extract, Coleus forskohlii, African mango seed, sea buckthorn, Garcinia cambogia, Capsiberry, and raspberry ketones are constantly put on the market and are purportedly validated by scientific research.
But do these products actually help you lose weight?
As doctors it is critical to acquire a broad scope of knowledge in this area because more attention than ever is paid to dietary supplements that are purported to facilitate weight loss. The big problem is that the public has been duped by the late-night television infomercials, and Internet scams that seduce desperate people who crave magic-bullet solutions to their weight problems.
But is there any “credible” evidence to support the notion that these dietary supplements for weight loss are the Holy Grail?
To this end, I worked with a Johns Hopkins University-based team to investigate the putative efficacy of weight-loss supplements by performing a systematic review of the scientific literature. Unfortunately, we found little evidence to validate their claims. 1
We reported that while one issue with dietary supplements for weight loss is a paucity of evidence to support their use another issue is the growing number of dietary supplements is suspected to cause hepatotoxicity.
The most important issue that has come to light is the “purity” and “authenticity” of the products. The recent findings by NY State Attorney General has discovered that several major retailers Target, GNC, Walmart, and Walgreens were selling dietary supplements had less than the desired amount of the “active ingredients” as displayed in their label-as required by federal law.
Why is it important to educate our patients about these ongoing problems, in particular those who are seeking solutions to being overweight?
The weight loss supplement industry is a multibillion industry ($2 billion in annual sales) despite a relative lack of scientific evidence to support their use. And some are lethal in some cases. For instance, Metabolife 356—an ephedra-containing supplement—the top-selling dietary supplement in 2000 with $70 million in sales, but was responsible for 64% of all herb-related adverse events in the U.S.
Another example of “over marketing” was the infamous story of how green coffee bean extract was knighted as a weight loss superstar despite only having one study showing limited benefit-leading to a formal investigation by the US Senate. 2
The Federal Trade Commission (FTC) subsequently announced that advertisements touting green coffee bean supplements for weight loss would be banned. As expected, the dietary supplement industry is fighting back against these allegations.
Which all points to a simple truth: There is no magic bullet for weight loss and there probably never will be.
Whether it’s the next fat loss pill or exotic supplement regime, focusing on these one-size-fits-all cures takes our attention away from what we really need to-manage the obesity crisis in this country: Develop flexible, realistic diet, exercise, and lifestyle modification plans that include social support, nutritional consultation, and other services to help people who really want and need to lose weight drop the extra pounds and keep them off for good.
To this end, I have spent over 40 years investigating the connection of dietary approaches to both weight gain and weight loss, as I was very heavy as a teenager. I lost significant weight (>40% body weight) by eating foods that built a better gut flora. I describe the details I of my personalized approach n my new book The Gut Balance Revolution.
When I was recruited to Johns Hopkins, the Human Microbiome Project was just an idea and I began a second career connecting the dots of how diet shifts the gut microbiome and in turn-metabolism, appetite and so much more.
My conclusions are well summarized in The Gut Balance Revolution but also in part in other book chapters and peer-reviewed papers. Overall, of all of the dietary supplements on the market, the ones with the most potential benefit are those that are derived from food and either directly boost the body’s metabolism and/or biodiversify the gut microbiome.
The dietary supplements that hold the greatest promise are the probiotics and the prebiotics which are food-derived nutrients that feed the probiotic friendly flora.
But even the data on probiotics is quite varied.
Consider the fact that at least 200 studies have been done on animals and humans on the use of different lactobacillus species for weight loss alone. One recent meta-analysis found that different strains of lactobacillus seem to have different effects on weight regulation and overall health. 3
So for those who venture out and try these mighty microbes to facilitate weight loss-has anyone vetted over counter probiotics for their authenticity, as did the NY State Attorney General for herbal supplements?
Yes, in 2013 Consumer Labs tested 19 different probiotic supplements on the market and found that only 14 had less than 16% of the labeled viable counts.
Best practices dictate that we utilize evidence-based medicine to navigate our patients to better health. I recommend that we begin with promoting a more wholesome diet. Yes-lifestyle and exercise are all forms of gene modulating interventions but even a recent study showed how exercise cannot mitigate a bad diet.
In closing, many doctors are asked to recite the oath in the tradition of Hippocrates, father of modern Medicine. Hippocrates once said, “Let Medicine be thy Food, and Food by thy Medicine”.
Gerard E. Mullin
Gerard E. Mullin, MD, a national authority on nutrition and integrative medicine, is an Associate Professor of Medicine and Director of Integrative GI Nutrition Services at The Johns Hopkins School of Medicine. http://thefoodmd.com/.* He is the author of the book (on sale June 9, 2015) The Gut Balance Revolution: Boost Your Metabolism, Restore Your Inner Ecology and lose the Weight for Good!
*His views do not necessarily reflect those of The Johns Hopkins Medical Institutes.
1 Mullin, G. Supplements for weight loss: Hype or help for obesity. Nutrition in Clinical Practice. 2014;29(842).
2 Mullin, G. Supplements for weight loss: Hype or help for obesity part II. The inside scoop on green coffee bean extract. Nutr Clin Pract. 2015 Apr;30(2):311-2.
3 Million M, Angelakis E, Paul M, Armougom F, Leibovici L, Raoult D. Comparative meta-analysis of the effect of Lactobacillus species on weight gain in humans and animals. Microbial Pathogenesis 2012;53:100-8.