I am asked almost daily from patients and from friends about my opinion on over the counter, or over the internet weight loss products. My answer is usually “there is really no scientific evidence that X product will work, so it is not something I would recommend.”
I get it. I’ve been obese before. I remember feeling so bad about myself, and feeling frustrated that I wasn’t able to lose weight and wanting a quick fix so badly. I remember reading advertisements about a new product that has been found to “melt away fat” or to “flush out fat” and I wanted that to be true.
However, being a doctor, I usually was able to stop myself before hitting the “buy now” button on one of those product sales pages because I know how to do quick literature searches. After a quick look for any scientific studies, I could easily find out that there was no real evidence that the product worked.
Here’s the run down on the most popular products
I have done the literature searches for you, and here is a run down on the most popular over the counter or internet products for weight loss. In this blog post, I’m limiting this discussion to pills which include medications and herbal supplements. I have divided the most popular products into three categories here.
- Category 1 – The products (really just one product) that work and that I have recommended to some patients.
- Category 2 – The products that might work a little, although there’s probably minimal benefit and not a lot of evidence. I don’t recommend these products to my patients.
- Category 3 – The products that are not helpful.
Category 1 – The one over-the-counter product that has been proven to decrease weight and that I have recommended to some patients.
There is really only one over the counter medication that has been proven to cause significant weight loss. Alli (the generic name of the medication is Orlistat 60 mg) is the only over the counter medication to treat obesity that has been proven to be effective. It is available in a double dose (120 mg) as Xenical as a prescription medication. This medication decreases fat that is absorbed from the foods that you eat. It has been shown to be effective in many clinical trials and has been approved by the FDA (Food and Drug Administration) for use in people with obesity.
I believe that the only reason that Alli is not more popular is because it has some uncomfortable side effects. Since the medication decreases absorption of fat from your intestines, it leads to more fat coming out in your stool. So if you eat a fatty meal, then you will have greasy stools. You might have cramping, or leakage of stool.
Alli is a reasonable medication to try if you are following a low-fat meal plan, or a daily calorie restricted meal plan. I would steer my patients away from this medication if they are following a keto diet or other low carb diet since those plans are higher in fat, and a high fat meal plan would be more likely to have side effects from the Alli.
Category 2 – The products that might work a little, although there’s probably minimal benefit and not a lot of evidence.
There are a few over the counter products that might cause a little weight loss, but the evidence is weak, and so I usually would not recommend these to my patients.
Caffeine might cause a little bit of weight loss initially if someone first starts drinking it, although generally the weight loss effect is minimal, and the weight loss effect wears off over time. Some of the over the counter products that contain caffeine such as green coffee bean extract and green tea extract might cause a little bit of weight loss initially.
There might be some effect of Hydroxycut. There was one small study published in 2009 looking at 16 people took an herbal med similar to hydroxycut and 16 people who took a placebo (sugar pill). This study showed that the people taking the herbal supplement lost some weight and the people taking the placebo did not lose any weight. It is difficult to draw conclusions from a small study, especially since these results were 9 years ago, and there are no other studies showing benefit since then.
Glucomannan is a type of fiber. Adding fiber has been shown to help a little weight weight loss when it is taken with water before meals.
There was one small study in 2012 (30 people taking the herb and 30 people not taking the herb) which showed modest benefit for weight loss with the herb in Meratrim. However, when there is one small study showing benefit, and years pass by without other studies, usually this means that there isn’t a significant benefit to the product.
Category 3 – The products that are not helpful in losing weight.
Garcinia cambogia has been shown to be equivalent to placebo, meaning that a sugar pill is equally effective as garcinia cambogia in causing weight loss.
There are no research studies that show that raspberry ketones are effective for weight loss.
Conjugated Linoleic Acid (CLA)
There have been several studies done to evaluate the effectiveness of CLA on weight loss, and there probably is not a benefit.
There is no evidence in research trials that forskolin helps with weight loss
Bitter Orange / Synephrine
Bitter orange/synephrine is similar to ephedrine. Ephedrine can cause weight loss but has significant side effects, and was banned from the market by the FDA in 2004. Even though bitter orange/synephrine is similar to ephidrine there is no research showing that synephrine helps with weight loss.
So, if most of these over-the-counter pills don’t cause weight loss, is there any other pill that can help me?
There are several FDA approved medications that have been proven in large studies to help in treating obesity. These anti-obesity medications require an evaluation by a healthcare provider, and are prescriptions. I will discuss these FDA approved anti-obesity medications in a future blog post. If you want to be notified of my blog posts, you can sign up for my newsletter at the top of your screen. Also, you can learn about the anti-obesity medications, and much more, in my ebook The Obesity Solution, a compassionate step-by-step guide to finally losing the weight and keeping it off.