The major problem with weight loss supplements and prescription medications (and the reason most of them have been yanked from store shelves—think fen-phen, sibutramine, and ephedra) is heart-related side effects.
They can increase heart rate, blood pressure, cholesterol, and blood sugars, and they can even increase feelings of stress and depression.
And since cardiovascular disease (CVD) is the number one killer of men and women, any pill that helps with weight loss but increases the risk of CVD is just not worth it! So is it possible to find a supplement that controls appetite, ramps up metabolism, or potentially reduces the risk of certain diseases while helping you lose weight? Yes! (Along with diet and exercise, of course.)
What is Obesity?
Obesity has just overtaken smoking as the top preventable cause of illness and premature death in the United States.
Approximately 70 percent of the population is now overweight or obese, and obesity in children has tripled over the past 30 years—it’s what I call a super epidemic. Just as smoking increases the risk for a variety of diseases, the health impact of obesity is staggering. Here is just a partial list of conditions that obesity can lead to or worsen.
- Acid reflux
- Atrial fibrillation
- Blood clots
- Cancer (including breast, colon, endometrial, esophageal, kidney, liver,
- ovarian, and prostate; and it may increase the risk of getting a more
- aggressive form of the cancer, as well)
- Complications from surgical procedures
- Eye diseases
- Fetal defects (from maternal obesity)
- Gallbladder disease
- Gout (high uric acid levels)
- Heart disease
- Heart failure
- Hiatal hernia
- High blood pressure
- High cholesterol
- Hot flashes
- Infertility (men and women)
- Low back pain
- Low testosterone
- NAFLD/NASH (a.k.a. fatty liver disease)
- Pregnancy complications (such as preeclampsia)
- Sexual dysfunction
- Sleep apnea
There are several different measures— besides the number on the scale—that can help gauge weight loss progress. My favorite is waist size; extra inches around the midsection are a good indication of excess fat in the abdomen, surrounding the organs, and this visceral fat is really bad for you. It increases the risk of both CVD and diabetes.
I also like to use cholesterol, blood sugar, blood pressure, and heart rate to evaluate progress. Body mass index (BMI) is another popular measurement, but it has some drawbacks. It uses height and weight to calculate overweight and obesity, but it doesn’t account for muscle mass, so if you lose 10 pounds of fat and gain 10 pounds of muscle, your BMI won’t change although your health status (and heart health) will! Many professional athletes have very little body fat but still appear to be overweight on a BMI chart because of muscle mass.
You can get body fat measured by a doctor or by a trainer at just about any gym. However, DEXA (dual-energy x-ray absorptiometry) is the gold standard for measuring body fat. It’s actually used for osteoporosis screening, so the next time you go in for one of these, ask for your body fat percentage, too, if you’re concerned about your weight.
The good news is that losing just 5 to 10 percent of your weight or several inches off your waist can lower the risk of heart problems by impacting the following:
- Reducing blood pressure by 10 points in those with hypertension
- Reducing blood sugar by 50 percent in people newly diagnosed with diabetes
- Reducing the chances of getting diabetes by 50 percent in those at risk for the disease
- Reducing total cholesterol by 10 percent, LDL (bad) cholesterol by 15 percent, and triglycerides by 30 percent and increasing HDL (good) cholesterol by 5 to 10 percent
- Reducing all-cause mortality by 20 percent, death from diabetes by 30 percent, and death from obesity by 40 percent
But here comes the bad news: Only one out of six people (17 percent) is able to lose 10 percent of their body weight and keep it off for a year. Dieting is tough. It’s like playing the slots in Vegas; you only hear about the winners, not the millions of losers (or “nonlosers,” in the case of weight). We have all sorts of high-calorie foods and drinks at our disposal, and typical modern life is fairly sedentary, what with desk jobs, YouTube, and suburban sprawl, which makes it so you have to drive to get anywhere. Plus, your body doesn’t like to lose weight.
Once you finally wrestle the scale into submission, your metabolism slows down, which makes it easier to put pounds back on even when you don’t increase the amount of food you’re eating (see “Metabolism by the Numbers” [above] for a way to avoid this conundrum). This is why it’s so important to pay attention to the type of food you’re eating and how you’re exercising.
Home Remedies For Weight Loss and Obesity
1. (tie) Whey protein powder 50 to 60 grams a day in divided doses between meals, ideally in isolate form
Why protein powder? It’s an easy way to increase protein intake; it helps suppress appetite while building and preserving muscle mass; it takes more energy to digest than carbs and fat; and it may lower blood pressure and improve cholesterol and blood sugar levels. Hundreds of human studies show it can do all of these things, and it’s safe for most people in moderation. There is no other dietary supplement in the world that can come close to making all of these claims—except fiber, of course.
The Recommended Dietary Allowance for protein is 0.8 grams per kilogram of body weight (there are 2.2 pounds per kilogram), but I think this is too low, especially if you need to lose weight and increase muscle. I believe that for every 2 pounds you weigh, you should get 1 gram of protein daily.
The average woman weighs 154 pounds, so that’s 77 grams of protein a day. If you look at daily intakes based on this recommendation, most people have a deficiency of it. Multiple studies, including a recent USDA clinical trial, have found that 50 to 60 grams of whey protein daily (in addition to what is obtained through diet) has been associated with more significant weight loss compared to other protein powders, such as soy. In my opinion, when you’re getting this much protein over a long period of time, you’ll do well with any type of concentrated protein source (powders).
Protein powders can be either animal-(whey, casein, or egg whites) or plant-based (soy, brown rice, hemp, or pea). Always look for products that are in isolate form, which usually contain no more than 100 to 125 calories per 20 to 25 grams of protein, no sugar and less than 5 grams of other carbs, no fat or cholesterol, very little sodium, and almost no lactose. There’s simply no better way to pack so much protein into so little space than with a powder (no protein bar is able to do this).
Research has shown better weight loss and muscle building with animal-based protein powders versus plant protein sources, probably because the animal powders have higher amounts of the branched-chain amino acids (BCAAs), such as leucine. These BCAAs have the ability to stimulate muscle protein synthesis to a greater degree than other amino acids. And more muscle mass equals a higher metabolism. Or it could just be that plant proteins need more studies in larger amounts than were tested. Bottom line: Use a protein powder that you’ll actually take on a daily basis (using a blend of powders or rotating them improves compliance for some dieters).
1. (tie) Soluble and insoluble fiber powder 10 to 15 grams of each a day
Fiber can help with appetite suppression, weight loss, blood sugar control, and cholesterol reduction. It also appears to temporarily increase metabolic signals in the body so that metabolism increases for several hours. There have been at least 14 human studies done with a type of soluble fiber called glucomannan, which expands in the stomach, keeping you full. Subjects taking between 3,000 to 4,000 milligrams a day (in capsules) for 4 to 16 weeks lost up to 10 pounds or more. Still, it’s expensive and we need more objective research.
Psyllium, another soluble fiber, has shown similar results in terms of heart health (not weight loss) at 10 to 15 grams per day. Psyllium and glucomannan (both are available in powder form), when combined with bran or other insoluble fiber products, such as bars or cereals, can also help you achieve that daily goal of 20 to 30 grams of fiber. (While soluble fiber comes in powder form, you’ll usually find insoluble fiber in foods and bars, not supplements.) Its heart-healthy benefits and potential to aid weight loss combined with its flexibility (powders, bars, etc.) make fiber a must-do for anyone who’s trying to drop pounds. It also helps counteract the constipation that a high-protein diet can cause.
2. Alpha-lipoic acid (ALA) 800 to 1,800 milligrams a day in divided doses, ideally 30 minutes before each major meal
This compound may activate a metabolic master on-off switch—known as 5’- AMP-activated protein kinase, or AMPK— according to research, which means it may speed up metabolism. (The diabetes drug metformin, which can also cause weight loss, may do this as well.) In some small trials, it helped patients taking prescription medications that cause weight gain (such as antipsychotic drugs) lose weight; a study of more than 1,100 people taking 800 milligrams of an ALA supplement called Liponax daily for 4 months resulted in appetite suppression, weight loss (8 to 9 percent), and waist reduction (6 to 11 centimeters). It also led to blood pressure reductions of up to eight points systolic and six points diastolic.
One large clinical trial of ALA (the most impressive supplement weight loss study I have ever seen designed and published) included people with diabetes and without who were overweight or obese. The 360 subjects took either a placebo, 1,200 milligrams of ALA, or 1,800 milligrams of ALA (in three divided daily doses) for 5 months.
After 20 weeks there was a 2 to 3 percent change in body weight on average in the high-dose ALA group and a 2- to 3-centimeter reduction in waist circumference. People taking the 1,200-milligram dose saw greater weight loss than a placebo, but there wasn’t a statistical difference. More than 20 percent of the individuals in the 1,800-milligram group lost 5 percent or more of their weight compared to 10 percent of the people taking the placebo (which shows you how strong the placebo effect is in a good clinical trial).
So, the impact of ALA on weight was excellent for a dietary supplement. It was equally impressive that approximately one-third of the participants had diabetes, another third had high cholesterol, and another third had hypertension.
In other words, this trial included men and women who were having a tough time losing weight and needed to make it a priority. Studies like this one are never seen in the supplement world, only the drug world. Of the thousands of weight loss supplements out there, there has never been a study done this well—or with results that were better than the placebo— with so many diverse individuals, which is why it was accepted into a major medical journal (the American Journal of Medicine).
Participants were also given 4 weeks prior to the start of the trial (this is called a run-in phase and is a critical part of any good study) to reduce total caloric intake by 600 calories per day (they ate a minimum of 1,200 calories daily so they couldn’t cheat and lose weight by severely restricting calories). This close monitoring of dietary changes throughout a study needs to be seen more often in weight loss research, especially considering that after a month or two, people usually start cheating. Keeping close track of the dietary changes helps keep the study groups equal so the true effects of the supplement can be seen.
Overall, side effects were similar to a placebo except that more individuals in the ALA groups complained of an itching sensation (13 cases compared to three in the placebo group). The itching did not lead to dropouts and was not predictive of who would lose weight. ALA can also cause a harmless urine smell similar to what many people experience after eating asparagus, and it can lower blood sugar too much in very rare circumstances.
ALA is one of the most exciting supplements for weight loss because it is heart healthy, has a long track record of safety in other areas of medicine, and appears to help men and women get their metabolisms going, along with diet and exercise. In fact, this is arguably the only supplement I have ever endorsed for weight loss apart from fiber and protein. Companies usually avoid recruiting subjects for studies who have diabetes or who are taking medications that promote weight gain because it’s very difficult to get good results!
5-HTP is an intermediate metabolite in the conversion of L-tryptophan to serotonin, which basically means taking it leads to more serotonin production. Increasing serotonin levels may result in fewer cravings, especially for sugar. Drugs that increase serotonin or impact its receptors are well known to cause appetite suppression, as exemplified by the drug lorcaserin, which is FDA approved for weight loss.
There were three interesting studies of weight loss with 5-HTP. In one clinical trial, obese individuals who took 300 milligrams three times daily for 12 weeks saw significantly reduced calorie intake (more than with a placebo) and a 50 percent reduction in carbohydrate intake. I would take it with meals, but more is not better. Start low and don’t exceed the dosage recommended above because too much can cause nightmares or vivid dreams, drowsiness, dizziness, nausea, and diarrhea (serotonin impacts the intestines and brain).
Most important, 5-HTP should not be combined with any other medications that also impact serotonin levels, such as antidepressants, without talking with your doctor. Because it’s a precursor to serotonin, I believe it can increase the risk of serotonin syndrome (a serious side effect of excessive serotonin production that can lead to hospitalization) and can possibly deplete other neurotransmitters.
4. Kidney bean extract
Kidney bean extract is touted as a carbohydrate blocker because it deactivates an enzyme in the gut (amylase) that digests carbohydrates, preventing their absorption, if you take it before starchy meals (bread, pasta, pizza).
Studies have shown 5 to 10 pounds of weight loss with doses of 455 to 3,000 milligrams daily. The supplement forces people to be more aware of carb intake, but it can backfire by providing a false sense of security; some people who take it eat more carbs and gain weight (I’ve seen it happen, folks). I’m not aware of any safety issues, so give it a try for 3 months.
5. MCT oil
MCT oil (a mix of coconut and palm kernel oils, which are medium-chain triglycerides), in combination with a ketogenic (70 to 90 percent fat) diet, can cause significant weight loss in overweight and obese kids and adults. I’m a big fan of it, but compliance is a huge problem. (See the Epilepsy section.)
What Supplements Are Useless For Weight Loss?
Apple cider vinegar
Taking several teaspoons of this in a glass or two of water suppresses your appetite by upsetting your stomach (you just don’t feel like eating afterward). But studies have shown little to no weight loss.
You can find this in many ephedra-free weight loss supplements. Derived from the unripe dried fruit and fruit peel of Citrus aurantium, it usually contains a small percentage (1 to 6 percent) of the compound synephrine, which may increase heart rate and blood pressure, especially when taken with other stimulants. In other words, it’s not worth the risk!
Caffeine boosts blood levels of epinephrine, a hormone that increases metabolic rate and helps burn fat. However, in clinical studies, caffeine pills have not worked better than a placebo, and they often increase heart rate and blood pressure. Other herbs with caffeine in them include coffee bean extract, kola nut, yerba mate, and guarana, and these aren’t helpful for weight loss either.
The active ingredient in chile peppers, capsaicin may slightly increase metabolism, but results with this supplement have translated to minimal or no weight loss. Eating real chile peppers makes more sense because it forces you to drink more water, which has the ability to make you feel slightly more full.
This mineral can potentially help regulate insulin or increase insulin sensitivity, especially in people with diabetes. Studies have also looked at chromium’s ability to increase metabolism, but so far they have shown only a minor benefit or none at all. I’m more excited about combining this supplement with other compounds, such as biotin, to improve the overall health of diabetics (see the Diabetes and Prediabetes section).
Conjugated linoleic acid
This is a big seller, but there has always been the question of whether this product raises cholesterol (it is partially a trans fat) or C-reactive protein (an inf lammatory marker) or other markers of heart disease, which is not a good thing.
It’s naturally found in meat and milk (from cows, goats, and sheep) and may prevent fat formation. One yearlong study found an average weight loss of 4 pounds with 3 grams of conjugated linoleic acid (CLA) daily, but there have been just as many studies showing that CLA does not work any better than a placebo.
Exotic fruit–based products (acai, African mango, lychee)
Some people think that exotic fruits work as weight loss aids because they’re found in areas that have a low obesity rate. But, no surprise here, neither acai nor lychee has any credible studies. African mango contains high amounts of soluble fiber, and in one impressive study there was significant weight and waist loss with it, but the problem is that until another study can repeat these results (and without funding by investors in the product), I remain skeptical.
“Fat” appetite suppressant shots
The thinking here is that taking a small dose of fat (monounsaturated, polyunsatu-rated, or saturated) sends a signal to the brain that helps control appetite. These shots (like the kind you order in a bar), which are often a combination of oat and palm oil, may have some small benefit and most likely work in a somewhat similar way to fish oil or plant oil pills.
But couldn’t you just take a teaspoon or two of canola, olive, coconut, or safflower oil? Or how about peanut butter? Sorry to burst any bubbles, but during the time this book was being put together, one of the best studies of oat and palm oil was published, and it did not beat the placebo!
Small amounts (1,000 to 2,000 milligrams a day) of the active ingredients EPA and DHA have been touted for weight loss (they may increase satiety by a small amount), but recent human studies have not supported a consistent or impressive impact on pounds. Some studies suggest just eating fish (it’s also high in protein) might be a better option.
Green tea pills
These contain EGCG, an antioxidant found in high amounts in a variety of teas, which increases metabolism and stimulates fat burning. However, many of the studies used an average of 520 milligrams of EGCG along with 100 milligrams or more of caffeine but saw only a minor (1 pound on average), if any, impact. Concentrated caffeine in this amount can increase anxiety, nervousness, stress, insomnia, and high blood pressure. An 8-ounce cup of brewed green tea contains 200 milligrams of EGCG and 45 milligrams of caffeine, and I would just stick with that!
This compound, which is similar to glucose, is derived from a plant that grows wild in India and Africa. It goes to the same taste buds on the tongue that sugar does, and it’s supposed to be able to reduce cravings for or the taste of sweets, as if you received a sugar fix. However, study results have been inconsistent, so it’s not worth it at this time.
hCG (human chorionic gonadotropin)
This is a popular liquid dietary supplement for appetite suppression that people usually take when they’re on very low-calorie diets (500 calories or less). However, hCG has not really worked better than a placebo in clinical trials. Some patients end up paying thousands of dollars and lose weight long term simply due to caloric restriction. In other words, it’s the extremely low-calorie diet that’s leading to the weight loss, not the hCG.
Hunters used to eat this South African plant to suppress appetite on long trips in the Kalahari Desert. Despite considerable investment in the product, it has not lived up to expectations, and in clinical studies it caused side effects— such as headaches, dizziness, nausea, vomiting, fatigue, gas, and even blood pressure increases— and there was no weight loss. Pass!
Hydroxycitric acid (HCA)
This compound is the active ingredient in many weight loss supplements (it’s currently being promoted on TV as the principal ingredient in Garcinia cambogia, a weight loss product). It supposedly blocks an enzyme that turns excess carbohydrates into fat and may also increase brain levels of serotonin. Yet, in well-done research studies it’s been a dud, which has also been my experience with it. And recently there has been the potential for serious toxicity when combined with other serotonin-enhancing drugs, such as antidepressants.
This is just a proprietary seed extract of the African mango, also known as IGOB131, which is supposed to suppress appetite and improve metabolism via multiple unproven pathways. It had great early research, but since then the methodology has been questioned, and I do not believe its ability to create weight loss is much better than a placebo. (I hope I’m wrong.)
This amino acid has been advertised as a replacement for glucose for brain fuel. Instead of giving in to your sugar craving, you take this. But these claims are based on animal studies, and human studies have not found it to be effective for weight loss. It’s also touted on the Internet as a sugar substitute that can reduce cravings for it. In reality, when you cut out most of the sugar in your diet for a long period of time, sugar cravings are reduced anyway. In other words, the benefit is not caused by the supplement but by the behavior that takes place around the supplement.
DHEA and 7-Keto-DHEA
DHEA (dehydroepiandrosterone) can be converted into male and female hormones in the human body and potentially stimulate the metabolism. Currently, there’s a lot of hype about 7-Keto-DHEA, which supposedly stimulates the metabolism without altering hormones, but good studies just aren’t there. Plus, there is some hint that 7-Keto may increase thyroid function a bit, and if this is the case, it could raise heart rate and blood pressure in the short term and lead to thyroid abnormalities (increased or decreased thyroid hormone) in the long term. I would just love to see a really good study done with 7-Keto, but I’ve worked with both of these products for more than a decade and they just don’t get me excited for weight loss. I hope someone proves me wrong!
This is one of the major aromatic compounds in raspberries (it’s a chemical that gives the fruit its scent), and it’s commonly used as a fragrance in cosmetics and as a flavoring agent in food products. It has never really had a good published study, but since it resembles capsaicin in structure somewhat, researchers theorize it may crank up metabolism the way capsaicin does, although it hasn’t been shown to be beneficial for weight loss either. I smell a rat—or a mouse—because only mouse studies have shown a potential benefit.
This dietary supplement (resveratrol is a compound found in red wine) is supposed to have antiaging effects and help you lose weight, but in some of the better recent studies with men and women, subjects haven’t seen weight loss or heart-healthy changes. Pharmaceutical companies have tried to make some magic out of this compound for a variety of conditions, but there has been no magic happening yet.
This is a pricey blend of flavorless, scented starch crystals that you sprinkle on food. It’s supposed to enhance the smell of food and trigger a feeling of fullness in the brain. The company-sponsored studies have not been published or peer reviewed at the time of my writing this, and a large number of subjects who started the study did not finish it. I don’t think Sensa makes any sense, and you shouldn’t spend your cents (get it) on it.
When you lose weight, vitamin D levels in the blood increase naturally because it gets released from the fatty tissue that you’re burning. But the vitamin itself doesn’t help with weight loss.
What Supplements Are Suitable For Kids to Lose Weight?
If your child has a large amount of weight to lose, please talk to a medical professional. Just be careful; you don’t want to create a sense of pill dependence (drug or supplement) at such a young age, unless it’s really necessary.
What Lifestyle Changes Can Help With Weight Loss?
Eat heart healthy
Low carb, low fat, vegan, paleo, Weight Watchers, Jenny Craig, gluten free—as long as it’s heart healthy (lowers blood pressure, blood sugar, cholesterol, heart rate, weight, or waist size) and mentally healthy, then I support it. That’s the Moyad rule on dieting.
Limit liquid calories
Alcohol, sugary sodas, fruit juices, and smoothies all contain calories, and there’s evidence that your body doesn’t recognize liquid calories in the same way it does solid calories. So you may not register the same sense of fullness even though you’ve downed a similar number of calories. Reducing or eliminating these drinks is one of the easiest ways to lose weight. That’s why almost every diet program tells you to cut out alcohol, soda, and fruit juices first!
My favorite saying about exercise and weight loss comes from my daughter: “Abs are made in the kitchen, not on the treadmill.” Research has clearly demonstrated that you do not need to exercise to lose weight or waist size! Diet trumps exercise. (I feel a however coming on . . .)
However, the reason exercise—both cardio and strength training—makes sense for 99.9 percent of people who want to drop pounds is that it improves mood, heart health, and metabolism and prevents muscle loss. It can help you keep the weight off.
Have you ever heard of HIIT (high-intensity interval training)? The concept is simple. You alternate between doing harder, more intense exercise followed by easier “recovery” bouts (often it’s 30 seconds to 2 minutes of hard work followed by an equal or longer amount of rest, repeated several times). And you can do it in as little as 20 to 30 minutes, versus 45 minutes of low- to moderate- intensity exercise.
Research shows that it improves fitness levels as well as longer exercise bouts do, and it may even target fat better. A recent study also suggested that HIIT doesn’t make you hungry the way moderate exercise might. You shouldn’t do it every day (it’s challenging), but a couple of times a week in addition to other workouts can make a difference in weight and body composition (the amount of fat and muscle that you have). Even beginners can do it because the harder intensities are relative to fitness level; you run or bike at a level that’s tough for you, not your neighbor.
Make small changes
Try to cut back by 100 to 200 calories a day—that’s one roll at dinner—so you don’t feel like you’re depriving yourself and you take weight off gradually, which is easier to maintain. I’m a firm believer that you need to pick a way of eating that works with your personality because you want to be able to stick with it long term.
Most people get half of the recommended 25 to 30 grams of fiber daily. Eating 1⁄3 to 1⁄2 cup of All-Bran, Fiber One, or other cereals (13 to 15 grams) and some flaxseed or chia seeds in the morning is an easy way to get your daily dose without having to run to the bathroom.
Look for products with mostly insoluble fiber plus some soluble fiber, including fruits, veggies, beans, seeds, some cereals, oatmeal, and some bars. Most protein and fiber bars are worthless because they have either too few calories and fiber or too many calories and too much cheap soluble fiber, which can cause gas and bloating. Plus, they don’t do much for weight loss.
Check your meds
Numerous prescription drugs can increase the risk of weight gain, including antidepressants, hormonal agents, beta-blockers, and steroids. I’m not saying to take yourself off them; just talk with a trusted doctor about your options.