How to Choose a diet pill or supplement for weight loss

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By Dr. Jennifer Kerns
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Choose a diet pill or supplement for weight loss

Losing weight is tough, and people occasionally turn to a diet pill or fat-burning supplement to help them in their efforts. Which ones actually work? Which ones are safe? And how do you know which one is best for YOU?

Difficulty: Moderate

Instructions

Step 1

How do you choose a diet pill? How do you know whether a diet pill or supplement is effective, safe, and right for you? There are several FDA-approved medications available, such as over-the-counter Alli (generic name orlistat), sibutramine, and phentermine (marketed under the trade names Fastin or Ionamin). There are also a plethora of "natural" supplements being marketed on the internet and TV infomercials, such as hoodia, acai berry, green tea extract, chromium, bitter orange, chitosan, and ephedra. Because these supplements do not claim to be a medication, they are not regulated by the FDA (and therefore safety studies are not required before they are sold to the public). They also don't have to be proven to be effective, and advertisers often pray on people's desperation to lose weight to take your money. A great example is acai berry, which has been widely promoted on the internet by people claiming that Dr. Mehmet Oz (on the Oprah Winfrey Show) recommends it. While Dr. Oz did say that the acai berry, like many other foods high in antioxidants, is probably a healthful food, he did NOT promote it for weight loss. In fact, according to ABC news, Oprah's lawyers are pursuing any company claiming that she or Dr. Oz promoted their product.
Step 2

If you are simply trying to lose 5 or 10 pounds, I highly recommend turning to calorie restriction and increased energy expenditure through exercise as your sole form of weight loss. Taking ANY supplement/pill, whether "all-natural" or regulated by the FDA, is bound to cost a lot of money and have side effects that we might not even know about yet. Think of ephedra, which worked wonderfully -- until we found that women were dying of hemorrhagic strokes because of it; or Fen-Phen, which seemed like a miracle drug until all of the heart damage was discovered... people died from these supplements/pills before they were removed from the market. ANY supplement can have side effects, so you should only consider taking one if your health is truly at risk from overweight/obesity (meaning your BMI is higher than 30, and/or you have obesity-related diseases such as type 2 diabetes), and you have already seriously tried to lose weight with diet/exercise and failed.
Step 3

Regarding "natural" supplements available over-the-counter, such as hoodia, acai berry, bitter orange, etc.: there is no scientific or medical evidence that ANY of these actually cause weight loss. That's not to say that they definitely *won't* work, and there is certainly something to be said for the placebo effect -- if you truly believe something will help you, it just might. The mind is a truly powerful thing. But no physician with any degree of concern for his/her patients could justify recommending that you take something that has not been studied and proven to at least be safe. Think long and hard before you subject your body to a substance that could potentially harm you (and this includes FDA-approved medications!).
Step 4

If you are ready to commit to a lifestyle change including diet and exercise and would like to boost your weight loss with a medication, there are a few options:
- Alli (orlistat) is a medication available over-the-counter (or by prescription as Xeni cal) that works by preventing your body from absorbing some of the fat you eat (and thereby reducing the calories you absorb). This can lead to loose, oily bowel movements and gas if you eat too much fat in your diet, and you might lose some of the fat-soluble vitamins (D, E, A, and K) along with it. But that's probably about the worst that will happen if you take Alli. The weight loss is modest, however: after an entire year of taking orlistat, only about 3-6 pounds more than the weight you would lose with diet/exercise alone.
- Phentermine is available only by prescription, and works by causing your body to release norepinephrine (one of the adrenaline-like "fight or flight" hormones) and thereby decreases appetite. It can cause physical and psychological dependence and is only to be used short-term (up to about 3 months); it can also raise heart rate and blood pressure and interact with some medications, though it usually well-tolerated.
- Sibutramine (trade name Meri dia) is also available only by prescription. It is an appetite-suppressant that works in a way similar to phentermine, by increasing the amount of norepinephrine and serotonin in the brain (by limiting reuptake). There have been some concerns about safety (including reports of heart failure, kidney problems, and even sudden death), but the FDA has not felt that evidence was strong enough to remove it from the market.