Over –The- Counter Weight Loss Supplements: What Works What Doesn’t?

By Tammy Zoeller, RCPhT

There are many over-the –counter products available for weight loss, in today’s market.

Caffeine is one of the largest selling weight loss medications. It is in most all weight loss preparations, and most all energy drinks. Caffeine is a stimulant; it is thought to cause weight loss by boosting metabolism to cause weight loss. Caffeine actually has a

diuretic effect that causes loss of water and therefore creates a weight loss. The weight lost from caffeine intake is actually water weight and not fats. Caffeine elevates the stress hormone cortisol, increases heart rate, blood pressure and causes the body to increase its energy stores, when this happens the body craves sweets. Caffeine stimulates the appetite by causing hypoglycemia (low blood sugar) which increases appetite and cravings. Caffeine interferes with the gamma-amino butyric acid, (GABA) in the brain, this is considered to be our “feel good messenger to the brain. Lack of GABA causes emotional eating due to stressful situations, this causes weight gain and not weight loss.

Herbal medications make up a very large amount of the products that are available for weight loss. There are several different preparations that are used for weight loss.

L-Carnatine is often used to aid in weight loss. L-Carnatine is a naturally occurring amino acid, it plays a vital role in the metabolism of fat. It is a transporter of fatty acids into the mitochondria, the powerhouse of the cell. L- Carnatine is found in red meat, dairy products avocados and tempeh. Studies show that we get adequate amounts of L-Carnatine in our foods and that supplement is not really needed. If there is a deficiency in the body of L-Carnatine once it is corrected the majority is excreted, so in this case more is not better.

Chromium picolonate is another popular herbal remedy used for weight loss; it is used to increase the effects of insulin secreted to cause breakdown of carbohydrates faster. Chromium picolonate is said to “burn fat.” Studies have not proven that taking chromium picolonate actually aids in weight loss.

Chitosan is another herbal remedy used for weight loss. Chitosan is made from a starch found in the skeleton of shellfish such as shrimp and crab, called chitin. Chistosan passes through the intestines without being absorbed and binds with fatty foods to rid them from the body so that is not absorbed. Studies have failed to prove that the use of Chitosan for weight loss has any more benefit in weight loss than using a placebo.

St. John’sWort is also commonly used for weight loss. It is actually marketed as an herbal antidepressant. St. John’s Wort is a very dangerous medication to take due to interactions with several other medications such as heart medications, blood thinners, cough medications containing dextromethorphan, and birth control pills, ssri’s, and it even interacts with foods such as aged cheeses, cured or aged meats and wines that contain tyramine. Individuals taking prescription medications for depression such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline need to stay away from St. Johns Wort completely because of serotonin syndrome. Serotonin syndrome is when your body accumulates too much serotonin. When you have too much serotonin in your body it can cause diarrhea, and severe symptoms such as muscle rigidity and even seizures. Stop taking the medication such asSt John’s Wort immediately if you experience serotonin syndrome symptoms. Serotonin syndrome will go away within a day of stopping the medication that is causing the problem.

The only FDA approved medication over-the counter for weight loss is Alli, (Orlistat). Alli has been involved in more than 100 clinical studies involving more than 300,000 patients to establish safety. Alli attaches to the natural enzymes in the digestive system that break down fat, therefore preventing about 1/4 of the fat that you eat from being broken down. If the fat is not broken down it can not be absorbed so your body will pass the fat quickly. If you eat fatty foods you may experience and urgency to pass fatty stool. When used as directed with diet changes and support from Alli’s program, including a registered dietician, to assist you in making the right choices and eating habits Alli will enhance your weight loss. Alli is to be used in conjunction with a low fat, reduced calorie diet for maximum weight loss.

Diet and exercise are the best ways to lose weight. Weight loss is a lifestyle choice and requires a total change in habits, food choices and portion control. Medication sometimes is good for a boost in metabolism to get you started but never a good idea for long term use. Contact your physician before you start any weight loss program.

Tammy Zoeller, RCPhT, has 20 years pharmacy experience  and is Currently enrolled in Nursing school. She can be reached at Valu Market Pharmacy 502-231-2424.  


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