of evidence of efficacy makes their use inadvisable
since there is no reason to accept any risk.
Some products claim to increase the body’s ther-
mogenesis. According to these claims, the body will
burn more calories in the resting state, leading to
increased weight loss. At one time, thyroid hormone
was prescribed for this purpose, but because of the
very high risks associated with thyroid, this use has
been discontinued. Comparable claims have been
made forgreen teaextract, but the weight loss benefits
of these products are not clear. In one study, patients
taking green tea had greater weight loss than the sub-
jects in the control group, but on careful review, it was
found that patients in the active group were exercising
more than patients taking placebo.Homeopathic remedies have been offered as
weight loss products. Homeopathy itself is controver-
sial at best, and there have been no reputable studies
indicating that homeopathic remedies have any value
in weight reduction.
Starch blockers are products which inhibit the
digestion of starch, and so reduce its caloric value.
This, in theory, should lead to reduced effective calorie
intake, however the value of these products has not
been demonstrated. Because these products are made
from bean husks, there has been an ongoing dispute in
the courts. The manufacturers argue that their prod-
ucts are animal feed, and not subject to regulation as
drugs, while the FDA has argued that the intended use
of the starch blockers is as a drug, and should be
subject to regulation. The courts have been divided
on how these products should be defined.Precautions
Because of the lack of standardization and high
frequency of adulteration in some products marketed
as herbal or natural weight loss remedies, people
choosing to buy products of this type should deal
only with a known and reputable supplier.
No weight loss product has demonstrated the ability
to induce weight loss without diet, exercise, and behav-
ioral modification. Although orlistat has been approved
for long-term use, this is defined as up to two years, and
in controlled studies, patients taking the drug showed
increases in weight during the second year.Aftercare
Weight-loss drugs are used as short-term adjuncts
to programs of diet, exercise, and behavioral changes,
such as portion control, that are intended to maintain
lifetime weight goals. These behaviors must be contin-
ued after the drugs are discontinued.Parental concerns
Weight-loss drugs are not normally indicated for
children under the age of 16. Children should not use
these drugs without proper medical supervision.Resources
BOOKS
Reynolds, J E ed.The Extra Pharmacopoeia, 30th edition.
London: The Pharmaceutical Press.
PERIODICALS
Birketvedt, GS, M. Shimshi, T. Erling, and J. Florholmen.
‘‘Experiences with three different fiber supplements
in weight reduction.’’Medical Science Monitor.
11 (January 2005)PI5–8.KEY TERMS
Anorexiant—A drug that causes loss of appetite
Caloric—Relating to heat or calories, also, full of
calories, and so likely to be fattening.
Dopamine—A neurotransmitter and precursor of
norepinephrine; found in high concentrations in
the brain.
Fiber—Nutrients in the diet which are not digested
by enzymes. Insoluable fiber travels through the
digestive tract and has a laxative effect.
Glucomannan—A plant substance composed of
long chains of the sugars glucose and mannose. It
is not digested, and may be ised as a laxative. The
material has been claimed to provide a feeling of
abdominal and intestinal fullness.
Hemorrhagic—Relating to escape of blood from
the vessels. Bleeding.
Homeopathic—Relating to homeopathy, a system
of treating diseases by giving people very small
doses of natural substances which, in healthy peo-
ple, cause the same symptoms as the disease being
treated.
Norepinephrine—A hormone that constricts blood
vessels.
Stroke—The sudden death of brain cells when the
blood supply is disrupted either through blockage
or bleeding.
Thermogenic—Producing heat. Relating to diet
drugs the term is used to indicate a drug which
causes increased use of calories without exercise.Diet drugs