by David McCormick, M.D., and Lisa McCormick

"Rapid weight loss—guaranteed!"

"Burn fat while you sleep!"

"Speed up your metabolism—naturally."

The Federal Trade Commission says promises like these convince American dieters to spend over $30 billion a year on products and programs that supposedly help you lose weight. But do they really work? Are they safe? Or are they just a ruse to get your money?

These are questions I often hear from my overweight patients in my family- medicine practice. And they usually don’t like the answers I give them. They want to believe there’s a magic pill or supplement that will permanently shed their excess pounds. Unfortunately, the FTC and other governmental and medical agencies say all you’ll lose with “quick-and-easy” weight-loss products is your money.

And many of these so-called miracle products have potentially harmful ingredients, such as ephedra and caffeine (which may be listed under a variety of names, including guarana, kola nut, maté and paullinia cupana). At high doses, these stimulants can cause high blood pressure, rapid heart rates and possibly even worse effects.

 In fact, in 2004, the Food and Drug Administration banned the sale of dietary supplements containing ephedra, saying the product posed an unreasonable health risk, potentially causing cardiovascular problems and even death.

However, in 2005, a judge partially overturned the ban, ruling that products containing 10 milligrams or less of ephedra could be sold, at least until the FDA could prove that low doses like these posed a health risk. So you can still find ephedra on the shelves, often under alternate names, such as Ma huang, epitonin, sida cordifolia and sinica.

Many patients ask me about the new “ephedra-free” products. I warn them to be wary of these, too. They often contain stimulants like bitter orange (also listed as green orange and neroli oil) and green-tea extract.

It’s important to remember that weight-loss supplements aren’t regulated or labeled like medications. They may not contain what their labels claim, and you may not know about possible serious side effects or interactions with medicines or other dietary supplements.

A good bet for weight-loss success is to talk to your doctor. You might be a candidate for a prescription weight-loss drug. These medications, unlike herbs and so-called miracle diets supplements, have FDA approval to assist in weight loss. They’ve undergone scientific testing. And they can only be given by a doctor, who will monitor your results and watch for any side effects.

A doctor can also determine if there’s a medical reason for your weight problem— like hypothyroidism, a condition in which your thyroid gland, which helps control metabolism, is sluggish. A simple blood test will reveal this problem. And the usual treatment is easy— one pill a day that replaces the thyroid hormone you’re missing.

No Pills; Just Results

Consider the success two of my patients achieved by eating less and exercising more:

"Raoul" is a 26 -yea r-old who weighed more than 400 pounds. I first saw him in 2002. We discussed the use of prescription weight-loss medicines like Meridia and Xenical. He wanted to try diet and exercise. He restricted himself to 1,500 calories a day and started walking 15 minutes a day. He worked up to 20 minutes and then started jogging. He now runs two miles daily and has also started lifting weights every other day. “It was hard the first three weeks,” he told me. “But after it became a habit it was much easier to continue.” In the past three years, Raoul has dropped 185 pounds. He now weighs 233 pounds and continues to follow a sensible diet and exercise regularly.

"Jimmy " is a 6 4 -yea r-old who weighed more than 300 pounds. He came to see me in 2003 to discuss various weight-loss options. On his own, he restricted his diet to 1,000 calories a day. (That’s actually lower than I would recommend.) He also started running. “At first I could only go about 100 feet,” he said. “I alternated between running and walking and gradually increased my distance.” In the past 18 months, he has lost 97 pounds. He now runs eight miles, four days a week. Last year, he finished the 26.2-mile Walt Disney World Marathon in five-and-one-half hours.

Quick Tips

Following is some advice I give my overweight patients who want to lose weight safely and keep it off:

1. Don’t fall for product s that promise quick-and-easy weight loss.
2. Lose your bad eating habits and unhealthy lifestyles, including:

• Skipping breakfast. That’s truly the most important meal of the day. A healthy, well-balanced breakfast will keep you full and stop you from snacking too much.
• Eating just one big meal a day. If you skip meals, you can put your body into starvation mode, in which it stores energy in the form of fat. That means you might gain weight instead. It’s healthier to eat five or six small meals through the day.
• Not keeping track of what you eat. When my patients do keep track, they’re surprised to see they often consume as many as 1,500 calories in one meal. One of the most interesting culprits is the salad bar. Lettuce is low in calories, but lettuce topped with cheese, croutons and salad dressing is calorie-rich. Two tablespoons of ranch dressing, for example, has about 140 calories.
• Not exercising. Take the stairs instead of the elevator. Ride your bike. Go for a walk. The importance of exercise also increases as you age. It keeps your bones strong and slows the onset of osteoporosis. Your metabolism also slows as your age, meaning you have to exercise more and eat less to maintain your current weight.
• Trying to lose several pounds in a week. If you do, much of that will be water weight, and it will come right back. Your goal should be to drop 1 pound a week. According to the Mayo Clinic, cutting 250 calories from your daily diet will help you lose about half a pound a week.
• No t eat ing a va riet y o f foods. Your diet should include whole grains, fruits, vegetables, dairy products, meats and beans. The key is to eat in moderation.

To change your lifestyle, work with your doctor to develop a long-term weight-loss and exercise plan. You won’t see results overnight, but if you stick to the plan, you should lose weight safely and permanently. That’s one claim I can guarantee.

About the Authors:  David McCormick, M.D., is a boardcertified family doctor with the Gashland Clinic in Kansas City, Mo., and a member of the National Council Against Health Fraud. Lisa McCormick, his wife, is an award-winning investigative reporter and former television producer whose specialties are consumer fraud and economic crime.

Last updated and/or approved: April 2008.
Original article appeared in spring 2006 issue. (Author bios current as of spring 2006.)

 

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