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WEIGHT LOSS SUPPLEMENTS

Copyright: Kent Sasse MD, MPH, FACS

With medical weight loss, as well as with commercial weight loss programs, a significant emphasis is placed on weight loss supplements.  But what is the best weight loss supplement? 

There are different theories as to what the weight loss supplement is meant to accomplish.  First, a weight loss supplement might serve as an appetite suppressant, so it is given in addition to, or as a supplement to, the regular food you are eating.  Examples of this might be herbal remedies, ephedrine-containing products and caffeine-containing products.  These supplements act more like drugs in that we hope they cause some appetite suppression by a chemical means in the brain. Prescription weight-loss drugs would also fall into this category and include drugs like phentermine and sibutramine. Another drug, Orlistat, and its lower-dose, over-the-counter equivalent called Alli, impairs the break-down of fats in the digestive tract and reduces the body’s absorption of fats.

A second type of weight loss supplement might aim for creating fullness or satiety by actually making our stomachs more full.  Examples of this would be supplements that consist mostly of fiber and are meant to be taken in addition to, or right before, the regular meals. The idea is that our stomach will become fuller and we could experience satisfaction eating fewer calories.  Stretch receptors in the stomach detect distention of the stomach wall and signal to our brains that we are full. So a weight-loss supplement that expands like fiber does with water can create some sense of fullness while adding little to no calories to our daily intake.

A recent concept for weight loss supplements that is increasingly employed in medically supervised weight-loss programs is the use of a weight loss supplement as a replacement for, and not, in addition to, a regular meal.  Many of the most effective weight loss strategies involve the use of meal replacement shakes and bars to very rigorously control the calorie intake and the nutritional composition over a period of time.  The result of completely replacing the regular foods and snacks we would otherwise consume is a clearer psychological demarcation of a specialized program with very specialized food intake. For many people, it is actually easier to completely forsake regular food and replace every meal with a shake or bar supplement, rather than try to simply reduce portions of the routine meals and items in the daily diet. Physicians specializing in medical weight loss find this type of program very effective in establishing successful weight loss. This success occurs because patients have greater success sticking with this tightly defined eating regimen, and because the weight loss supplements employed result in significant appetite suppression and the creation of a calorie deficit that melts away pounds.

Yet another type of weight loss supplement stems from the idea that we need to change our eating habits so that we consume regular, small meals that preferably consist of a significant protein component, as well as vitamins and trace minerals.  With more frequent, smaller meals and snacks throughout the day, something must then take the place of the large sit-down meal. Under this concept, the most common weight loss supplement would be a snack, usually consisting of a protein-based bar that might have 150 to 230 calories. Consuming this type of weight loss supplement in-between meals often will prevent a person from seeking a less healthy snack that is higher in calories and higher in carbohydrates.  Furthermore, the supplements that do contain a higher proportion of protein allow us to have the building blocks for creating lean body mass or muscle mass.  And lean body mass is what we strive to build, while we burn the fat mass that makes us unhealthy.

One important thing about the goal of losing weight is that there is, overall, less of a need to truly “supplement” nutrients than there would be for a body builder, for example, who is seeking to add pounds and therefore needs to supplement the nutritional intake with added calories.  The main goal of weight loss supplements is to help us reduce the overall daily calorie consumption and shed pounds. If we can reduce our overall calories consumption to a level that is less than the total calories we burn with daily activity, then we have created a calories deficit, and our bodies will burn fat stores to find the energy needed for daily activities.

Some day modern science may bring us the “ideal weight loss supplement”.  What would that consist of?  In theory, the ideal weight loss supplement would suppress our appetite and remove the hunger we feel, helping us limit snacks and treats and unnecessary calories, and control our normal portions so that we do not eat excess calories at mealtime either.  This supplement might also provide us the nutrients, vitamins and trace minerals that we are missing from our routine diet.  It would help us develop lean body mass and prevent the surges of circulating blood sugar and hormones insulin and leptin that stimulate more appetite and more growth of fat.  Will such a supplement ever be available?

Some day, perhaps, but until that day arrives, we are left with a dizzying array of weight loss supplements from which to choose. Medical weight loss experts recommend using weight loss supplements in the context of an overall weight loss strategy that involves exercise and changes in eating habits over time. Meal replacements serve as an effective and clear substitute for routine and high-calorie meals. Protein bars serve as a good mid-afternoon snack, especially if they prevent us from finding other treats that would add more calories and carbohydrates to our daily intake. And lastly, prescribed medications such as phentermine serve as effective weight loss supplements for a person seeking to lose weight under a doctor’s care.

 

About the Author: Kent Sasse MD, MPH, FACS is the medical director of the Western Bariatric Institute and iMetabolic: Medical Weight Loss Clinic.  He is a highly experienced and accomplished bariatric surgeon, author, expert and featured speaker nationally in the field of weight reduction, bariatric medicine and surgery.

References:
Cost-effectiveness of pharmacological anti-obesity treatments: a systematic review. Neovius M, Narbro K. Int J Obes (Lond). 2008 Dec;32(12):1752-63. Epub 2008 Nov 4. PMID: 18982009
Long-term weight loss and weight-loss maintenance strategies. Rössner S, Hammarstrand M, Hemmingsson E, Neovius M, Johansson K. Obes Rev. 2008 Nov;9(6):624-30. Epub 2008 Sep 1. PMID: 18764886
The effectiveness of popular, non-prescription weight loss supplements. Egger G, Cameron-Smith D, Stanton R. Med J Aust. 1999 Dec 6-20;171(11-12):604-8. Review.  PMID: 10721343

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