The Dangers of Herbal Weight Loss Products

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The Dangers of Herbal Weight Loss Products

We’ve all seen the ads for “natural” products that can help you lose weight fast or help suppress appetite. But, do any of these really work? It’s a real gamble because there are no standards for these products; the manufacturer doesn’t have to prove that the product is safe or effective or even that the product contains the ingredients listed on the label.

In 1994, Congress passed the Dietary Supplement and Education Act (DSHEA), which relegated herbal agents to the category of “dietary supplements.” In effect, this removed these products from the purview of the Food and Drug Administration (FDA). Currently there are no standard requirements that herbal products be either safe or effective. In addition, no government agency inspects the manufacture or degree of purity or accuracy of contents of these products. Thus, there is no way to know how much of the ingredients listed are really present in any sample. As a result, herbal products are a completely unregulated source of potentially dangerous products readily available to anyone who wants to lose weight.

A recent review demonstrated how widespread use of these agents is in the general population. Between 1990 and 1997, use of herbal therapies increased by 380%, and in 1997 alone consumers spent $5.5 billion on herbal therapies. Further complicating this issue is that 60% of patients do not tell their physicians that they are using herbal products.

Advertising for these agents is also ubiquitous. Magazines, newspapers, TV, and health food stores, grocery stores, and pharmacy outlets are prominent sources that extol the advantages of these preparations. In addition, direct consumer mailings, many targeting teenage girls, encourage patients with eating disorders to read fantastic claims for these agents and how to acquire them. The Internet has exploded with an abundance of claims for various herbal preparations.

To help remedy this problem, Congress recently created the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH), Bethesda, MD. Currently researchers are studying some herbs that have been helpful for some persons, including St. John’s Wort (used for depression), gingko biloba (energy and memory), saw palmetto (prostate health), and glucosamine/chondroitin (bones and joints).

Several herbal products of particular interest for persons with eating disorders are found in products that claim to aid weight loss, as well as appetite suppressants and laxatives.

Herbs for Weight Loss

So far the only herbs that have shown any promise as weight-loss drugs are ephedrine and caffeine. These are marketed as a combination of ephedrine and caffeine or as the herbal sources, which include the drug ma huang (ephedrine) and a source of caffeine such as guarana seed or kola nut. The big problem is that the botanical sources may contain too much or too little of either ingredient; there is no way to know since there are no standards for this.

However, even if they result in slight weight loss, there are substantial risks. The recent ephedra-related deaths of professional baseball player, Steve Belcher (see “Briefly” on page 16), and other amateur athletes, has brought the dangers of using ephedra for weight loss to the public eye.

Caffeine—What’s the Harm?

Caffeine, which is found in varying doses in beverages and medications, can cause insomnia, tremors, and acts as a diuretic. It is the most widely used “drug” in the world, thanks to tea and coffee lovers. By itself, caffeine isn’t harmful for most people. However, when caffeine is teamed with ephedrine, it can speed up the heart (tachycardia), and cases of heart attacks and stroke have been reported. Other side effects include acute hepatitis, headache, tremor, nervousness, and insomnia.

Ephedra (Ma Huang): One to Avoid

The Chinese have used ephedra for more than 5,000 years. An extract of this powerful herb is ephedrine, one of the most effective treatments known for asthma, allergies, and sinus problems. Ephedra is a central nervous system stimulator that can increase pulse rate and blood pressure. Other side-effects may include headache, nervousness, sleeplessness, anxiety, nausea, and urinary problems. Reputable manufacturers include warnings about this on the label.

One problem with ma huang is that many herbal manufacturers spike their ephedra-combining weight loss products with caffeine, usually by adding herbs such as guarana seed or kola nut. By itself caffeine can raise blood pressure and cause heart palpitations. When it is teamed with ephedra, the effects are magnified.

We strongly recommend that you not use ephedra-containing products.

Yohimbine: No Proven Benefits

Yohimbine is made from the bark of a West African evergreen tree and was originally used as an aphrodisiac and stimulant for warriors preparing for battle. Some appetite suppressants contain yohimbine. Promoters also claim that it helps decrease body fat. Potential side effects include anxiety, elevated blood pressure, a feeling of queasiness, insomnia, rapid heartbeat, tremors, and vomiting. The FDA has declared yohimbine unsafe and ineffective as an over-the-counter drug.

Laxatives: Dulling Down the GI Tract

First, and most importantly, laxatives do not really cause the loss of significant amounts of food or help in weight loss. They do cause dehydration and reflex fluid retention. Therefore, laxative use is an ineffective weight-control technique and can be dangerous.

A number of these herbs contain ingredients that act by irritating the lining of the intestines or by directly stimulating the nerves; over time and with overstimulation, the bowel becomes nonresponsive. Laxatives often contain stimulants such as bisacodyl, cascara sagrada, or senna. Bisacodyl can lead to stomach irritation, cramping, and loss of fluids and electrolytes. Cascara sagrada can cause severe vomiting, electrolyte imbalance, and loss of potassium, which can make certain diuretics more toxic. Finally, senna can cause abdominal cramps, nausea, increase mucus secretion, and eventually help lead to reduced bowel function.

What Can You Do?

If you buy herbs, how can you tell which have the highest quality and if they really contain the ingredients that the label claims? There are no guarantees that the ingredients listed will match the actual contents, so remember that contamination, mislabeling, and misidentification are possible and even likely from some manufacturers.

What To Do If You Have a Bad Reaction to a Herbal Product

If you become ill from taking an herbal remedy, call your doctor. You or your doctor should also report the problem to the FDA. Call 800-FDA-1088 (800-332-1088) or go to the FDA’s MedWatch Web site www.fda.gov/medwatch.

When you call, they will ask for certain information:

  1. Contact information for the person who became ill.
  2. Name and address of your doctor or hospital where you were treated.
  3. A description of the problem.
  4. The name of the herbal product and the store where you bought it.

It is also a good idea to contact the manufacturer or distributor listed on the product label, as well as the store where you bought the product; include the lot number listed on the bottle or box.

Resources

Finally, a little knowledge goes a long way—there are many resources available through your local library and the Internet. Some helpful Internet sites are:

www.herc.org/contrib/herbs.html
www.fda.gov/medwatch
www.MayoClinic.com

By Mary K. Stein, Managing Editor
Reprinted with permission from Eating Disorders Recovery Today
Spring 2003 Volume 1, Number 4
©2003 Gürze Books

About the Author

Mary K. Stein is Managing Editor of Eating Disorders Today and the clinical newsletter, Eating Disorders Review, which featured an article on this subject by James L. Roerig, PharmD, BCPP and James E. Mitchell, MD from the University of North Dakota, Fargo that was used as a primariy reference for this article.

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