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Over-the-counter weight-loss pills: Do they work?
The temptation to use over-the-counter weight-loss pills to lose weight fast is strong. But are these products safe and effective?
By Mayo Clinic staffThe appeal of losing weight quickly is hard to resist. But do weight-loss pills and products lighten anything but your wallet? And are they a safe option for weight loss? Here's a look at some over-the-counter weight-loss pills and what they will and won't do for you.
Over-the-counter (OTC) weight-loss pills: What you need to know
A number of weight-loss pills are available at your local drugstore, supermarket or health food store. Even more options are available online. Most haven't been proved effective, and some may be downright dangerous.
How can companies sell potentially unsafe products? Dietary supplements and weight-loss aids aren't subject to the same rigorous standards as are prescription drugs. Thus, they can be sold with limited proof of effectiveness or safety. Once a product is on the market, however, the Food and Drug Administration (FDA) monitors its safety and can take action to ban or recall dangerous products.
For this reason, it's important to do your homework if you're thinking about trying weight-loss pills. Read labels and talk with your doctor or pharmacist. Also check the FDA Web site for alerts about safety concerns and product recalls. The table shows common weight-loss pills and what the research shows about their effectiveness and safety.
| Product | Claim | Effectiveness | Safety |
|---|---|---|---|
| Alli — OTC version of prescription drug orlistat (Xenical) | Decreases absorption of dietary fat | Effective; weight-loss amounts typically less for OTC versus prescription | FDA investigating reports of liver injury |
| Bitter orange | Increases calories burned | Insufficient reliable evidence to rate | Possibly unsafe |
| Chitosan | Blocks absorption of dietary fat | Insufficient reliable evidence to rate | Possibly safe |
| Chromium | Increases calories burned, decreases appetite and builds muscle | Insufficient reliable evidence to rate | Likely safe |
| Conjugated linoleic acid (CLA) | Reduces body fat and builds muscle | Possibly effective | Possibly safe |
| Country mallow (heartleaf) | Decreases appetite and increases calories burned | Insufficient reliable evidence to rate | Likely unsafe and banned by FDA |
| Ephedra | Decreases appetite | Possibly effective | Likely unsafe and banned by FDA |
| Green tea extract | Increases calorie and fat metabolism and decreases appetite | Insufficient reliable evidence to rate | Possibly safe |
| Guar gum | Blocks absorption of dietary fat and increases feeling of fullness | Possibly ineffective | Likely safe |
| Hoodia | Decreases appetite | Insufficient reliable evidence to rate | Insufficient information |
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- Frequently asked questions. Alli. http://www.myalli.com/faq.aspx. Accessed Jan. 26, 2010.
- Wyatt HR, et al. Over the counter Orlistat: What will your patients want to know? Obesity Management. 2007;3:204.
- Schwarts SM, et al. Compliance, behavior change, and weight loss with orlistat in an over-the-counter setting. Obesity. 2008;16:623.
- Early communication about an ongoing safety review - Orlistat (marketed as Alli and Xenical). U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm179166.htm. Accessed Jan. 26, 2010.
- Bitter orange. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 26, 2010.
- Chitosan. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 26, 2010.
- Chromium. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 26, 2010.
- Conjugated linoleic acid (CLA). Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 26, 2010.
- Country mallow. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 26, 2010.
- Ephedra. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 26, 2010.
- Green tea extract. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 26, 2010.
- Guar gum. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 26, 2010.
- Hoodia. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 26, 2010.
- Bray GA, et al. Drug therapy of obesity. http://www.uptodate.com/home/index.html. Accessed Jan. 19, 2010.
- Natural medicines in the clinical management of obesity. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 22, 2010.
- Saper RB, et al. Common dietary supplements for weight loss. American Family Physician. 2004;70:1731.
- Dietary supplement current good manufacturing practices (CGMPs) and interim final rule (IFR) facts. U.S. Food and Drug Administration. http://www.fda.gov/Food/DietarySupplements/GuidanceComplianceRegulatoryInformation/RegulationsLaws/ucm110858.htm. Accessed Jan. 19, 2010.
- MedWatch: The FDA Safety Information and Adverse Event Reporting Program. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/default.htm. Accessed Jan. 22, 2010.
- FDA expands warning to consumers about tainted weight loss pills. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116998.htm. Accessed Jan. 20, 2010.
- Hensrud DD (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 26, 2010.
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