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Obesity



Related Terms
  • Adolescent obesity, bariatric surgery, BMI, body mass index, body weight, childhood obesity, diet, endocrine disease, exercise, gastric bypass, liposuction, metabolism, morbid obesity, morbidly obese, obesity in the elderly, overeating, super obesity.

Background
  • Obesity occurs when an individual has an increased amount of body fat. It is usually defined as being 20-30% above the normal body weight for someone of the same age, gender, and height.
  • Morbid obesity is usually defined as being 50-100% above the normal body weight for someone of the same age, gender, and height.
  • Many factors, including an individual's age, gender, and height, are considered to determine if he/she is overweight. People increase in weight until they are fully grown. On average, females tend to gain about 16 pounds of body weight from age 25-54. In contrast, males tend to gain about 10 pounds of body weight from age 25-45. By around age 55, both men and women start to decline in weight. Females naturally have more body fat and less muscles mass than men. It is also normal for taller individuals to weigh more than shorter individuals.
  • Obesity is typically considered a long-term condition that often persists for many years. Researchers believe that many factors, including poor diet, overeating, pregnancy, medications, medical conditions, genetics, gender, and age, may contribute to a person becoming obese.
  • Obesity can have serious long-term effects on health. Individuals who are overweight have an increased risk of developing many life-threatening illnesses including heart disease, high blood pressure, stroke, obesity, diabetes, osteoporosis, and cancer. According to the American Heart Association, obesity was associated with nearly 112,000 deaths in 2005.
  • In the United States, obesity is considered an epidemic. More than half of all Americans are considered overweight, and about 20% of children are overweight. In 2005, 140 million Americans were considered overweight or obese, according to the American Heart Association. Nearly 33% of Americans are considered obese, and these numbers continue to grow.

Complications
  • Depression: Individuals who are obese often suffer from depression. This may occur if the patient's weight limits his/her ability to perform certain activities. Depression may also occur if the patient has poor self-esteem as a result of his/her weight.
  • Heart disease: Obese individuals have an increased risk of developing high blood pressure. This is because the extra fat tissue, like other tissues in the body, requires oxygen from the blood. Therefore, the circulatory system is strained and the heart rate increases as it tries to supply a larger-than-normal body with enough oxygenated blood.
  • In addition, obesity tends to increase the amount of insulin in the blood. High levels of insulin cause the body to retain sodium and water, which increases blood volume.
  • Individuals who are overweight also have an increased risk of developing high cholesterol. High cholesterol can cause plaque deposits to form in the arteries. Plaque is composed of cholesterol, other fatty substances, fibrous tissue, and calcium. When plaque builds up in the arteries, it causes atherosclerosis (hardening of the arteries) or coronary artery disease (CAD). Atherosclerosis can lead to plaque ruptures and blockages in the arteries. If the blood supply to the heart is blocked, a heart attack may occur. If blood supply to the brain is blocked, a stroke may occur.
  • Sleep apnea: Obese patients have an increased risk of developing sleep apnea, a serious condition that occurs when the individual stops breathing for short periods of time during sleep. In obese patients, sleep apnea typically occurs when excess fat in the upper airway obstructs breathing. Because sleep apnea causes individuals to wake up frequently throughout the night, patients are often drowsy during the day.
  • Diabetes: Obese patients are more likely to develop type 2 diabetes. This condition occurs when the body becomes resistant to a hormone called insulin. As a result, patients with type 2 diabetes have too much sugar in their bloodstream.
  • Cancer: Many types of cancer, including colon cancer, rectal colon, esophageal cancer, kidney cancer, breast cancer, and prostate cancer, are associated with being overweight.
  • Physical discomfort: Obese patients may suffer from chronic pain in various parts of the body. This is because fat eventually starts to crowd the space near the internal organs, impairs blood circulation, and puts extra strain and pressure on the body's joints. Sometimes the fat in the abdomen prevents patients from sitting comfortably. Pain is most likely to develop in the feet, joints, back, and muscles. It may be difficult for obese patients to breathe when they are sitting up.
  • Fertility problems and sexual dysfunction: Men and women who are obese may suffer from fertility problems. In general, being obese decreases an individual's sex drive (libido). It may also make it be difficult for males to achieve or maintain an erection.
  • In addition, several studies have found that obesity may decrease an individual's sexual quality of life. Researchers have found that obesity is associated with a lack of enjoyment of sexual activity, lack of sexual desire, difficulties with sexual performance, and avoidance of sexual encounters. Many studies have also found that obese patients who lose weight experience an increase in their sexual quality of life.
  • Birth defects: Obese females have an increased risk of having children with gestational diabetes or other complications during pregnancy that may lead to birth defects.
  • Osteoarthritis: Obese individuals are more likely to develop a degenerative joint disease called osteoarthritis. This is because being overweight increases the strain put on the weight-bearing joints, such as the knees and ankles.
  • Osteoporosis: Obese individuals have an increased risk of developing osteoporosis, which causes the bones to become weak and brittle. The bones become porous and less dense. As a result, individuals are more likely to fracture their bones if they slip, fall, or injure themselves. Some evidence suggests that osteoporosis may develop in obese patients because fat cells infiltrate the bone marrow. In addition, it has been shown that individuals who live sedentary lifestyles have an increased risk of developing osteoporosis.

Integrative therapies
  • Note: Although some integrative therapies have been shown to promote weight loss, not all treatments are safe. Most experts believe that overweight or obese individuals should aim to lose weight gradually with long-term lifestyle changes that include a healthy diet and regular exercise.
  • Strong scientific evidence:
  • Ephedra: Ephedra contains the chemical ephedrine, which appears to cause weight loss when used in combination with caffeine, based on the available scientific evidence. The results of research on ephedrine alone (without caffeine) are unclear. The amounts of ephedrine in commercially available products have widely varied.
  • However, even though this herb has been shown to help reduce weight, it is unsafe for humans for this indication. Serious reactions, including heart attack, stroke, seizure, and death, have occurred with using ephedra. The U.S. Food and Drug Administration (FDA) has banned sales of ephedra dietary supplements in all states.
  • Good scientific evidence:
  • 5-HTP: 5-HTP is the precursor for serotonin. Serotonin is the brain chemical associated with sleep, mood, movement, feeding, and nervousness. 5-HTP may alter serotonin levels in the brain, which may then reduce eating behaviors and promote weight loss in obese individuals.
  • Avoid if allergic to 5-HTP. Use cautiously with a history of psychological disorders. Avoid if pregnant or breastfeeding.
  • The Atkins Diet: The Atkins Diet® is an eating style that radically departs from the U.S. Food and Drug Administration's (FDA) food pyramid. The Atkins Diet® advocates an increased consumption of fats as the primary source of energy while simultaneously restricting the intake of carbohydrates. This limitation is based on the premise that eating carbohydrates (e.g. bread, cereal, potatoes, or pasta) results in the excessive secretion of insulin, potentially resulting in increased fat stores. A carbohydrate-restricted diet has been shown to result in weight loss in obese and non-obese individuals. Effects at one year may be less and dropout rates are high. Overall the studies suggest that the Atkins Diet® does result in long-term weight loss. However, patients should consult with a qualified healthcare professional before beginning any new diet to discuss possible adverse effects and negative health consequences.
  • Avoid with severe kidney disease or kidney disorders. Avoid if taking growth hormone. Use cautiously with mood disorders (e.g. depression), schizophrenia, or bipolar disorders, or if taking medications to treat these disorders. Use cautiously in athletes due to potential for muscle cramps, negative feelings towards exercise, fatigue, or hypoglycemia. Use cautiously with osteoporosis, gout, diabetes, menstrual disorders, gastrointestinal disorders, celiac disease, skin conditions, epilepsy, heart disease, anemia, thyroid disorders, or history of stroke or heart attack. Use cautiously in malnourished individuals, vegetarians, or in individuals with absorption concerns. Use cautiously if taking diuretics, medications that alter cholesterol, medications that alter blood sugar, medications for seizures, steroids, or nonsteroidal anti-inflammatory drugs (NSAIDs). Avoid if pregnant or breastfeeding.
  • DHEA: DHEA (dehydroepiandrosterone) is a hormone that is produced by the adrenal glands. Most human studies investigating the effects of DHEA on weight or fat loss support its use for this purpose.
  • Avoid if allergic to DHEA. Avoid with a history of seizures. Use cautiously with adrenal or thyroid disorders. Use cautiously if taking anticoagulants, or drugs, herbs, or supplements that treat diabetes, heart disease, seizure, or stroke. Stop use two weeks before and immediately after surgery/dental/diagnostic procedures with bleeding risks. Avoid if pregnant or breastfeeding.
  • Psychotherapy: Psychotherapy is an interactive process between a person and a qualified mental health professional. The patient explores thoughts, feelings, and behaviors to help with problem solving. Several studies indicate that people who are overweight or obese may benefit from behavioral and cognitive-behavioral psychotherapy in combination with diet and exercise to lose weight.
  • Psychotherapy cannot always fix mental or emotional conditions. Psychiatric drugs are sometimes needed. In some cases, symptoms may worsen if the proper medication is not taken. Not all therapists are qualified to work with all problems. Use cautiously with serious mental illnesses or some medical conditions because some forms of psychotherapy may stir up strong emotional feelings and expression.
  • Unclear or conflicting scientific evidence:
  • Acupuncture: Acupuncture is commonly used throughout the world. According to Chinese medicine theory, the human body contains a network of energy pathways through which vital energy, called "chi," circulates. These pathways contain specific "points" that function like gates, allowing chi to flow through the body. Needles are inserted into these points to regulate the flow of chi. Studies have produced inconclusive evidence on whether acupuncture might contribute to weight loss. Some studies show modest benefit but others show none. Currently, there is insufficient available evidence to recommend either for or against acupuncture in weight loss.
  • Needles must be sterile in order to avoid disease transmission. Avoid with valvular heart disease, infections, bleeding disorders, medical conditions of unknown origin, or neurological disorders. Avoid on areas that have received radiation therapy and during pregnancy. Avoid if taking anticoagulants. Use cautiously with pulmonary disease (e.g. asthma or emphysema). Use cautiously in elderly or medically compromised patients, diabetics, or with a history of seizures. Avoid electroacupuncture with arrhythmia (irregular heartbeat) or in patients with pacemakers.
  • Ayurveda: Ayurveda is a form of natural medicine that originated in ancient India more than 5,000 years ago. Evidence is inconclusive on whether the traditional herb guggulu (Medohar) may contribute to weight loss in obese patients. More studies are needed to examine this treatment.
  • Ayurvedic herbs should be used cautiously because they are potent, and some constituents can be potentially toxic if taken in large amounts or for a long time. Some herbs imported from India have been reported to contain high levels of toxic metals. Ayurvedic herbs can interact with other herbs, foods, and drugs. A qualified healthcare professional should be consulted before taking. Use guggul cautiously with peptic ulcer disease. Avoid sour food, alcohol, and heavy exercise with guggul. Mahayograj guggul should not be taken for long periods of time. Avoid Ayurveda with traumatic injuries, acute pain, advanced disease stages, or medical conditions that require surgery.
  • Betaine anhydrous: Betaine is found in most microorganisms, plants, and marine animals. There is currently insufficient available evidence supporting betaine for weight loss.
  • Avoid if allergic to betaine anhydrous or cocamidopropylbetaine, a form of betaine. Use cautiously with kidney disease, obesity, or psychiatric conditions. Avoid if pregnant or breastfeeding.
  • Bitter orange: Bitter orange (Citrus aurantium) comes from a flowering, fruit-bearing evergreen tree native to tropical Asia. It is now widely grown in the Mediterranean region and elsewhere. Bitter orange is a common ingredient in dietary supplements as a weight loss aid and appetite suppressant. Since the ban on ephedra, some weight loss products previously containing ephedrine have been reformulated to include bitter orange. Although bitter orange is popularly used for weight loss, the effects of bitter orange are largely unknown, and more study is needed to make a strong recommendation.
  • Avoid if allergic or hypersensitive to bitter orange or any members of the Rutaceae family. Avoid with heart disease, narrow-angel glaucoma, intestinal colic, or long QT interval syndrome. Avoid if taking anti-adrenergic agents, beta-blockers, QT-interval prolonging drugs, monoamine oxidase inhibitors (MAOIs), stimulants, or honey. Use cautiously with headache, overactive thyroid, or if fair-skinned. Avoid if pregnant or breastfeeding.
  • Calcium: Calcium is the most abundant mineral in the human body. Calcium is needed for muscle contraction, blood vessel contraction and expansion, the release of hormones and enzymes, and nervous system signaling. Diets with higher calcium density (high levels of calcium per total calories) have been associated with a reduced incidence of being overweight or obese in several studies. While more research is needed to understand the relationships between calcium intake and body fat, these findings emphasize the importance of maintaining an adequate calcium intake while attempting to diet or lose weight.
  • Avoid if allergic or hypersensitive to calcium or lactose. High doses taken by mouth may cause kidney stones. Avoid with high levels of calcium in the blood, high levels of calcium in urine, high levels of parathyroid hormone, bone tumors, digitalis toxicity, ventricular fibrillation (ventricles of the heart contract in unsynchronized rhythm), kidney stones, kidney disease, or sarcoidosis. Use cautiously with achlorhydria (absence of hydrochloric acid in gastric juices) or arrhythmia (irregular heartbeat). Calcium appears to be safe in pregnant or breastfeeding women. Talk to a healthcare provider to determine appropriate dosing during pregnancy and breastfeeding. Calcium supplements made from dolomite, oyster shells, or bone meal may contain unacceptable levels of lead.
  • Damiana: Damiana, which includes the aromatic species Turnera diffusa and Turnera aphrodisiaca,grows wild in the subtropical regions of the Americas and Africa. "YGD," containing yerbe mate (leaves of Ilex paraguayenis), guarana (seeds of Paullinia cupana), and damiana (leaves of Turnera diffusa var. aphrodisiaca), is an herbal preparation frequently used for weight loss. More studies using damiana alone are needed before a recommendation can be made.
  • Avoid if allergic/hypersensitive to Turnera diffusa, Turnera aphrodisiaca, their constituents, or related plants in the Turneraceae family. Use cautiously with a history of breast cancer. Avoid with Alzheimer's disease or Parkinson's disease. Use cautiously with psychiatric disorders. Use cautiously if taking medications that alter blood sugar levels.
  • Evening primrose: Evening primrose oil contains an omega-6 essential fatty acid called gamma-linolenic acid (GLA), believed to be the active ingredient. Initial human study suggests that evening primrose oil may have no effects on weight loss.
  • Avoid if allergic to plants in the Onagraceae family (e.g. willow's herb or enchanter's nightshade), or gamma-linolenic acid. Avoid with seizure disorders. Use cautiously if taking mental illness drugs. Stop use two weeks before surgery with anesthesia. Avoid if pregnant or breastfeeding.
  • Garcinia: Garcinia cambogia is an extremely small purple fruit that is naturally found in India and Southeast Asia. Evidence supporting hydroxycitric acid, the active ingredient in Garcinia cambogia, for weight loss is mixed. Additional study is warranted to clarify early findings.
  • Avoid if allergic or hypersensitive to Garcinia cambogia. Use cautiously with a history of diabetes, rhabdomyolysis (breakdown of skeletal muscle), or with HMG-CoA reductase inhibitors ("statins"). Avoid with Alzheimer's disease. Avoid if pregnant or breastfeeding.
  • Green tea: Green tea is made from the dried leaves of Camellia sinensis, an evergreen shrub. Green tea has a long history of use, dating back about 5,000 years ago in China. There are several small human studies addressing the use of green tea extract (GTE) capsules for weight loss or weight maintenance in overweight or average weight individuals. Study results are mixed. Better research is needed before a recommendation can be made in this area.
  • Avoid if allergic or hypersensitive to caffeine or tannin. Use cautiously with diabetes or liver disease.
  • Guarana: Guarana is a native species of South America and has stimulating properties when taken orally. Guarana has the same stimulatory effect as caffeine and is often used for energy, weight loss, and as an additive to soft drinks (e.g. Dark Dog Lemon®, Guts®, and Josta®). Caffeine has been used as a weight loss agent due to its ability to burn calories by increasing heat output. In available studies, guarana has been studied with other herbs, making it difficult to draw a conclusion based on the effects of guarana alone. Additional study is needed in this area.
  • Avoid if allergic to guarana (Paullinia cupana), caffeine, tannins, or related species of the Sapindaceae family. Avoid with high blood pressure, psychological or psychiatric disorders, liver disorders, or irregular heartbeat. Avoid if taking other stimulatory agents, especially ephedra. Use cautiously with breast disease, impaired kidney function, diabetes, pre-existing mitral valve prolapse, iron deficiency, gastric or duodenal ulcers, bleeding disorders, glaucoma, or if at risk for osteoporosis. Use cautiously if undergoing electroconvulsive therapy (ECT). Avoid if pregnant or breastfeeding.
  • Guggul: Guggul (gum guggul) is a resin produced by the mukul mirth tree. There is insufficient evidence to support the use of guggul or guggul derivatives for the management of obesity.
  • Avoid if allergic to guggul. Avoid with a history of thyroid disorders, anorexia, bulimia, or bleeding disorders. Avoid if pregnant or breastfeeding.
  • Hypnosis, hypnotherapy: Hypnosis is a trance-like state in which a person becomes more aware and is more open to suggestion. Hypnotherapy has been used to treat health conditions or to change behaviors. Research suggests that hypnosis may be valuable as an adjunct to cognitive behavioral therapy for weight loss. However, it is unclear if hypnotherapy used alone is beneficial in this area.
  • Use cautiously with mental illnesses (e.g. psychosis/schizophrenia, bipolar disorder, multiple personality disorder, or dissociative disorders) or seizure disorders.
  • L-carnitine: L-carnitine is an amino acid. Early evidence shows that L-carnitine may have no effect on weight loss in obese patients. Further studies are needed before a firm conclusion can be made.
  • Avoid if allergic or hypersensitivity to carnitine. Use cautiously with peripheral vascular disease, high blood pressure, alcohol-induced liver cirrhosis, or diabetes. Use cautiously in low birth weight infants and individuals on hemodialysis. Use cautiously if taking anticoagulants (blood thinners), beta-blockers, or calcium channel blockers. Avoid if pregnant or breastfeeding.
  • Licorice: Licorice is harvested from the root and dried rhizomes of the low-growing shrub Glycyrrhiza glabra. Preliminary data show that licorice may reduce body fat mass. Further research is needed to confirm these results.
  • Avoid if allergic to licorice, any component of licorice, or any member of the Fabaceae (Leguminosae) plant family. Avoid licorice with congestive heart failure, coronary heart disease, kidney disease, liver disease, fluid retention, high blood pressure, hormonal abnormalities, or if taking diuretics. Licorice can cause abnormally low testosterone levels in men or high prolactin or estrogen levels in women. This may make it difficult to become pregnant and may cause menstrual abnormalities.
  • Lutein: Lutein and zeaxanthin are found in high levels in foods such as green vegetables, egg yolk, kiwi fruit, grapes, orange juice, zucchini, squash, and corn. Currently, there is insufficient available evidence to recommend for or against the use of lutein for obesity.
  • Avoid if allergic or hypersensitive to lutein or zeaxanthin. Use cautiously if at risk for heart disease or cancer. Avoid if pregnant or breastfeeding.
  • Macrobiotic diet: Macrobiotics is a popular approach to diet that stresses vegetarianism and consumption of whole, healthy foods. Proponents of macrobiotics advocate a flexible approach that allows supplementation with dairy, fish, or other supplements as needed on an individual basis. There is evidence that a macrobiotic diet may lead to reduced body size and obesity, as well as increased leanness in preschool children compared to children on a normal diet. Studies are needed to determine whether or not these changes contribute to good health in children.
  • The macrobiotic diet poses a risk of nutrition deficiencies. However, this can be avoided with appropriate menu planning. Use cautiously with cancer or other medical conditions without expert planning or supplementation. Not recommended in children or adolescents without professional guidance or appropriate supplementation. Not recommended in pregnant or lactating women due to potential deficiencies, unless properly supplemented.
  • Moxibustion: Moxibustion is a therapeutic method in traditional Chinese medicine, classical (five element) acupuncture, and Japanese acupuncture. During moxibustion, an herb (usually mugwort) is burned above the skin or on the acupuncture points for the purpose of introducing heat into an acupuncture point to alleviate symptoms. It may be applied in the form of a cone, stick, or loose herb; or it may be placed on the head of an acupuncture needle to manipulate the temperature gradient of the needle. Evidence does not support use of moxibustion to aid in weight loss at this time, although it may contribute to increased psychological well-being and improved eating attitudes in obese patients. More studies are needed to determine whether or not moxibustion may play a role in weight loss.
  • Use cautiously over large blood vessels and on thin or weak skin. Avoid with aneurysms, any kind of "heat syndrome," heart disease, convulsions, cramps, diabetic neuropathy, extreme fatigue, anemia, fever, or inflammatory conditions. Avoid over allergic skin conditions, ulcerated sores, skin adhesions, areas of inflammation, or over contraindicated acupuncture points. Avoid use on the face, genitals, head, nipples, or skin adhesions. Avoid in patients who have just finished exercising or taking a hot bath or shower. Use cautiously in elderly people with large vessels. Not advisable to bathe or shower for up to 24 hours after a moxibustion treatment. Avoid if pregnant or breastfeeding.
  • Psyllium: Psyllium, also known as ispaghula, comes from the husks of the seeds of Plantago ovata. The reviewed evidence seems to show that psyllium may improve blood sugar and lipid levels, which has been associated with obesity in some children. However, further studies are needed to clarify its effects and the mechanisms involved. Body weight reduction has not been proven to be associated with psyllium use in adults.
  • Avoid if allergic or hypersensitive to psyllium, ispaghula, or English plantain (Plantago lanceolata). Prescription drugs should be taken one hour before or two hours after psyllium. Use cautiously if pregnant or breastfeeding because psyllium may lower blood sugar levels.
  • Rhubarb: In traditional Chinese medicine (TCM), rhubarb is used as an ulcer remedy, and it is considered a bitter, cold, dry herb used to "clear heat" from the liver, stomach, and blood. One three-stage study looked at the effects of rhubarb on simple obesity. Although the study indicates a positive effect compared to two other obesity treatments and a control group, more high-quality studies are needed to confirm rhubarb's role in weight gain and loss.
  • Avoid if allergic to rhubarb, its constituents, or related plants from the Polygonaceae family. Avoid using rhubarb for more than two weeks. Avoid with atony, colitis, Crohn's disease, dehydration electrolyte depletion, diarrhea, hemorrhoids, insufficient liver function, intestinal obstruction, ileus, irritable bowel syndrome (IBS), menstruation, pre-eclampsia, kidney disorders, ulcerative colitis, or urinary problems. Avoid handling rhubarb leaves, as it may cause contact dermatitis. Avoid rhubarb in children younger than age 12 due to water depletion. Use cautiously with bleeding disorders, heart conditions, constipation, thin or brittle bones, or with a history of kidney stones. Use cautiously if taking anti-psychotic drugs, anticoagulants, or oral drugs, herbs, or supplements (including calcium, iron, and zinc). Avoid if pregnant or breastfeeding.
  • Seaweed, kelp, bladderwrack: Bladderwrack (Fucus vesiculosus) is a brown seaweed found along the northern coasts of the Atlantic and Pacific oceans and North and Baltic seas. There is not enough scientific evidence to determine if bladderwrack can help obese patients lose weight. Further research is warranted in this area.
  • Avoid if allergic or hypersensitive to Fucus vesiculosus or iodine. Avoid with a history of thyroid disease, bleeding, acne, kidney disease, blood clots, nerve disorders, high blood pressure, stroke, or diabetes. Avoid if pregnant or breastfeeding.
  • Soy: Due to limited human study, there is not enough evidence to recommend for or against the use of soy for weight reduction. Further research is needed before a recommendation can be made.
  • In theory, soy supplements may interfere with the effects of some chemotherapy regimens or radiation therapy because of its antioxidant properties. Use cautiously if taking anticoagulants. The use of soy is often discouraged in patients with hormone-sensitive cancer (e.g. such as breast, ovarian, or uterine cancer) due to concerns about possible estrogen-like effects, which may theoretically stimulate tumor growth.
  • Spirulina: The term spirulina refers to a large number of cyanobacteria, or blue-green algae. Spirulina is a popular therapy for weight loss, and it is sometimes marketed as a "vitamin enriched" appetite suppressant. However, little scientific information is available on the effects of spirulina on weight loss in humans.
  • Avoid if allergic or hypersensitive to spirulina or blue-green algae. Avoid with phenylketonuria. Avoid if pregnant or breastfeeding.
  • Taurine: Currently, there is insufficient available evidence to recommend for or against the use of taurine in the treatment of obesity.
  • Taurine is an amino acid and it is unlikely that there are allergies related to this constituent. However, allergies may occur from multi-ingredient products that contain taurine. Use cautiously with high VLDL cholesterol, hypertriglyceridemia, or with a history of low blood pressure, coagulation disorders, potential for mania, or epilepsy. Use cautiously if taking hypolipidemic medications or hypotensive, hypoglycemic, anti-platelet, or anticoagulant medications. Avoid consumption of energy drinks containing taurine, caffeine, glucuronolactone, B vitamins, and other ingredients before consuming alcohol or exercising. Use cautiously if pregnant or breastfeeding. Taurine is a natural component of breast milk.
  • Vitamin A (retinol): Vitamin A is a fat-soluble vitamin that is derived from two sources: retinoids and carotenoids. Retinoids are found in animal sources (e.g. livers, kidneys, eggs, and dairy products). Carotenoids are found in plants (e.g. dark or yellow vegetables). Daily vitamin A with calcium has been suggested for weight loss. In one study, an average loss of two pounds was reported after two years of supplementation in young women. However, further research is needed before a firm conclusion can be made in this area.
  • Avoid if allergic or hypersensitive to vitamin A. Vitamin A toxicity can occur if taken at high dosages. Use cautiously with liver disease or alcoholism. Smokers who consume alcohol and beta-carotene may be at an increased risk for lung cancer or heart disease. Vitamin A appears safe in pregnant women if taken at recommended doses. Use cautiously if breastfeeding because the benefits or dangers to nursing infants are not clearly established.
  • Yoga: Yoga is an ancient system of relaxation, exercise, and healing with origins in Indian philosophy. Yoga has been described as "the union of mind, body, and spirit," which addresses physical, mental, intellectual, emotional, and spiritual dimensions towards an overall harmonious state of being. Preliminary research does not provide clear answers. Yoga, in addition to healthy eating habits, may reduce weight. Better studies are necessary to form conclusions about the potential benefits of yoga alone.
  • Yoga is generally considered to be safe in healthy individuals when practiced appropriately. Avoid some inverted poses with disc disease of the spine, fragile or atherosclerotic neck arteries, extremely high or low blood pressure, glaucoma, detachment of the retina, ear problems, severe osteoporosis, cervical spondylitis, or if at risk for blood clots. Certain yoga breathing techniques should be avoided in people with heart or lung disease. Use cautiously with a history of psychotic disorders. Yoga techniques are believed to be safe during pregnancy and breastfeeding when practiced under the guidance of expert instruction. However, poses that put pressure on the uterus, such as abdominal twists, should be avoided in pregnancy.
  • Traditional or theoretical uses lacking sufficient evidence:
  • Gymnema: While preliminary research reports that gymnema may be beneficial in patients with type 1 or type 2 diabetes, there is currently no available clinical evidence with use of gymnema for obesity, a purported traditional or theoretical use. High quality human research is needed in this area to further understand gymnema's potential use for obesity.
  • Hoodia: Hoodia (Hoodia gordonii) has purportedly been used and recently marketed as an appetite suppressant and weight reduction aid. Secondary sources note that the Bushmen of the Kalahari have eaten it to help ward off hunger and thirst during long trips in the desert.
  • Unlike ephedra, hoodia does not appear to work as a stimulant, but rather it acts as an appetite suppressant. The pharmaceutical company, Phytopharm, has found hoodia promising and is currently attempting to isolate the appetite-suppressing molecule, P57, to create a patented diet drug in the future. P57 was at one time licensed to Pfizer for development, but was discontinued in 2003.
  • There are currently no available reliable human trials demonstrating efficacy and safety of hoodia for any indication. Additional research is needed in this area before a clinical recommendation can be made.
  • Fair negative scientific evidence:
  • Acupressure, shiatsu: During acupressure, finger pressure is applied to specific acupoints on the body. Preliminary evidence suggests that acupressure may not be effective for weight loss.
  • With proper training, acupressure appears to be safe if self-administered or administered by an experienced therapist. No serious long-term complications have been reported, according to scientific data. Hand nerve injury and herpes zoster ("shingles") cases have been reported after shiatsu massage. Forceful acupressure may cause bruising.
  • Beta-glucan: Beta-glucan is a fiber derived that comes from the cell walls of algae, bacteria, fungi, yeast, and plants. Researchers suggest different types of fiber may have an effect on satiety and energy intake. Short-term use of fermentable fiber or nonfermentable fiber supplements does not appear to promote weight loss. More study is needed to confirm these findings.
  • Avoid if allergic or hypersensitive to beta-glucan. When taken by mouth, beta-glucans are generally considered safe. Use cautiously with AIDS or AIDS-related complex (ARC). Avoid using particulate insoluble beta-glucan, as preliminary evidence suggests intravenous beta-glucans in the microparticulate form may cause serious side effects including hepatosplenomegaly (enlargement of both the liver and the spleen). Avoid if pregnant or breastfeeding.

Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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