Garcinia weight loss medication
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Garcinia Cambogia: Safe for Weight Loss?
In this Article
In this Article
In this Article
Garcinia cambogia, a tropical fruit also known as the Malabar tamarind, is a popular weight-loss supplement. People say it blocks your body's ability to make fat and it puts the brakes on your appetite. It could help keep blood sugar and cholesterol levels in check, too. You'll find it in bottles on the shelf at the store as well as mixed with other ingredients in diet products.
Does it live up to its hype? Maybe a little, but it might not be worth it.
How It Works
The active ingredient in the fruit's rind, hydroxycitric acid, or HCA, has boosted fat-burning and cut back appetite in studies. It appears to block an enzyme called citrate lyase, which your body uses to make fat. It also raises levels of the brain chemical serotonin, which may make you feel less hungry.
But actual weight loss results aren't impressive. A review published in the Journal of Obesityfound that people who took garcinia cambogia in studies lost about 2 pounds more than people who didn't take it. The reviewers couldn't say for sure that the weight loss was because of the supplement. It could have been from the lower-calorie diet and exercise programs the people in the studies typically followed. Better studies are needed to find out if HCA really helps people lose a lot of weight and keep it off.
Type 2 Diabetes and High Cholesterol
Garcinia cambogia may make it easier for your body to use glucose, the sugar your cells need for energy. Mice that got garcinia cambogia in one study had lower insulin levels than mice that didn't. That's another reason, besides weight loss, that people with diabetes are interested in it. However, if you're taking garcinia cambogia along with a medication to control your blood sugar, your glucose could get dangerously low.
Some research has found that garcinia cambogia can also improve cholesterol levels, lowering triglycerides and LDL (the "bad" cholesterol) and raising HDL (the "good" cholesterol). But you shouldn't use it if you're already on a prescription for your cholesterol.
Possible Side Effects
When you take garcinia cambogia, you might get:
In 2009, the Food and Drug Administration warned everyone to stop using a weight-loss product that contained garcinia cambogia because some people taking it got serious liver problems. The product had other ingredients, too, so it's not clear that garcinia cambogia was to blame. While some research suggests the supplement is safe for your liver, other research says no.
Garcinia cambogia may interact badly with:
You definitely don't want to use it when you're pregnant or nursing, or if you have kidney or liver problems. It is possible that manic symptoms may emerge as a side effect.
To Buy or Not to Buy
Since study results are mixed, you should talk with your doctor to help you decide if taking garcinia cambogia is a good idea. Even if it's safe, it may not help you lose much weight. It's probably wiser to spend your money on healthy food or an exercise DVD.
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Can Garcinia Cambogia Help with Weight Loss?
Is there such a thing as a weight loss miracle drug?
Today’s market is full of “miracle drugs” and supplements that claim to help you drop pounds fast.
Dietary fiber is thought to interfere with HCA, which could have inhibited weight loss in the HCA group.
It’s no wonder they fly off the shelves and into medicine cabinets across the country. TV personality Dr. Oz and others like him have showered praise on one of these products in particular: the controversial garcinia cambogia fruit.
Garcinia cambogia is a citrus fruit that grows in Southeast Asia. An extract from the fruit’s rind, hydroxycitric acid (HCA), has historically been used for cooking, but it has also been used for weight loss. You can buy garcinia cambogia online or at most health and supplement stores. It comes in pill form or as a powder. Let’s look at what, if anything, garcinia cambogia can do for your weight.
Advocates say that HCA, an organic acid, works by making you feel full, reducing your appetite, and affecting your metabolism. It’s this effect that has led many to herald it as a natural weight loss cure. Some say it may also help improve high cholesterol or enhance athletic performance.
The list of garcinia cambogia’s rumored benefits is a long one. It can be hard to determine the truth to the claims about its “miracle” properties. So, how do these health claims match up to scientific research?
1. Claim: Makes you feel full
Verdict: No evidence. An extensive review of the existing research on garcinia cambogia determined that there simply wasn’t conclusive evidence to suggest that the supplement or HCA had any effects on appetite and satiety. Although some rodent studies had positive results, no human studies could replicate them.
2. Claim: Lowers body weight
Verdict: No evidence. Existing evidence doesn’t prove that garcinia cambogia alone can facilitate weight loss. A 12-week, randomized, double-blind, placebo-controlled study published in JAMA found that the supplement didn’t help with significant weight loss or decrease in fat mass. Both the control and garcinia group were placed on high-fiber, low-calorie diets.
3. Claim: Speeds metabolism
Verdict: Some evidence. There is some evidence that supplementing with garcinia cambogia can influence fat metabolism. Several studies have found that both mice and humans experience an increase in fat metabolism after supplementing with HCA.
4. Claim: Enhances athletic performance
Verdict: Some evidence. Garcinia cambogia may increase the amount of time it takes to reach exhaustion during exercise, according to one study. Another study that used mice had similar results, showing that HCA enhanced endurance during running.
In addition to knowing how well it works, you’ll also want to know about a supplement’s potential side effects. Reported side effects for garcinia cambogia are mild. They include:
There are still other factors you should consider when deciding whether to use a supplement such as garcinia cambogia.
As with all dietary supplements, HCA could interact with medications you take. Before starting HCA, be sure to talk to your doctor. Make sure they know about all medications you take, including prescription and over-the-counter drugs as well as other supplements.
Part of the allure of garcinia cambogia is the fact that it comes from a fruit, so it’s considered “natural.” However, this alone doesn’t make it a worthwhile supplement or even safe. The Food and Drug Administration (FDA) recommends using caution with products that claim to be quick fixes, promise fast weight loss, and use the term “natural.” Natural doesn’t necessarily mean safe. There are many poisonous plants that are natural, but can cause you serious harm. Many plants interfere with medication or are actually medications themselves.
More importantly, dietary supplements such as garcinia cambogia aren’t studied or approved by the FDA before they go on the market. Furthermore, supplement makers can claim that their products support normal body functions as long as they have a disclaimer stating that the FDA hasn’t evaluated those statements.
It can be powerful tool for you to aid in weight loss.
Don’t believe the LIES about Garcinia Cambogia Popular, but… For more than a decade Garcinia Cambogia has been included in various weight loss products, but exploded in popularity in 2012 when Dr Julie Chen talked about it on the Dr Oz TV show.
In other words, supplements containing garcinia cambogia have not been rigorously tested for effectiveness, quality, purity, or safety.
Possible liver problems
In 2009, the FDA recalled a product that contained garcinia cambogia because it was found to cause liver problems. Research since then has been conflicted, with some citing a link between garcinia cambogia and liver damage and other research finding no link. You should discuss this risk with your doctor.
A review of studies on HCA found that no studies have effectively looked at garcinia cambogia use for longer than 12 weeks. That means there isn’t enough evidence to ensure that it’s safe and effective for long-term use.
The danger of scams
It’s free, so what’s the harm, right? Actually, those free trials for products that claim to help you lose weight fast can present more harm than you might think. From surprise shipping fees to extra charges for products you didn’t realize you ordered, these trials can end up costing you money. For information on how to avoid these scams, check out this page from the Federal Trade Commission.
“Miracle” weight loss solutions rarely live up to the hype. Even when there is scientific evidence of positive results, the results are often so mild and minimal that users are disappointed to learn they still have to exercise and control their eating in order to reap lasting and significant weight loss.
Dr. Oz has come under fire for promoting “miracle” weight loss products on his show. His claims got him into trouble with the U.S. Senate Subcommittee on Consumer Protection, Product Safety, and Insurance. There’s a reason that claims such as his about products with no clear evidence of effectiveness are taken seriously. Many consumers trust his opinion and could be misled into buying something that is, at best, a waste of time and money, and at worst, laden with potential side effects.
According to the FDA, any product, whether natural or man-made, that’s strong enough to work like a drug is capable of producing side effects. Before you add a dietary supplement to your weight loss plan, discuss it with your doctor. They can tell you if the product may be harmful or may be worth a try.
The best approach for weight loss is eating less fat and calories. Choose to eat whole, non-processed foods and burn calories with activity.
Weight Loss With Medication
There's no magic bullet yet -- but for people with obesity, weight loss drugs can be a helpful part of treatment.
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To many people, any weight loss drug seems like it must be a scam. It's just too good to be true, as plausible as an effective bust-enlargement cream or Home Alchemy Kit.
However, weight loss drugs -- like Xenical and Meridia -- do exist. They also work. And pharmaceutical companies across the globe are industriously working on more. They're not for cosmetic use, so mildly overweight people fretting about bathing suit season shouldn't apply. Their effects are also modest, usually resulting in a loss of no more than 10% of a person's body weight. Contrary to some hopes, they don't replace diet and exercise; weight loss drugs only work in conjunction with lifestyle changes.
Why Use a Weight Loss Drug?
Many people, including doctors, have a strong aversion to using weight loss drugs to treat obesity, according to Holly Wyatt, MD, an endocrinologist at the University of Colorado Health Sciences Center. The longstanding wisdom was that obesity resulted from a failure of willpower. If only people would just stop eating so much and get off the couch, no one would be obese. So why bother with drugs?
But that simple way of thinking is increasingly under fire from experts. It isn't the whole story.
"Lifestyle is a big factor in why people gain weight," Wyatt tells WebMD. "But there's a definitely a genetic and a physiologic reason, too.
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Because of differences in physiology, some people will just have a harder time losing and maintaining weight than others."
George A. Bray, MD, professor of medicine at Louisiana State University, agrees that the traditional view of obesity -- as essentially a moral failing -- is wrong.
"Are people who are massively overweight because they lack [the hormone] leptin 'weak-willed'?" asks Bray. "No, and, in fact, some kind of neurochemical derangement probably underlies most obesity."
"It's cruel and hurtful to categorize overweight and obese Americans as 'lazy' or 'weak-willed,'" he says, "and to conclude that all they need to do is just push themselves away from the table."
Obesity as a Disease
Obesity is a killer. So is it enough for a doctor to tell a chronically obese person to lose weight and leave it at that? Wyatt and Bray both point out that we routinely use medication for other conditions that can be controlled by changes in diet and exercise.
For instance, diabetes and high blood pressure can both be helped substantially by changes in your lifestyle. But doctors still prescribe medication for both conditions. It would be highly unlikely for your doctor to refuse to give you diabetes medicine simply because you could control the disease with more exercise and a stricter diet but don't. Everyone knows that permanent lifestyle changes are very hard to make, Wyatt says.
"We don't punish diabetics or people with high blood pressure by withholding medicine," says Wyatt. "So why should we punish people with obesity? If you have a medication that will make it easier for people to lose weight, why not use it?"
Wyatt and Bray both stress that anyone who needs to lose weight should try lifestyle changes first. But for those who can't seem to do it with exercise and diet alone, weight loss drugs could help.
The Causes of Obesity
At the most basic level, your weight is determined by the balance between the amount of energy you take in and the amount you expend -- the food you eat and the calories you burn. If you burn more calories than you eat, you'll lose weight; if you eat more than you burn, you'll gain.
However, while that equation is still roughly true, researchers have found that it's a lot more complicated. The body has many complex and interacting mechanisms that help regulate your weight.
One of them is the hormone leptin, which is secreted by fat cells. Your brain detects the amount of leptin in your system and uses it as a kind of barometer. Not enough leptin presumably means that you need more food; enough leptin is a sign that you've eaten as much as you need, and your brain triggers feelings of fullness. The problem is that many obese people are leptin-resistant. Their brains don't correctly detect the amount of leptin in the system, "thinking" that the level is lower than it really is. As a result, a leptin-resistant person will keep feeling hungry after a person with normal leptin levels would feel full.
Leptin is only one of many different mechanisms that regulate weight. Any kind of abnormality in these systems could make it harder for a person to lose weight and keep it off.
Weight and Genetics
Wyatt observes that, from an evolutionary standpoint, there's an advantage to building up excess fat. For most of human history, people were subject to periodic famines. Those who retained excess fat might have been more likely to survive a famine than those who didn't. The problem is that this evolutionary adaptation -- that may have saved the lives of our ancient ancestors during difficult times -- is hurting us now.
This is not to say that having a predisposition to being obese means you will be obese. The fact that Americans are heavier now than they were a generation ago proves that genes aren't the whole story. It's the changes in our environment that have made the biggest difference, Wyatt says.
A genetic predisposition toward obesity will only come into play when the environment is right.
It was designed for deep cellular and digestive colon cleanse, but it doesn’t just stop there.
Getting obese was unlikely when our ancestors were eking out an existence on the savannah. But when we live in a society of sedentary jobs, sedentary entertainment, and cheap, plentiful and colossally caloric meals available at countless locations near you, that genetic predisposition can make a big difference.
How Do Medications Help?
The two drugs currently approved by the FDA to treat long-term obesity are Xenical and Meridia. They work in different ways. Meridia affects certain chemicals in the brain and makes people feel full without eating as much.
Xenical works very differently. It isn't absorbed by the system. Instead, it binds to fat cells in the gastrointestinal tract and prevents them from being absorbed, just like the ingredient Olestra used in some low-fat foods. The usual dose can reduce the amount of fat that's absorbed by about 30%.
The FDA has approved the use of weight loss drugs in people with a BMI of 30 or as low as 27 in some people who have illnesses related to obesity, like diabetes or heart disease. The BMI is a measurement based on height and weight. According to the National Institutes of Health, a normal BMI ranges from 18.5 to 24.9, 25-29.9 is overweight, and anything above that is obese.
Other drugs may be helpful in some cases. For instance, Wyatt has had good success with the generic drug phentermine, which suppresses appetite like Meridia. However, the FDA has not approved phentermine for long-term use. That's not because it was found unsafe -- it's just that no one has funded a study of its long-term effectiveness. And because studies are expensive, no pharmaceutical company will want to spend the money testing a generic drug that it doesn't exclusively own.
As much as people may dream of the pill that lets them lose weight without diet or exercise -- the claim of countless hucksters and infomercials -- none of these drugs works that way. Studies have shown that these drugs really only work in conjunction with lifestyle changes.
The amount of weight that people lose on weight loss drugs varies: Some people have great success and some don't. On average, people don't lose more than 10% of their baseline weight -- that's a 20-pound weight loss for a person who is 200 pounds. Generally, people lose the most weight in the first three to six months on the drugs and then plateau.
A 10% weight loss may not sound like a lot. But experts stress that modest weight loss -- even 5% -- can make a big difference in your risk of developing disease. Many studies have shown the effectiveness of weight loss drugs in reducing health risks. For instance, a recently published study of Xenical found that it could cut the risk of type 2 diabetes by 37%.
How Long Would Someone Need to Use Them?
Studies have shown that if a person on one of these medications doesn't lose 4 pounds in the first four weeks, then it can probably be stopped; it's unlikely that the drug is going to work. If someone does have success with a drug, it should probably be taken long term. Weight loss drugs are not a quick fix. Instead, they're more like medication for high blood pressure or diabetes, Wyatt says. Obesity really is a chronic disease.
"The physiology that causes someone to become obese doesn't go away," says Wyatt. Stopping the drugs usually means that the weight will come back. And losing the weight doesn't matter as much as keeping it off. If you lost 20 pounds but regained it all within the year, it's not going to help all that much.
Long-term treatment doesn't mean that people will necessarily be taking the same weight loss drug every day for the rest of their lives. Instead, it's possible that someone might switch between Xenical, Meridia, or other drugs.
It may also be possible for people to take breaks in treatment. "Weight isn't like blood pressure," says Wyatt. "If you stop taking your blood pressure medication, it goes up within a few days. Regaining weight takes longer." So far, studies have not shown any advantages to using weight loss drugs periodically.
Even if it's safe, it may not help you lose much weight.
But as researchers learn more about how to best use these medications, it may be a possible form of treatment in the future, Wyatt says.
Are They Safe?
One of the biggest concerns for anyone considering a weight loss drug is its safety. The fear is understandable. The much-touted combination of weight loss drugs called fen-phen -- phentermine and another drug, fenfluramine -- was found to cause dangerous damage to the heart valves in some people. As a result, both fenfluramine and Redux, another similar weight loss drug, were pulled from the shelves in 1997. On its own, phentermine is considered safe and still used.
Being cautious about any weight loss drug is good policy. None of these drugs have been around that long, and so we can't be sure of their long-term effects.
That said, the safety records for both Xenical and Meridia are good and the risk of side effects are low. Meridia can cause headaches, dry mouth, and a rise in the pulse and blood pressure.
Xenical can cause gastrointestinal side effects, such as spotting, an urgent need to go to the bathroom, and an increased number of bowel movements. These side effects tend to fade over time, and are aggravated by eating a high-fat meal. Xenical can also reduce the amount of vitamins that your body absorbs, so you may need to take a multivitamin to compensate.
But researchers have found no side effects like those of fen-phen.
"Any medication carries risk," says Wyatt. "But at this point, I think that [Xenical and Meridia] are as safe as any other medication that we routinely prescribe." In fact, because of the fen-phen debacle, she thinks that weight loss drugs may be held to an even higher level of safety than other types of medicine.
Wyatt also observes that the very small risks of these drugs have to be compared to the real risks of obesity, such as high blood pressure, diabetes, stroke and heart disease. For people who are very obese, another way to frame the choice could be to compare the low risks of weight loss drugs with the higher risks of bariatric surgery, often called stomach stapling.
The Future of Weight Loss Medications
Many doctors and researchers hope the weight loss drugs of the next decade will make Xenical and Meridia look crude. As researchers learn more and more about the complex set of mechanisms that regulate our weight, the drugs we use will become increasingly sophisticated.
A number of medications are now in various stages of development with more specific targets. Many are designed to affect some of the hormones -- such as leptin -- that play a role in appetite and weight regulation.
Wyatt has modest hopes for new weight loss drugs in the immediate future. "I don't see any of the new drugs as obvious blockbusters," she says. She points out that we may need combinations of new drugs to have a substantial effect. The problem is that there are so many different mechanisms that affect our weight that just targeting one may not be enough.
Bray says we'll just have to wait. "Until we get the data from the long-term trials of these drugs," he tells WebMD, "we just won't know how safe or effective they are."
"We're really just in the early stages of using weight loss drugs," says Wyatt. "It's just like when we first began to use drugs for high blood pressure, and they didn't work all that well and caused a lot of side effects. But we'll get better drugs, and as we do, doctors will use them more and more."
So barring some unforeseen breakthrough, weight loss drugs are not going to be "the answer" to obesity any time soon. But along with diet and exercise, they can be an important part of the solution.
SOURCES: George A. Bray, MD, Boyd Professor at Louisiana State University; professor of medicine at the LSU Medical Center. Holly R. Wyatt, MD, assistant professor of medicine, division of endocrinology, University of Colorado Health Sciences Center, Denver. Wyatt, H. Postgraduate Medicine, January, 2004; vol. 115. National Institute of Diabetes and Digestive and Kidney Diseases.