If there was really an absolutely safe weight loss pill, you would never see an overweight doctor. Reams have been written about the use of chromium in weight loss, as also green tea. A small study done in Sydney says it’s possible these products may make you more prone to cancer. Similarly, Litramine, derived from the leaves of the prickly pear cactus and traditionally used in Mexico for weight loss, is said to bind fat in the stomach and prevent its absorption.
However, Lorraine McCreary of the British Dietetics Association claims that it can dangerously lower blood sugar in diabetics. She also warns that many such pills are taken in addition to a regulated diet in motivated patients, and it is likely that it is the diet that helps, rather than the pills. There are, of course, numerous herbal products that make many claims. But the market for herbal products is poorly regulated in many countries, giving the impression that since these products are ‘natural’, they cannot hurt.
This is not true. Garcinia Cambogia (Malabar tamarind) became popular for weight loss after being featured on the Dr Oz show in 2012. But an article in the Journal of Obesity says the resultant weight loss was limited to 2 lbs, which is far from impressive. Remember that many of these so-called dietary substances are far from safe. Consider this example: a young woman in California took usnic acid, a naturally occurring antimicrobial substance that was touted for weight loss.
Seventeen days after she started taking it, she was in coma, with advanced liver failure. It took an emergency liver transplant to save her. I have seen and heard of a similar situation where the use of Ayurvedic medication for weight loss caused renal failure and subsequent death. Such deaths are extremely distressing; in the long run, it is better to be fat than dead from medical misadventure.But the fantasy of being thin is engraved in patients’ minds, and it is common for patients to seek advice regarding ‘miracle pills’ that promise weight loss, along with surgical procedures like bariatric surgery. I tell my patients that if there was a safe pill to lose weight, you would never see a fat person. Through the ages, from dexamphetamine to other weight loss pills that have appeared in medical pharmacopeia, most have proved to be so fraught with side-effects – some even increasing the propensity to suicide – that doctors shy away from them.
Among newer, relatively safer drugs is one called Orlistat, which blocks fat from entering your intestine; the fat is subsequently excreted in your stool. But it is important to remember that fat is necessary for the absorption of certain fat-soluble Vitamins like A, D, E, and K, and one can suffer from deficiencies with repeated use of the drug. Cases of severe liver injury have been reported, and of course, you get loose stools because of malabsorption of fat, skin blisters and kidney stones. Other drugs that are in vogue are Naltrexone and Bupropion, the first actually used to treat alcohol dependence, and the second to treat depression.
And anyway, if you don’t lose five per cent of your body weight in 12 weeks, then this is unlikely to help you. Other drugs like phentermine because they stimulate the sympathetic nerves system, cause palpitation and a rise in blood pressure. Many newer anti-diabetes drugs also cause weight loss, but no formal database on weight loss resulting from their use in normal patients exists. In the final analysis, obesity is certainly not an easy problem to address. Dietetics is very important. But if you wish to use medication to lose weight, do discuss the pros and cons with your doctor first.