Are there any effective over-the-counter (OTC) exercise supplements for weight loss?

Over-the-Counter Exercise Supplements for Weight Loss

There is no clear evidence that over-the-counter exercise supplements are effective for weight loss. 1 Multiple high-quality guidelines consistently show that despite widespread marketing and exorbitant claims, nutrition supplements such as herbs, botanicals, high-dose vitamins and minerals, amino acids, enzymes, and antioxidants lack proven efficacy for obesity management or weight loss.

Evidence Against Supplement Effectiveness

• Several large systematic reviews demonstrate that most trials evaluating nutrition supplements for weight loss are of low quality and at high risk for bias 1
• High-quality published studies show little or no weight loss benefits from supplements 1
• Despite the popularity of weight-loss supplements, most produce modest effects at best (less than 2 kg weight loss) and many have few or no randomized clinical trials examining their effectiveness 2
• Current guidelines explicitly state there is no clear evidence that dietary supplements are effective for weight loss 1

Potential Concerns with Supplements

• Safety concerns exist with many weight loss supplements, particularly those containing metabolic stimulants (e.g., caffeine, ephedra, synephrine) 2
• Over-the-counter dietary supplements are not reviewed or approved for safety or efficacy by regulatory agencies 3
• Ingredient lists on supplements might not be complete, and advertising can be misleading 3
• The risk of contamination with prohibited substances in dietary supplements has been recognized for decades 1

Evidence-Based Approaches to Weight Loss

Instead of supplements, guidelines recommend these effective approaches:

• Structured programs emphasizing lifestyle changes, including education, reduced fat and energy intake, regular physical activity, and regular participant contact, can produce long-term weight loss of 5-7% of starting weight 1
• High-frequency counseling (≥16 sessions in 6 months) focusing on nutrition changes, physical activity, and behavioral strategies to achieve a 500-750 kcal/day energy deficit 1
• Regular physical activity (200-300 min/week) for weight maintenance 1
• Behavioral changes that create an energy deficit, regardless of macronutrient composition 1

Special Considerations

• Some foods or supplements such as green tea, fiber, and calcium supplements or dairy products may complement a healthy lifestyle to produce small weight losses or prevent weight gain over time, but effects are minimal 2
• Vitamin/mineral supplementation (e.g., iron, vitamin B12, vitamin D) may be indicated in cases of documented deficiency, but not specifically for weight loss 1
• Protein supplements may be indicated as adjuncts to medically supervised weight loss therapies, but not as primary weight loss agents 1

Effective Medical Approaches

For those requiring medical intervention beyond lifestyle changes:

• FDA-approved obesity medications have been shown to improve glycemia in people with type 2 diabetes and obesity 1
• Medications with beneficial effects on weight include GLP-1 receptor agonists, dual GIP and GLP-1 receptor agonists (tirzepatide), sodium-glucose cotransporter 2 inhibitors, metformin, and amylin mimetics 1
• For individuals with diabetes and overweight/obesity, the preferred pharmacotherapy should be a GLP-1 receptor agonist or dual GIP/GLP-1 receptor agonist with greater weight loss efficacy (i.e., semaglutide or tirzepatide) 1

In conclusion, individuals seeking weight loss should focus on evidence-based approaches including caloric deficit through diet, regular physical activity, and behavioral strategies rather than unproven supplements. For those requiring additional intervention, FDA-approved medications prescribed by healthcare providers offer more reliable and safer options.