From the Guidelines
The most evidence-based weight loss supplement is not a traditional supplement, but rather glucagon-like peptide-1 (GLP-1) receptor agonists, specifically semaglutide and tirzepatide, as supported by recent guidelines 1. These medications have been shown to produce significant weight loss when combined with lifestyle modifications. The use of traditional nutrition supplements, such as herbs and botanicals, high-dose vitamins and minerals, amino acids, enzymes, and antioxidants, is not supported by high-quality evidence for obesity management or weight loss 1. In fact, several large systematic reviews have found that most trials evaluating nutrition supplements for weight loss are of low quality and at high risk for bias, with little to no weight loss benefits demonstrated in high-quality published studies 1. Key points to consider when using GLP-1 receptor agonists for weight loss include:
- Semaglutide is typically started at 0.25mg weekly by injection, gradually increasing to 2.4mg weekly for weight management.
- Tirzepatide begins at 2.5mg weekly injections, potentially increasing to 15mg weekly.
- These medications work by mimicking hormones that regulate appetite and blood sugar, making you feel fuller longer and reducing hunger signals to the brain.
- They also slow gastric emptying, extending the feeling of fullness after meals.
- Users typically experience 10-15% body weight loss with semaglutide and potentially 15-20% with tirzepatide when combined with lifestyle modifications over 12-18 months.
- Side effects may include nausea, vomiting, diarrhea, and constipation, which often improve over time.
- These medications require a prescription and ongoing medical supervision, and insurance coverage varies significantly.
- They represent a long-term approach to weight management rather than a quick fix, and discontinuation may result in weight regain. It's essential to consult with a healthcare professional before starting any weight loss regimen, especially when considering prescription medications like GLP-1 receptor agonists. Additionally, comprehensive weight loss maintenance programs that provide ongoing monitoring and support are crucial for long-term success, as emphasized in recent guidelines 1.
From the FDA Drug Label
Use for weight loss in overweight adults, 18 years and older, when used along with a reduced-calorie and low-fat diet Directions read the enclosed brochure for other important information diet and exercise are the starting points for any weight loss program. Phentermine Hydrochloride, USP 15 mg and 30 mg is indicated as a short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity for patients with an initial body mass index greater than or equal to 30 kg/m 2, or greater than or equal to 27 kg/m 2 in the presence of other risk factors
The most evidence-based peer-reviewed weight loss supplement is orlistat (PO), as it is indicated for weight loss in overweight adults, 18 years and older, when used along with a reduced-calorie and low-fat diet 2. Key points:
- Orlistat is used for weight loss in overweight adults.
- It should be used along with a reduced-calorie and low-fat diet.
- Phentermine is also used for weight loss, but it is indicated for short-term use and has more restrictions, such as not being recommended for use in patients 16 years of age and under 3.
From the Research
Most Evidence-Based Peer-Reviewed Weight Loss Supplements
There are several weight loss supplements that have been studied in peer-reviewed research. The following are some of the most evidence-based options:
- Orlistat: a medication that has been approved by the FDA for chronic weight management, with studies showing a placebo-subtracted weight reduction of 2.9% 4
- Phentermine/topiramate: a medication that has been approved by the FDA for chronic weight management, with studies showing a placebo-subtracted weight reduction of 6.8% 4
- Liraglutide: a medication that has been approved by the FDA for chronic weight management, with studies showing a placebo-subtracted weight reduction of 5.4% 4
- Naltrexone/bupropion: a medication that has been approved by the FDA for chronic weight management, with studies showing a placebo-subtracted weight reduction of 4.0% 4
- Semaglutide: a medication that has been shown to produce an average weight loss of 15% at 1 year, and is considered a promising option for weight loss 5
Dietary Supplements and Alternative Therapies
It's worth noting that many dietary supplements and alternative therapies marketed for weight loss are not regulated by the FDA and have limited evidence to support their efficacy and safety 6. Healthcare providers should be aware of the lack of evidence and deficiencies in regulatory oversight of these products.
Lifestyle Interventions
In addition to medication, lifestyle interventions such as increased energy expenditure through exercise and decreased energy intake through caloric restriction are also important for weight loss and maintenance 7, 8. A combination of regular physical activity, healthy food choices, and portion control can help individuals achieve and maintain a healthy weight.