What is the most evidence-based, peer-reviewed weight loss supplement?

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 (brand names Wegovy, Ozempic) and tirzepatide (Mounjaro, Zepbound), as there is no clear evidence that nutrition supplements are effective for obesity management or weight loss 1. These medications have demonstrated the most significant and consistent weight loss results in clinical trials, with participants losing approximately 15-20% of their body weight over 68 weeks with semaglutide and up to 22.5% with tirzepatide. The typical starting dose for semaglutide is 0.25mg weekly by injection, gradually increasing to 2.4mg weekly, while tirzepatide starts at 2.5mg weekly and can increase 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, contributing to prolonged satiety. Side effects can include nausea, vomiting, diarrhea, and constipation, which often improve over time. These medications require a prescription and should be used alongside lifestyle modifications including calorie reduction and increased physical activity. They are typically indicated for individuals with a BMI of 30 or higher, or 27 with weight-related health conditions. Insurance coverage varies, and these medications may be costly without coverage. Some key points to consider when using these medications include:

• They should be used under the guidance of a healthcare professional
• They should be used in conjunction with a comprehensive lifestyle intervention, including diet and exercise
• They may have potential side effects, and patients should be closely monitored
• They may be costly, and insurance coverage may vary It's also important to note that while these medications have shown significant weight loss results, they should not be used as a replacement for a healthy lifestyle, but rather as a tool to aid in weight loss. Additionally, it's worth mentioning that the evidence for traditional weight loss supplements is limited, and many lack evidence of effectiveness, with some promoting unscientific and possibly dangerous practices 1. Therefore, it's essential to approach weight loss with a comprehensive and evidence-based approach, rather than relying on unproven supplements. Some key takeaways from the evidence include:
• The importance of a comprehensive lifestyle intervention, including diet and exercise, in achieving and maintaining weight loss
• The potential benefits of GLP-1 receptor agonists, such as semaglutide and tirzepatide, in achieving significant weight loss
• The need for close monitoring and guidance from a healthcare professional when using these medications
• The importance of approaching weight loss with a critical and evidence-based perspective, rather than relying on unproven supplements or fad diets.

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

Weight Loss Supplements

• The most evidence-based peer-reviewed weight loss supplements are not explicitly mentioned in the provided studies, as they focus on pharmacotherapy, lifestyle interventions, and surgical interventions for weight loss.
• However, the studies discuss various anti-obesity medications that have been approved by the FDA for chronic weight management, including orlistat, phentermine/topiramate, naltrexone/bupropion, and liraglutide 4.
• Another study mentions semaglutide 2.4 mg weekly, which has recently emerged and produces significant weight loss, with an average of 15% weight loss at 1 year 5.
• It is essential to note that these medications should be used under the guidance of a healthcare provider, as they may have adverse effects and are not suitable for everyone.

Lifestyle Interventions

• Lifestyle changes, including regular physical activity, healthy food choices, and portion control, are crucial for weight loss and maintenance 6, 7, 8.
• A low-calorie diet with a low fat or carbohydrate content is recommended for weight loss, and some macronutrient composition-based diets, such as the ketogenic diet or high-protein diet, may be considered in some cases 7.
• Meal timing is also an important factor in weight management, and higher-calorie breakfasts in combination with overnight fasting may help prevent obesity 7.

Surgical Interventions

• Metabolic bariatric surgery (MBS) is an effective treatment option for significant and sustained weight loss, particularly for individuals with obesity-related co-morbidities 8.
• MBS can reduce the progression of obesity-related co-morbidities and improve overall health outcomes 8.
• However, it is essential to carefully evaluate the potential risks and benefits of MBS and to discuss the suitability of this option with a healthcare provider 8.