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

From the Guidelines

Based on current evidence, there is no clear evidence that nutrition supplements are effective for obesity management or weight loss, and therefore, the most evidence-based approach to weight loss is through comprehensive lifestyle interventions, including calorie reduction, increased physical activity, and behavioral changes, as recommended by trained practitioners in medical settings 1.

Key Points to Consider

• The use of nutrition supplements, such as herbs and botanicals, high-dose vitamins and minerals, amino acids, enzymes, antioxidants, etc., is not supported by high-quality evidence for weight loss 1.
• Comprehensive lifestyle interventions, including calorie reduction, increased physical activity, and behavioral changes, are the most effective approach to weight loss, and should be provided by trained practitioners in medical settings with ongoing monitoring and support 1.
• Structured, very-low-calorie meals, typically 800–1,000 kcal/day, utilizing high-protein foods and meal replacement products, may increase the pace and/or magnitude of initial weight loss and glycemic improvements, but should only be prescribed for short-term use (generally up to 3 months) and under close medical supervision 1.
• Vitamin/mineral supplementation, such as iron, vitamin B12, and vitamin D, may be indicated in cases of documented deficiency, but is not a substitute for a comprehensive weight loss plan 1.

Recommendations for Weight Loss

• Comprehensive lifestyle interventions, including calorie reduction, increased physical activity, and behavioral changes, should be the primary approach to weight loss 1.
• Trained practitioners in medical settings should provide ongoing monitoring and support to individuals attempting to lose weight 1.
• Structured, very-low-calorie meals and meal replacement products may be considered for short-term use (generally up to 3 months) under close medical supervision 1.
• Vitamin/mineral supplementation should only be considered in cases of documented deficiency, and under the guidance of a healthcare professional 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 and phentermine, as they are both FDA-approved for weight loss in adults.

• Orlistat is indicated for weight loss in overweight adults, 18 years and older, when used along with a reduced-calorie and low-fat diet 2.
• Phentermine is indicated as a short-term adjunct in a regimen of weight reduction based on exercise, behavioral modification, and caloric restriction in the management of exogenous obesity 3. Key points to consider when choosing a weight loss supplement:
• Always consult with a doctor before starting any weight loss program.
• Combine the supplement with a reduced-calorie diet and exercise program.
• Monitor progress and adjust the program as needed. Note: These supplements have specific indications and contraindications, and their use should be individualized based on patient needs and health status 2 3.

From the Research

Weight Loss Supplements

• The most evidence-based peer-reviewed weight loss supplements are prescription medications, including orlistat, phentermine/topiramate, naltrexone/bupropion, and liraglutide, as they have been shown to result in significant weight loss and improved cardiometabolism 4.
• These medications have been approved by the FDA for chronic weight management, but they can be costly and may have adverse effects in some individuals 4.
• Over-the-counter medications and supplements have limited evidence supporting their effectiveness for weight loss 5.

Evidence-Based Strategies

• A combination of increased energy expenditure through exercise and decreased energy intake through caloric restriction is the mainstay of behavioral interventions for weight loss 5.
• Lifestyle changes, including regular physical activity, healthy food choices, and portion control, must be adopted and maintained for long-term weight loss 5, 6.
• Dietary strategies, such as a low-calorie diet with a low fat or carbohydrate content, or a very-low-calorie diet for a short period, can be effective for weight loss 6.

Individualized Approaches

• Strategies for weight loss and maintenance should be individualized, taking into account patient preferences, chronic conditions, and comorbidities 4, 6.
• Healthcare providers should work with patients to choose the best strategy for their specific needs and circumstances 5, 6.
• A multidisciplinary team, including healthcare providers, nutritionists, exercise specialists, and behavioral interventionists, can provide ongoing support and guidance for patients 5.