Evidence lacking for “alternative” weight-loss therapies

Posted 07 July 2021

A systematic review of published research evaluating the efficacy of dietary supplements and “alternative therapies” for weight loss among people at least 18 years of age has found that supportive evidence is weak. Many clinical trials were also hampered by a significant risk of bias due to inconsistent testing methods. Problems with studies include small sample sizes, short follow-up periods, and poor study designs.
Reference: Batsis JA. A systematic review of dietary supplements and alternative therapies for weight loss. Obesity, June 23, 2021

Key findings included:

  • Out of 315 randomized controlled trials included in the review, 52 were classified as having a low risk of bias, of which 16 demonstrated significant weight changes for tested therapies compared to placebo.
  • No high-quality evidence supported acupuncture, calcium-vitamin D supplementation, chocolate/cocoa, phenylpropanolamineguar gumPhaseolus vulgarispyruvate, and mind-body interventions as weight-loss therapies.
  • At least half of the low-risk-of-bias studies of chromiumephedra and caffeine, garcinia and/or hydroxycitrategreen tea, and conjugated linoleic acid showed no difference between treatment and placebo groups.
  • The only study of chitosan for weight loss with a low risk of bias found an average loss of 5 lbs. in a six-week follow-up period.
  • Out of 66 randomized controlled trials testing therapies in 39 miscellaneous categories, only 16 had a low risk of bias, but 10 of these provided no supportive evidence and six noted an average weight loss of only 1.5 to 6.6 pounds.

Drugs approved by the U.S. Food and Drug Administration (FDA) since 2015 have enabled obese children, adolescents, and adults to lose substantial weight though not as much weight loss as can be achieved through bariatric surgery.
Reference: Yanovski SZ. Yanovski JA. Progress in pharmacotherapy for obesity. JAMA, June 23, 2021; Abbasi J. Semaglutide’s success could usher in a “new dawn” for obesity treatment. JAMA, June 23, 2021

Many insurers do not cover anti-obesity medications or require prior authorization.

Source: Consumer Health Digest #21-26 July 4. 2021

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