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ABSTRACT: "Nontraditional" or "alternative" treatments are extremely popular, especially with respect to obesity and body composition. Although such treatments are widely used, it is not clear that these are supported by the existing data in the peer-reviewed literature. Herein, we review the data on 18 methods/products advocated as potential anti-obesity/fat-reducing agents. We have found that none have been convincingly demonstrated to be safe and effective in two or more peer-reviewed publications of randomized double-blind placebo-controlled trials conducted by at least two independent laboratories. Nevertheless, some have plausible mechanisms of action and encouraging preliminary data that are sufficiently provocative to merit further research.
KEY WORDS: weight loss, nutritional supplements, herbal medicines, body composition.
I. INTRODUCTION
According to a recent survey, over 42% of U.S. adults reported using one or more forms of alternative medicine in 1997, spending an estimated $27 billion out of pocket on such therapies.1 It is also estimated that over 50% of the U.S. adult population is overweight or obese.2 Finally, it is estimated that approximately 38% of women and 24% of men are trying to lose weight at any point in time.3 Given these three facts, it is not surprising that "alternative" treatments for weight loss abound. Evidence for this can be found on television, in any "health food" store, or in advertisements in the back of many popular magazines.
Safe and effective alternative treatments for weight loss would be very desirable given that obesity is an increasingly prevalent condition with serious adverse health outcomes.4 However, the majority of alternative treatments for weight loss have not been clearly demonstrated to be safe or effective. The purpose of this review is to describe some of the more widely advertised alternative treatments for weight loss/fat reduction and summarize the data concerning their safety and efficacy. We also review compounds that are purported to produce changes in body composition under certain circumstances. It is hoped that this review provides health professionals with useful information to pass along to their patients and helps identify areas where future research would be useful.
II. METHODS
A. Defining Alternative Treatments
We define alternative treatments by exclusion. Specifically, we define any currently available treatment intended to produce weight loss or fat reduction as alternative if it is not...