Key Info for Compounding Pharmacists About the Effectiveness of OTC Weight Loss Supplements

Key Info for Compounding Pharmacists About the Effectiveness of OTC Weight Loss Supplements

i-pillCompounding pharmacists don’t need the latest statistics to know that obesity is on the rise and that there’s a big market for OTC weight loss supplements. Whether you stock weight-loss products or not, you will likely encounter patients struggling to lose weight and who have questions. To guide their decisions, you need to know which ingredients are effective, as well as those to avoid even if they’re advertised as being effective. More importantly, you must be prepared to manage their expectations about results from supplements and to remind them that diet and exercise are still the key components for successful weight loss.

Ingredients in OTC Weight Loss Supplements

When people shop for over-the-counter weight loss supplements, they look for appetite suppressants, fat burners and metabolism boosters. A multitude of products claim to be “extreme fat busters,” or carry some other exaggerated statement. While compounding pharmacists know such claims are false, your customers may not. All they care about is losing weight and many have reached the point where they’ll try anything that at least seems safe. It’s important to be ready to answer their questions with solid information, so here’s a list of the ingredients that are backed by evidence:

  • Caffeine: Caffeine promotes lipolysis and boosts thermogenesis through several pathways, but primarily as a phosphodiesterase inhibitor.1 Your patients may not realize that if they consume a lot of dietary caffeine, they’ve developed tolerance to it and supplements won’t be effective if they don’t contain enough caffeine to break that threshold. Patients should not add supplements to their normal daily intake if they’ll end up consuming more than 400 milligrams of caffeine daily.2
  • Green Coffee Bean Extract: Raw coffee beans contain high levels of chlorogenic acid, an antioxidant that lowers absorption of glucose in lab animals and may inhibit fat accumulation in the liver. Chlorogenic acid exhibits lipolytic activity that looks promising for weight loss, but high-quality clinical trials are needed to prove efficacy.
  • Green tea: In addition to caffeine, green tea contains polyphenols called catechins. The most potent catechin—epigallocatechin gallate or EGCG—functions as a fat burner. It upregulates enzymes that stimulate fat oxidation and decreases fat absorption by inhibiting pancreatic enzymes.3 EGCG is not readily absorbed into the bloodstream, but taking it on an empty stomach may improve its bioavailability.
  • Capsaicin: Clinical trials show that capsaicin can modestly boost fat oxidation, diminish appetite and increase energy expenditure.4
  • Appetite suppressants: A small study with ten overweight men found that drinking a hot ginger beverage induced satiety.5 Caralluma fimbriata and 5-HTP may be able to stop hunger cravings, but their effectiveness must be substantiated with research.
  • Nutrient blockers: Phaseolus—white kidney bean extract—helps block absorption of carbohydrates, while the fiber chitosan inhibits fat absorption. Both have the potential to support weight loss, but their overall effect needs to be verified.

Hoodia gordonii, Garcinia cambogia and conjugated linoleic acid are widely touted for weight loss but the evidence produced so far shows they’re not effective. L-carnitine can help burn fat, but only if the patient is deficient in carnitine.

Some ingredients are effective, but carry the risk of adverse effects. Patients should avoid:

  • Ephedrine
  • Yohimbe
  • Bitter orange, or synephrine

Weight-loss supplements often contain a mind-boggling number of ingredients, possibly because manufacturers are trying to follow the concept of stacking, or combining synergistic ingredients to enhance results. Stacking works for some purposes, but it’s complex and should always be tailored for each individual. One popular stack that’s often billed as the most powerful fat burner ever—the ECA stack—contains ephedrine, caffeine and aspirin. The aspirin is added to counteract the potential for ephedrine to cause blood clots, which only serves to show that it should be avoided.

Tips for Counseling Patients Seeking Weight Loss Supplements

An article in Pharmacy Today encourages pharmacists to assess the BMI of overweight patients to determine whether they’re candidates for drug therapy.6 Knowing BMI is always important—and obese patients may need pharmaceuticals—but many overweight patients aren’t ready to take that step. They need accurate information about supplements, but stop to consider your approach before reaching out to these patients. The American Pharmacists Association published an article emphasizing the significance of the words used during counseling.7 Two words to avoid are obese/obesity and fat. Replace them with words like excess weight, weight problem or unhealthy body weight. It may seem trivial, but you’re likely to lose any chance of establishing a therapeutic relationship if you begin with the word obese.

Here are a few other tips to keep in mind when counseling overweight patients:

  • Realistic expectations: Patients need to know that OTC weight loss supplements—even those back by evidence—only have a small effect. The best use for fat burners and metabolism boosters may be to help offset the sluggish metabolism that results from following a low-calorie diet.
  • Diet and exercise count: No matter what weight loss supplement patients use, it’s guaranteed to fail if they individuals restrict calories and engage in regular exercise. Be prepared to refer patients to local weight-loss programs. During counseling, ask whether painful joints and muscles inhibit their activity and discuss compounded topical pain relief.
  • Accountability: It’s easier to lose weight when patients are accountable for their progress, which can be accomplished by joining a program, a weekly weigh-in with a friend, or by keeping a journal of their daily diet and weight.
  • Quality and safety: Some supplements contain unauthorized and dangerous ingredients that don’t appear on the label. On the flip side, supplements sometimes lack the ingredients listed on the label. Advise patients to purchase products with an independent quality seal, such as the USP Verified or NSF marks.
  • Medication interactions: Ask patients purchasing weight loss supplements if they take medications. Propose a medication review so you can screen for potential interactions.
  • FDA-approved appetite suppressants: Phentermine, phendimetrazine and diethylpropion aren’t for everyone, but they’re effective and many patients don’t know they’re available. Suggest patients consult their physician to discuss the options.

Reach Out to Patients About the Effectiveness of OTC Weight Loss Supplements

The process of losing weight is difficult enough, but now experts are beginning to identify hormonal changes that influence weight gain and loss and ultimately make it more of a challenge. The odds of long-term success improve when patients have support. Compounding pharmacists who maintain a connection and who are simply available to answer questions about the effectiveness of otc weight loss supplementscan make the difference for overweight patients.

Pharmaceutica North America provides high-quality bulk APIs, custom compounding kits and OTC supplements that support the health and well-being of your patients. Call us today to talk about how we can help you achieve customized patient care through compounding medications.

Show 7 footnotes

  1. “Thermogenic Ingredients and Body Weight Regulation,” February 2010, http://www.nature.com/ijo/journal/v34/n4/full/ijo2009299a.html#Mechanisms-of-action
  2. “Caffeine in the Diet,” April 2015, https://www.nlm.nih.gov/medlineplus/ency/article/002445.htm
  3. “Catechin- and Caffeine-Rich Teas for Control of Body Weight in Humans,” December 2013, http://ajcn.nutrition.org/content/98/6/1682S.long
  4. “Capsaicin May Have Important Potential for Promoting Vascular and Metabolic Health,” June 2015, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477151/
  5. “Ginger Consumption Enhances the Thermic Effect of Food and Promotes Feelings of Satiety Without Affecting Metabolic and Hormonal Parameters in Overweight Men: A Pilot Study,” October 2012, http://www.ncbi.nlm.nih.gov/pubmed/22538118
  6. “Pharmacists Have Role in Prevention and Management of Obesity,” May 2015, http://pharmacytoday.org/article/S1042-0991(15)30334-0/fulltext
  7. “Helping Patients With Weight Management,” May 2015, http://www.pharmacist.com/helping-patients-weight-management
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