Restricted accessResearch articleFirst published online 2021-12
Comparing effectiveness of fat burners and thermogenic supplements to diet and exercise for weight loss and cardiometabolic health: Systematic review and meta-analysis
Those who are overfat face an onslaught of advice for losing weight, including using dietary supplements that purport to have fat burning capabilities to achieve a reduced body mass, fat mass and improvement in cardiometabolic health in combination with exercise or diet and exercise regimens.
Aim:
To examine long-term effectiveness of supplements for both weight loss and improvements in cardiometabolic health for these individuals.
Methods:
A PRISMA methods of systematic review was conducted from August 2018 through January 2019 using Medline, PubChem, PubMed, EBOSCO CINHAL and SPORTDiscus, and Google Scholar yielding 23,441 returns of which 21 studies (duration greater than 8 weeks with participant populations of BMI greater than 24.9) were included for meta-analysis. Meta-analysis examined pooled effect size and 95% confidence interval for: body mass, fat mass, fat-free mass, total cholesterol, high-density lipoproteins, low-density lipoproteins, resting metabolic rate. Intra-study effect sizes were compared with previously reported results for diet or diet and exercise in a 2x2 chi-square analysis for the number of studies that induced effects greater than or less than the effect size.
Results:
There is a general trend to show effectiveness (effect size greater than 0.00) for obtaining beneficial changes from use of thermogenic dietary supplements, yet the 95% confidence interval for effect size crossed 0.00 (indicating no benefit). Chi-square comparison to exercise, or combination of diet and exercise, indicates that responses induced from weight-loss supplements were less effective than what is obtained from utilizing exercise, or diet and exercise, without additional weight-loss supplements.
Conclusion:
There appears to be limited benefit that may be derived from the inclusion of thermogenic dietary supplements to reduce body mass and improve cardiometabolic health for individuals who are overfat.
AllisonDBGaddeKMGarveyWT, et al. (2012) Controlled-release phentermine/topiramate in severely obese adults: A randomized controlled trial (EQUIP). Obesity (Silver Spring, Md)20: 330–342.
2.
AuvichayapatPPrapochanungMTunkamnerdthaiO, et al. (2008) Effectiveness of green tea on weight reduction in obese Thais: A randomized, controlled trial. Physiology and Behavior93: 486–491.
3.
BelzaAJessenAB (2005) Bioactive food stimulants of sympathetic activity: Effect on 24-hour energy expenditure and fat oxidation. European Journal of Clinical Nutrition59: 733–741.
4.
BelzaAFrandsenEKondrupJ (2007) Body fat loss achieved by stimulation of thermogenesis by a combination of bioactive food ingredients: A placebo-controlled, double-blind 8-week intervention in obese subjects. International Journal of Obesity (2007)31: 121–130.
5.
BersaniFSCovielloMImperatoriC, et al. (2015) Adverse psychiatric effects associated with herbal weight-loss products. BioMed Research International2015: 120679.
6.
BoothFWLayeMJ (2009) Lack of adequate appreciation of physical exercise’s complexities can pre-empt appropriate design and interpretation in scientific discovery. Journal of Physiology (London)587: 5527–5539.
7.
BoozerCNDalyPAHomelP, et al. (2002) Herbal ephedra/caffeine for weight loss: A 6-month randomized safety and efficacy trial. International Journal of Obesity and Related Metabolic Disorders26: 593–604.
8.
BoozerCNNasserJAHeymsfieldSB, et al. (2001) An herbal supplement containing Ma Huang-Guarana for weight loss: A randomized, double-blind trial. International Journal of Obesity and Related Metabolic Disorders25: 316–324.
9.
BouchardNCHowlandMAGrellerHA, et al. (2005) Ischemic stroke associated with use of an ephedra-free dietary supplement containing synephrine. Mayo Clinic Proceedings80: 541–545.
10.
BuchananRBeckettRD (2013) Green Coffee for Pharmacological Weight Loss. Journal of Evidence-Based Complementary and Alternative Medicine18: 309–313.
11.
CalfeeRFadaleP (2006) Popular ergogenic drugs and supplements in young athletes. Pediatrics117: e577–589.
12.
CampbellBIColquhounRJZitoG, et al. (2016) The effects of a fat loss supplement on resting metabolic rate and hemodynamic variables in resistance trained males: a randomized, double-blind, placebo-controlled, cross-over trial. Journal of the International Society of Sports Nutrition13: 14.
13.
ClarkJE (2012) An overview of the contribution of fatness and fitness factors, and the role of exercise, in the formation of health status for individuals who are overweight. Journal of Diabetes and Metabolic Disorders11: 19.
14.
ClarkJE (2015) Diet, exercise or diet with exercise: Comparing the effectiveness of treatment options for weight-loss and changes in fitness for adults (18–65 years old) who are overfat, or obese; Systematic review and meta-analysis. Journal of Diabetes and Metabolic Disorders14: 31.
15.
ClarkJE (2016) The impact of duration on effectiveness of exercise: The implication for periodization of training and goal setting for individuals who are overfat: A meta-analysis. Biology of Sport33: 309–333.
16.
ClarkJE (2019) Diets and diet therapy: Diet supplements for exercise. In: FerrantiPBerryEMAndersonJR (eds) Encyclopedia of Food Security and Sustainability. Elsevier, 161–170.
17.
ClarkJEGoonDT (2015) The role of resistance training for treatment of obesity related health issues and for changing health status of the individual who is overfat or obese: A review. Journal of Sports Medicine and Physical Fitness55: 205–222.
18.
CoulterAARebelloCJGreenwayFL (2018) Centrally acting agents for obesity: Past, present and future. Drugs78: 1113–1132.
19.
DixitKKamathDVAlluriKV, et al. (2018) Efficacy of a novel herbal formulation for weight loss demonstrated in a 16-week randomized, double-blind, placebo-controlled clinical trial with healthy overweight adults. Diabetes, Obesity & Metabolism20: 2633–2641.
20.
DonsmarkMLangfortJHolmC, et al. (2005) Hormone-sensitive lipase as mediator of lipolysis in contracting skeletal muscle. Exercise and Sport Sciences Reviews33: 127–133.
21.
EkorM (2014) The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Frontiers in Pharmacology4: 177.
22.
EsteghamatiAMazaheriTVahidi RadM, et al. (2015) Complementary and alternative medicine for the treatment of obesity: A critical review. International Journal of Endocrinology and Metabolism13: e19678.
23.
EthanDBaschCHHillyerGC, et al. (2016) An analysis of weight loss articles and advertisements in mainstream women’s health and fitness magazines. Health Promotion Perspectives6: 80–84.
24.
FigueiredoPRLdSiebraALdANetoLJdL, et al. (2015) Obesity and natural products. Journal of Food and Nutrition Research3: 540–549.
25.
Garcia-CortesMRobles-DiazMOrtega-AlonsoA, et al. (2016) Hepatotoxicity by dietary supplements: A tabular listing and clinical characteristics. International Journal of Molecular Sciences17: 537.
26.
GarveyWTRyanDHLookM, et al. (2012) Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): A randomized, placebo-controlled, phase 3 extension study. American Journal of Clinical Nutrition95: 297–308.
27.
GreenwayFDe Jonge-LevitanLMartinC, et al. (2006) Dietary herbal supplements with phenylephrine for weight loss. Journal of Medicinal Food9: 572–578.
28.
GreenwayFLDe JongeLBlanchardD, et al. (2004) Effect of a dietary herbal supplement containing caffeine and ephedra on weight, metabolic rate, and body composition. Obesity Research12: 1152–1157.
29.
GurleyBJGardnerSFWhiteLM, et al. (1998) Ephedrine pharmacokinetics after the ingestion of nutritional supplements containing Ephedra sinica (ma huang). Therapeutic Drug Monitoring20: 439–445.
30.
HallKD (2013) Diet versus exercise in “the biggest loser” weight loss competition. Obesity21: 957–959.
31.
HallerCAJacobPBenowitzNL (2002) Pharmacology of ephedra alkaloids and caffeine after single-dose dietary supplement use. Clinical Pharmacology and Therapeutics71: 421–432.
32.
HallerCAJacobPBenowitzNL (2004) Enhanced stimulant and metabolic effects of combined ephedrine and caffeine. Clinical Pharmacology and Therapeutics75: 259–273.
33.
HannabassKOlsenKR (2016) Fat burn X: Burning more than fat. British Medical Journal Case Reports2016.
34.
HarpazETamirSWeinsteinA, et al. (2017) The effect of caffeine on energy balance. Journal of Basic and Clinical Physiology and Pharmacology28: 1–10.
35.
Hasani-RanjbarSJouyandehZAbdollahiM (2013) A systematic review of anti-obesity medicinal plants - an update. Journal of Diabetes and Metabolic Disorders12: 28.
36.
HaunerHHastreiterLWerdierD, et al. (2017) Efficacy and safety of cathine (nor-pseudoephedrine) in the treatment of obesity: A randomized dose-finding study. Obesity Facts10: 407–419.
37.
HendricksEJ (2017) Off-label drugs for weight management. Diabetes, Metabolic Syndrome and Obesity10: 223–234.
38.
HeubergerJCohenAF (2019) Review of WADA prohibited substances: Limited evidence for performance-enhancing effects. Sports Medicine49(4): 525–539.
39.
HeymsfieldSBAllisonDBVasselliJR, et al. (1998) Garcinia cambogia (Hydroxycitric Acid) as a potential antiobesity agent. Journal of the American Medical Association280(18): 1596–1600.
40.
HurselRWesterterp-PlantengaMS (2009) Green tea catechin plus caffeine supplementation to a high-protein diet has no additional effect on body weight maintenance after weight loss. American Journal of Clinical Nutrition89: 822–830.
41.
InchiosaMA (2011) Experience (mostly negative) with the use of sympathomimetic agents for weight loss. Journal of Obesity2011; 2011: 764584.
42.
JenkinsonDMHarbertAJ (2008) Supplements and sports. American Family Physician78: 1039–1046.
KerksickCMWilbornCDRobertsMD, et al. (2018) ISSN exercise and sports nutrition review update: research & recommendations. Journal of the International Society of Sports Nutrition15: 38.
45.
KovacsEMLejeuneMPNijsI, et al. (2004) Effects of green tea on weight maintenance after body-weight loss. British Journal of Nutrition91: 431–437.
46.
LiuAGSmithSRFujiokaK, et al. (2013) The effect of leptin, caffeine/ephedrine, and their combination upon visceral fat mass and weight loss. Obesity (Silver Spring, MD)21: 1991–1996.
47.
LiuYSunMYaoH, et al. (2017) Herbal medicine for the treatment of obesity: An overview of scientific evidence from 2007 to 2017. Evidence-Based Complementary and Alternative Medicine2017: 8943059.
48.
Mielgo-AyusoJBarrenecheaLAlcortaP, et al. (2014) Effects of dietary supplementation with epigallocatechin-3-gallate on weight loss, energy homeostasis, cardiometabolic risk factors and liver function in obese women: randomised, double-blind, placebo-controlled clinical trial. British Journal of Nutrition111: 1263–1271.
49.
NassarEMorellionJHudsonG, et al. (2008) Effects of ingesting a thermogenic/anti-inflammatory supplement while participating in a resistance training program on indices of body composition and metabolic, cardiovascular, muscular, and hemodynamic function in overweight females. Journal of the International Society of Sports Nutrition5: P25.
National Center for Complementary and Integrative Health [NCCIH] (2018) Dietary supplements marketed for weight loss, bodybuilding, and sexual enhancement: What the science says. Available at: https://nccih.nih.gov/health/providers/digest/DietarySupplements.
52.
NgondiJLEtoundiBCNyangonoCB, et al. (2009) IGOB131, a novel seed extract of the West African plant Irvingia gabonensis, significantly reduces body weight and improves metabolic parameters in overweight humans in a randomized double-blind placebo controlled investigation. Lipids in Health and Disease8: 7.
53.
NogiecCDKasifS (2013) To supplement or not to supplement: A metabolic network framework for human nutritional supplements. PloS One8: e68751.
54.
PopeHGJrWoodRIRogolA, et al. (2014) Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocrine Reviews35: 341–375.
55.
Rios-HoyoAGutierrez-SalmeanG (2016) New dietary supplements for obesity: What we currently know. Current Obesity Reports5: 262–270.
56.
SaidOKhalilKFulderS, et al. (2010) A double blinded- randomized clinical study of “Weightlevel”, a combination of four medicinal plants used in traditional Greco-Arab and Islamic medicine. The Open Complementary Medicine Journal2010: 1–6.
57.
SaperRBEisenbergDMPhillipsRS (2004) Common dietary supplements for weight loss. American Family Physician70: 1731–1738.
58.
SchulmanS (2003) Addressing the potential risks associated with ephedra use: A review of recent efforts. Public Health Reports118: 487–492.
59.
SchwingshacklLDiasSStrasserB, et al. (2013) Impact of different training modalities on anthropometric and metabolic characteristics in overweight/obese subjects: a systematic review and network meta-analysis. PloS One8: e82853.
60.
ShekellePGHardyMLMortonSC, et al. (2003) Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: A meta-analysis. Journal of the American Medical Association289: 1537–1545.
61.
SmithSRGarveyWTGreenwayFL, et al. (2017) Coadministration of lorcaserin and phentermine for weight management: A 12-week, randomized, pilot safety study. Obesity (Silver Spring, MD)25: 857–865.
62.
SoniMGCarabinIGGriffithsJC, et al. (2004) Safety of ephedra: Lessons learned. Toxicology Letters150: 97–110.
63.
SteinCM (2002) Are herbal products dietary supplements or drugs? An important question for public safety. Clinical Pharmacology and Therapeutics71: 411–413.
64.
StohsSJBadmaevV (2016) A review of natural stimulant and non-stimulant thermogenic agents. Phytotherapy Research30: 732–740.
65.
StohsSJPreussHGSharaM (2011) A review of the receptor-binding properties of p-synephrine as related to its pharmacological effects. Oxidative Medicine and Cellular Longevity2011: 482973.
66.
ThomE (2007) The effect of chlorogenic acid enriched coffee on glucose absorption in healhty volunteers and its effect on body mass when used long-term in overweight and obese people. The Journal of International Medical Research35: 900–908.
67.
VaughanRAConnCAMermierCM (2014) Effects of commercially available dietary supplements on resting energy expenditure: A brief report. ISRN Nutrition2014: 650264.
68.
WangHWenYDuY, et al. (2010) Effects of catechin enriched green tea on body composition. Obesity (Silver Spring, MD)18: 773–779.
69.
Westerterp-PlantengaMSLejeuneMPGMKovacsEMR (2005) Body weight loss and weight maintenance in relation to habitual caffeine intake and green tea supplementation. Obesity Research13: 1195–1204.
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