"An antique collection of herbal medicines" by Øyvind Holmstad / CC BY-SA 3.0

Herbals Don’t Work for Weight Loss

Feb 21, 2020

By Steven Novella

One of the frustrating things I encounter as a practicing physician is listening to patients describe how they are motivated to improve their health, and then list all the things they are doing, none of which will improve their health. I am eating organic, taking probiotics, taking supplements, and “eating clean.” They may go into detail about their “paleo” diet, some specific megavitamin or superfood, or list the herbal supplements they think will supercharge some aspect of their health.

This is not their fault. They are motivated and taking action and responsibility for their health, but they have been failed by society. The regulatory infrastructure in place to protect the public from false or misleading health claims, from outright fraud, charlatans and snake oil peddlers has clearly failed. Further, the public largely assumed they are protected from fraud, when clearly they are not. People must protect themselves with information, often having to find on their own the glimmers of reliable information hiding in a sea of misinformation and slick marketing. So let me add one bit of helpful information – herbal supplements, according to a recent systematic review, do not work for weight loss.

To be more technically precise – there is currently insufficient evidence to conclude that any herbal product reviewed is effective for weight loss. Historically the most common reason for insufficient evidence of efficacy for a treatment that has been studied is that it simply does not work, or has only a clinically insignificant effect (which is functionally the same thing). You can hold out for larger and better studies to show a statistically and clinically significant effect, but don’t hold your breath, and in the meantime the most reasonable approach is to consider such treatments as ineffective until proven otherwise.

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One comment on “Herbals Don’t Work for Weight Loss”

  • Herbal medicine are marketed not as the drugs they are, but as supplements, which means they can imply health claims without the burden of evidence…

    Back in the late 70s, when the vitamin and supplement industry was really taking off, the FDA was debating how to classify them. Enter lobbyists for the respective industries, and their Man on the Hill, Orrin Hatch.

    https://khn.org/news/how-sen-orrin-hatch-changed-americas-health-care/

    As the industry grew, there was a debate over how to regulate it: Should it be more like food or like drugs? In 1994, Hatch sponsored the Dietary Supplement Health and Education Act, known as DSHEA, which treats supplements more like food.

    Classifying supplements as food instead of drugs allows them to be marketed with significantly more freedom in advertising. Any regulating as a result of injuries or death occurs after the fact, and the burden of proof is on the public. Unlike drugs, which are required to be rigorously tested before being allowed to enter the market.

    Bottom line: we really need campaign finance reform.

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