What we need to know about taking any intervention for obesity, including these two new medications, is that they're not a quick fix. They're not a magic pill or, in this case, a magic injection," says Dr. Acosta, a Mayo Clinic expert in treating obesity and co-author of "The Mayo Clinic Diet Rx."
This week, Dr. Mehmet Oz, host of "The Dr. Oz Show," sat down to explain to senators why he, as a surgeon and popular doctor, promotes what some experts have called unscientific claims about "magical" weight-loss products on his show.
However, Oz said he uses "flowery language" to give his audience a little nudge of hope and motivation to lose weight, because they already know that adjusting diet and exercising are the things they need to do. [10 Fitness Apps: Which Is Best for Your Personality?]
"I actually do personally believe in the items I talk about on the show. I passionately study them. I recognize that, oftentimes, they don't have the scientific muster to present as fact. Nevertheless, I would give my audience the same advice I give my family, and I have given my family these products," Oz said.
Green coffee bean extract: Perhaps the most well-known weight-loss supplement that Oz has popularized is green coffee bean extract, whose major ingredients are chlorogenic acids. "You may think magic is make-believe, but this little bean has scientists saying they've found the magic weight-loss cure for every body type. It's green coffee extract," Oz said about the supplement during an episode that aired in 2012.
Testifying in front of the panel, Oz defended his endorsement of green coffee beans by citing a study that found people who took the supplements did lose weight. However, that study was funded by the product's manufacturer, McCaskill noted.
These purported weight-loss supplements could even be harmful, recent research suggests. A study in mice, published last year in the Journal of Agricultural and Food Chemistry, found that chlorogenic acid in green coffee bean extract didn't help prevent weight gain in mice fed a high-fat diet and was linked to an unhealthy buildup of fat in the liver.
Raspberry ketone: Oz has called raspberry ketones "the No. 1 miracle" fat-burner. This compound found in raspberries has been tested in animals and in cells in the lab, but never for weight loss in humans. Some research in animals has suggested that it might increase some measures of metabolism. Still, there is no reliable scientific proof that it improves weight loss in people, and no study has examined its safety and dosage.
Garcinia cambogia extract: Garcinia cambogia is a small, tasty fruit native to Southeast Asia, and was featured in Oz's "The Newest, Fastest Fat Busters" episode. The extract contains a compound called hydroxycitric acid (HCA) that is touted for weight loss, but studies have produced mixed results. One study, a randomized controlled trial published in The Journal of the American Medical Association in 1998, even found that people who took the supplement as part of their weight-loss diet lost less weight than the control group who took a placebo.
African mango diet pill: Irvingia, or African mango extract, is another product touted for weight loss that Oz has talked about on his show. In a 2013 review of studies, published in the Journal of Dietary Supplements, the researchers concluded that the effects of this supplement on body weight and related outcomes were unproven, and therefore, they said, the supplement could not be recommended as a weight-loss aid.
Saffron extract: This expensive, exotic spice that is frequently used in Middle Eastern cooking has much folklore describing its ability to lighten up mood, but modern science hasn't found it is a "miracle appetite suppressant" as Oz has claimed. No independent studies of the supplement have found that it helps people lose weight.
There is no magic pill that will cure obesity, a condition that affects over 40% of adults in the United States. But new types of medicines have been life-changing for many people who have struggled with weight. They are anti-obesity medications, and part of what makes them unique is how they are prescribed: They are used to treat obesity as a chronic metabolic disease, rather than perpetuating the misconception that obesity is a problem that can be overcome by willpower.
Anti-obesity medications have been around for decades, and there are several currently in use. But tirzepatide and semaglutide are the first of a new generation of highly effective hormone-based obesity medications. Other medications like this are being developed as well.
Common symptoms of tirzepatide and semaglutide are diarrhea, nausea, and vomiting, and the two treatments have a box warning citing a potential risk of thyroid C-cell tumors (based on studies in rodents; there is no evidence of this in humans).
But not everyone is eligible for treatment with semaglutide. Doctors can prescribe it for adults who have obesity, with a body mass index (BMI) of greater than 30, or those who are overweight, with a BMI greater than 27, accompanied by weight-related medical problems such as high blood pressure, type 2 diabetes, or high cholesterol. (BMI is a measure used to determine weight categories. The Centers for Disease Control and Prevention [CDC] provides BMI calculators on its website.) The medication is not recommended for those with a personal or family history of certain endocrine or thyroid tumors, specifically, medullary thyroid cancer.
Depending on the patient and their other diseases, anti-obesity medications can also help with other weight-related medical problems, such as improving blood pressure or cholesterol levels, improving blood sugar levels in patients with diabetes, and delaying the onset of type 2 diabetes. The class of GLP-1 analogue medications has also been found to decrease the occurrence of repeat heart attacks and strokes in those who have type 2 diabetes.
In March 2024, the Centers for Medicare and Medicaid Services issued new guidance saying Medicare Part D plans can start covering anti-obesity drugs if they are also approved for an added health benefit, such as heart health.
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Johann Hari: It's really important for people to understand this is not a fad. This is not a new diet drug craze. I've heard it described that way. This is a profound medical breakthrough that will have remarkable effects. And whether it'll be better or worse, it's a really important question, and disturbingly, the answer is, I don't know, despite all the research I did.
Mary Long: I'm Mary Long, and that's Johann Hari, author of the new book Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs. My colleague, Ricky Mulvey, caught up with Hari for a conversation about how these drugs work, the problems they solve, and the problems they create.
Ricky Mulvey: The book is Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs. I'll record at the top to all of our listeners. It's part memoir, part explainer, part investigative journalism. I found it beautifully written, and it dramatically affected the way I view obesity, increased my empathy toward it, and then also gave me a greater understanding of these drugs. Johann, thanks for coming on the show, and thanks for the book.
Ricky Mulvey: You've described these weight loss drugs as an artificial solution to an artificial problem. Can you break down the artificial problem for people who are less familiar with it, maybe have healthy eating habits?
Johann Hari: I would just say to anyone listening to the podcast, stop for a moment, pause the podcast, and Google something for me. I was born in 1979. Just Google photographs of beaches in the United States in the year I was born, 1979. Just go away and do that, and then come back. If you've come back, you will notice something a bit strange when you look at those photos. The vast majority of people in them look to us to be skinny or jacked. You look at it and go, where was everyone else on the beach in Miami that day? Where was everyone else on the beach in Provincetown? Then you look at the figures. In the year I was born, obesity was very low all over the world. Between the year I was born and the year I turned 21, obesity doubled in the United States. Then in the next 20 years, severe obesity doubled again. There's been a staggering explosion of obesity in my lifetime. You basically have 300,000 years where human beings exist in obesity was very rare. Then it ticks up a little bit during the 20th century, and then it goes supersonic in the 45 years I've been on Earth. Why? What happened? We know the answer broadly. Obesity explodes everywhere, every country that makes one specific change. It's not where people suddenly become lazy, or greedy, or lack willpower. It's where people move from mostly eating fresh, healthy foods that are prepared on the day, whole foods, to mostly eating processed and ultra-processed foods, which are constructed out of chemicals in factories in a process that isn't even called cooking; it's called manufacturing food.
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