In the wake of the ban against phen-fen and Redux, many weight-loss clinics began recommending "natural phen-fen" or "herbal phen-fen." Available at health food stores, these products are being hyped as safer, more natural alternatives to the now-banned diet drugs. However, herbal phen-fen may not be without risks.
The key ingredient in these formulas is ephedra, a powerful, nonprescription herbal stimulant that has been marketed heavily for weight loss. However, ephedra is linked to heart attacks, strokes, seizures, brain hemorrhages, and deaths. The FDA is keeping a close eye on ephedra.
The other ingredient in herbal phen-fen is St. John's wort, an herb that depresses the central nervous system. According to a number of clinical trials, St. John's wort shows great promise in relieving mild depression and anxiety. But its side effects include weight gain, mild nausea, stomachache, tiredness, and sensitivity to sunlight. There is no evidence that St. John's wort leads to weight loss, although it might be helpful in reducing depression and thus fending off depression-related food binges.
These herbs have opposing actions: Ephedrine is a stimulant, and St. John's wort is a depressant. No one really knows how such a combination could affect the body. Until more testing is done, there is no good rationale for supplementing with herbal phen-fen.
The FDA has herbal phen-fen producers on alert. In a position paper issued November 6, 1997, and posted on its Internet web site, the FDA said that it "considers these products to be unapproved drugs because their names reflect that they are intended for the same use as the anti-obesity drugs, fenfluramine and phentermine . . . FDA regards any over-the-counter product commercially promoted as an alternative to prescription anti-obesity drugs (such as phentermine and fenfluramine) to be a drug. The agency is taking appropriate regulatory action to remove such products from the market."
In other words, companies selling herbal phen-fen supplements and labeling them as such have to be careful about how they promote, market, and name their natural diet aids. In fact, there were nearly 1,000 reports in 1993 of poisonings caused by herbs contaminated with belladonna.
Many ads, or even a product name, starts making the supplement sound like a drug, that is, that it can cure obesity, the product and its manufacturer may be in regulatory hot water. By law, supplements cannot expressly or implicitly claim to diagnose, treat, prevent, or cure a disease. If they do, they must be regarded as drugs and then must meet the safety and effectiveness standards for drugs.
Does this mean you should forgo herbal teas altogether? Not at all. Herbal teas are a healthy alternative to caffeine-containing beverages. Teas with mint, rose hips, blackberry, raspberry, and chamomile, as well as those formulated with cold-fighting herbs like echinacea and goldenseal, and many others, are excellent beverages. However, if you should ever have an adverse reaction after taking any herbal preparation, see your physician right away.
In addition to the weight-loss supplements already covered, there are several others on the market claiming to burn fat, accelerate metabolism, increase endurance, and confer a host of other benefits. Some look promising, but we just don't know enough about them yet. Others are downright dangerous or patently bogus. What follows is a look at these products those worth a try and those better left alone.