Do Appetite Suppressants Work?

Reading Time: 8 minutesWant to lose weight? Eat less.

Believe me, I know that’s easier said than done. So it’s no surprise that products that claim to suppress appetite are among the most common weight loss aids purchased, and no doubt a huge chunk of the $66 billion weight-loss industry, especially since one in every three American adults is significantly overweight or obese.

Here we look at a variety of appetite suppressants including dietary supplements, prescription drugs and natural suppressants, including specific foods.

The Cleveland Clinic, among myriad other authoritative nutritional science sources, explains it this way:

Medications classified as appetite suppressants act upon the body’s central nervous system, tricking the body into believing that it is not hungry. … Appetite suppressants can be prescribed or purchased over-the-counter…[and] are used as a short-term treatment for patients with obesity.[1]

That’s the gist. And they do this in a number of ways, but mostly getting your central nervous system to send a message to your brain to increase its production of serotonin, the neurotransmitter which tells you you’re happily satiated.

So which appetite suppressants actually work? Let’s take a look.

Dietary Supplement Appetite Suppressants

Do dietary supplements satisfy your cravings or curb hunger?

First off, dietary supplements are not drugs and are not evaluated by the U. S. Food and Drug Administration (FDA), and their efficacy is up for debate at best. At worst, some may be dicey and possibly dangerous for some people. Always talk to your doctor before taking any dietary supplement.

Garcinia cambogia

Garcinia cambogia is alleged to—in part—prevent fat from being absorbed through enzyme blocking. But we are curious about how it supposedly decreases appetite.

The ingredient in garcinia cambogia alleged to do just that is hydroxycitric acid (HCA). Sounds familiar, right? The 2009 Hydroxycut controversy when the FDA lambasted the HCA supplement as being potentially very damaging to the liver? It should be noted that Hydroxycut had other ingredients in it besides garcinia cambogia, and one comprehensive study did suggest garcinia couldn’t necessarily be vilified as a single ingredient. But that doesn’t negate the strong warning the FDA put out.

That warning did not deter many; garcinia cambogia is a popular diet aid, claiming to increase serotonin—which is said to curb appetite. Some agree HCA increases serotonin; but even if it does that, will it crush appetite and result in weight loss?

A study published in the 1998 Journal of the American Medical Association found:

A total of 135 subjects were randomized to either active hydroxycitric acid…or placebo … Patients in both groups lost a significant amount of weight during the 12-week treatment period… however, between-group weight loss differences were not statistically significant…There were no significant differences in estimated percentage of body fat mass loss between treatment groups, and the fraction of subject weight loss as fat was not influenced by treatment group. Conclusions.— Garcinia cambogia failed to produce significant weight loss and fat mass loss beyond that observed with placebo.[2]

And a meta-review of several Randomized Control Trials (RCTs) published in the 2011 Journal of Obesity concluded:The evidence from RCTs suggests that Garcinia extracts/HCA generate weight loss on the short term. However, the magnitude of this effect is small, is no longer statistically significant when only rigorous RCTs are considered, and its clinical relevance seems questionable. Future trials should be more rigorous, longer in duration, and better reported. [3]

Bottom line? Likely not effective.

Hoodia gordonii

Hoodia gordonii is another popular dietary supplement that claims to be an appetite suppressant. Some South African peoples, traditionally Bushmen, used the succulent plant to stave off hunger. But there’s no human clinical study I can find that validates its efficacy, and also no reports of serious side effects that I can locate.

The other issue, as with all herbal supplements, is the authenticity or quality. There’s a great headline that’s been overused but still works: “What’s All the Hoopla Over Hoodia?’” Maybe it’s hubbub. [4]

Physician Brent Bauer, writing for the Mayo Clinic, says there’s no evidence that hoodia helps with weight loss and also no science on the safety of hoodia. “In addition, the quality of hoodia products varies widely. In some cases, hoodia products have been found to contain unidentified ingredients that could be harmful.” [5]

When dietary supplement manufacturers go too far with claims, sometimes the feds step in. In 2011 the Federal Trade Commission (FTC) settled a case against hoodia manufactures for millions “…as part of its ongoing efforts to stop bogus health claims.” The FTC alleged that Nutraceuticals and Stella Labs “made false and deceptive claims about hoodia and its effectiveness as a treatment for obesity, and falsely claimed that their ingredient was hoodia when it was not.” [6]

The company and its top executives settled for tens of millions of dollars and were prohibited from “making any weight-loss claims related to foods, drugs, or dietary supplements…” And one executive even had to “turn over a vacation home and other assets …” [6]

Honesty is not only the best policy, it’ll save you millions. And your vacation house.

Bottom line
Hoodia is a hoax, in my opinion.

Glucomannan and Caralluma

Glucomannan and Caralluma are two supplements combined in one dietary aid call Skinny Fiber, but each also stands on its own as an alleged appetite suppressant.

According to WebMD, glucomannan may work in the gut by absorbing water and creating a bulky fiber, which may accomplish two things: a treatment for constipation, and it may also “slow the absorption of sugar and cholesterol from the gastrointestinal tract, helping to control sugar levels in diabetes, and reducing cholesterol levels.” [7]

There is some research that says glucomannan may improve weight loss—and there’s some that says not. Like the NIH’s Office of Dietary Supplements (ODS), which says that not only does this ingredient have no effect on body weight, it’s really dangerous: “…Significant safety concerns reported for tablet forms, which might cause esophageal obstructions.” [8]

Yes. People have nearly choked to death on this stuff. [9]

The caralluma cactus that grows wild in India, Africa, Saudi Arabia, Canary Islands, Afghanistan, and some locations in Europe is—like hoodia—thought to be used by hunter-gatherers to quench thirst and decrease appetites on long hunts. So, naturally, the diet supplement industry took note.

The active chemical in the plant was extracted and is marketed as an appetite suppressant and weight loss aid. The science is mixed, not surprisingly. There’s some evidence caralluma may decrease hunger if used over time, but it apparently does not decrease weight, body mass index (BMI), body fat, or hip measurements. More evidence is needed to rate its effectiveness, says WebMD. [10]

Bottom line: Meh. Probably not worth the money if it even works. Plus, who knows what quantity and quality is in that supplement? There’s no way to know.

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Prescription Drug Appetite Suppressants

There’s a long history of using drugs as appetite suppressants in the United States, and up until 1991—when the FDA banned more than 100 diet drug ingredients—plenty of people, women especially, got hooked on amphetamines and amphetamine-like concoctions. Today, there are only a handful of FDA-approved weight loss drugs, a couple of which work as appetite suppressants.

Qsymia is a mix of two medications – phentermine, which decreases appetite, and topiramate, which is used to treat seizures or migraine headaches. Qsymia is supposed to make you feel full when you haven’t filled your belly. This drug combination is said to be one of the most effective for helping people lose weight. And some research studies have shown this to be among the most effective of approved diet pills, with the NIH pointing to the combination of the two drugs as the secret sauce. [11]

This drug does come with plenty of side effects; the most glaring is that if you are pregnant or considering having a child or children, be forewarned that this drug can cause birth defects. It also brings with it a cornucopia of uncomfortable side effects – which for some might be an okay trade-off – including constipation, dry mouth, changes in the way things taste, a tingling in the hands and feet, and the phentermine often gives people trouble sleeping. There are a number of other contraindications (fancy word for side effects) for Qsymia, which may be deal-breakers for people with a history of mood issues or heart trouble, among other conditions.

Bottom line
Talk to your doctor.

Belviq is the brand name of the drug lorcaserin, which works in your brain to make you “feel” full by acting on serotonin receptors. There are several issues with Belviq. The NIH is not convinced of the drug’s potential for weight loss. And the list of side effects is extensive, running the gamut from constipation, drowsiness, muscle aches, insomnia and dry mouth/eyes to some pretty serious ones like agitation, anxiety, confusion, and hallucinations, severe gastrointestinal problems, irregular heartbeat, difficulty breathing, and even cognitive issues, depression, dissociation, and male breast enlargement. [12]

So rightly, the NIH wonders if the small amount of weight that may be lost is worth the possibility for side effects from the uncomfortable to the frightening. Lorcaserin also reacts badly with a very long list of other medications so make sure your doctor knows exactly what you take: over-the-counter remedies to herbs, and supplements.

Bottom line
Again, your doctor will know best.
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Foods as Appetite Suppressants

WebMD says foods consisting of fiber, water, and plain old air are nature’s best appetite suppressants. Not accomplished by tricking your brain, these voluminous foods instead actually fill your belly, so in this case, size matters. [13]

Foods that take up a lot of space in your belly and are whole, fresh, nutrient-dense and – best of all – low-calorie, or the calories in them are the best kind of calories you can consume, and they just may be the best appetite suppressants out there. Not only will consuming these foods help to naturally curb your appetite, volume foods fill you up with fewer calories. The more of these foods you add to your diet, the more weight you just may lose. Healthy homemade soups and stews filled with vegetables and lean proteins (like chicken), beans in the mix, too. Lots of fiber-rich vegetables and fruits, lean proteins, and whole grains. Plus healthy fats like nuts and avocados. Avocados in particular are packed with fiber, a monounsaturated fat that’s great for your heart, and this is one food that also sends that signal to your brain: ‘I’m full!’

The Centers for Disease Control (CDC) has the job of sharing the cold hard facts about obesity in America:

Obesity is common, serious and costly. More than one-third of U.S. adults (34.9% or 78.6 million) have obesity.[14]

But the CDC also delivers great advice on what to eat (and a lot of it) to satiate, crush appetite and, lose weight. Its advice?

The number of calories in a particular amount or weight of food is called “calorie density” or “energy density.” Low-calorie-dense foods are ones that don’t pack a lot of calories into each bite. Foods that have a lot of water or fiber and little fat are usually low in calorie density. They will help you feel full without an unnecessary amount of calories. [15]

Sounds like what I just said. The CDC suggests, and nutrition researchers agree, that your plate should be comprised mostly of fruits, vegetables, whole grains, lean meats, poultry, fish, beans, eggs, nuts, and fat free or low-fat milk and milk products. [15] [16]

Avoid the stuff that’s making you fat—and often, increasing hunger:

  • fried foods (you’ll find a lot of them have baked variations that are just as tasty)
  • fatty meats (Yes, those burgers)
  • full-fat dairy (Extra cheese? No.)
  • processed foods loaded with extra fat, sugar, and often, sodium

All of these not only contribute to weight gain and are super unhealthy, they don’t fill you up; rather, they tell your brain: “feed me more.” You can eat a bag of Lays (‘Bet you can’t eat just one.’) and never feel satisfied—maybe even sick and guilty—because these are low-nutrient, high-calorie foods. It’s not worth it. Same with sweets like candy and cookies; you’ll get a quick sugar rush, and then the crash and your body craves more. It’s a vicious cycle.

Want to suppress that appetite? Opt for the foods that make you feel full: fruits like apples, whole grains like oatmeal, nuts like almonds, and Greek yogurt. A 2011 Harvard School of Medicine study published in the New England Journal of Medicine confirms this. [17]

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The Bottom Line

Eat yourself full with food, good-for-you, fat-busting, belly-full foods like vegetables, fruits, lean proteins, beans, nuts, and don’t forget that Greek yogurt! These are the appetite suppressants I recommend. No pill, just eat yourself full. Healthily.

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