By Anastasia Yefremova
It seems like every other day a new magic pill or one-size-fits-all miracle diet appears that is guaranteed to take that extra weight off , no strings attached and no extra effort necessary. We marvel at the before and after pictures of happy, smiling consumers, claiming the latest weight loss fad really, honestly works and their lives are truly, irrevocably changed for the better because they took a chance on this one product. From pills that contain the secret ingredients that give Japanese women their slim figures, to ones that have, allegedly, sold millions so they deserve your notice, magic weight management solutions can be found everywhere.
So then why does the Centers for Disease Control and Prevention (CDC) report over a third of Americans are obese, and obesity-related conditions like heart disease, stroke, Type 2 diabetes and certain types of cancer are among the leading causes of preventable death?
Several nutrition experts offered their thoughts. Elizabeth Avery, a registered dietitian at Boston’s Emerson College, and Felicia Stoler, nutritionist, exercise physiologist and author, are members of the Academy of Nutrition and Dietetics. The academy is governed by national leaders in nutrition and health, and more than 70 percent of its 75,000 members are registered dietitians. Stoler is also a member of the Society for Nutrition Education and Behavior, an international community of professionals involved in nutrition education and health promotion. The society has been actively engaged in advocacy and legislative actions. Registered nurse Jamie Kubik offers a more holistic perspective on the place nutrition holds in the broader medical context.
Plugging the nutritional holes
There are multivitamins and there are dietary supplements. In a country where so few (if any) of those are actually regulated by the Food and Drug Administration (FDA), it can be difficult for health care professionals and nutrition experts to tell one from the other let alone the average consumer. And that may be disconcerting, considering that over half of Americans use dietary supplements, CDC numbers show.
But even people knowledgeable about the vitamins and supplements disagree. Elizabeth Avery said there is a clear and distinct difference between a multivitamin and a dietary supplement. Felicia Stoler, argued they are one and the same. According to Jamie Kubik, the least headache-inducing way to think of the issue is that “a dietary supplement can include vitamins, but not all dietary supplements are vitamins.”
“They can be a fiber, flax seeds, anything that you add to your diet,” Kubik said. “A broader term than vitamins.”
Some ingredients in dietary supplements are legal, others are not, said Avery. While vitamins are for the most part safer, dietary supplements are not regulated by the FDA and can be dangerous as consumers don’t always know what they are ingesting.
“There are prescription medication in some, banned substances in others,” Avery said. “The amount of active ingredients can vary in each bottle, so you never really know what you’re getting.”
According to Stoler, Germans are required to present a prescription to get nutrients. She believes Americans should be too. But the FDA lacks the funding and people to enforce any such policy and the industry has fought to keep it that way, Stoler said. Sheadded that supplement industry has a vested interest in consumers buying potentially diluted products lacking the active amount of ingredients.
“People tend to abuse or not have all the facts in choosing dietary supplements,” Kubik said. “It would be in their best benefit to talk to a health care provider. You don’t know if they have a preexisting condition and that can be dangerous.”
Even vitamins, generally safer than dietary supplements, can be harmful if taken in excess. The easiest to overdose are fat soluble vitamins like A, D, E and K, which can, in fact, become toxic and have very negative effects.
“Some people think, if one is good, two or three are better,” Avery said. “So they might take two or three multivitamins, which is not healthy or safe. If you look on the back of a multivitamin and mineral, some of those provide more than 100 percent or your daily needs. You can be taking 600 percent of your daily need.”
Stoler warned that “pills do not make up for a lifestyle or an accumulation of lifestyle habits and behaviors,” and are no substitute for a well-rounded diet. However, she described them as a booster shot filling in what we may be missing through our food. And they can be an absolute necessity for people with food allergies, people who restrict certain foods due to ethical or religious reasons, people with eating disorders or athletes looking to improve their performance, Avery said. Stoler and Avery agreed with Kubik that consumers should always proceed with caution when they self-medicate nutrition-wise and either consult with a health care professional, or do their homework.
“You can go on FDA.gov to find out if there have been any recalls, withdrawals or safety alerts. You can check if your supplement has been contaminated by going to consumerlab.com. There are tons of reputable organizations and websites on which you can check the safety of your supplement,” Avery said.
Pills make the fat go away
Weight loss pills like Lipozene and Hydroxycut are a whole other ballgame. Kubik doesn’t consider them as dietary supplements at all.
“With those you get into a crazed zone,” she said. “A lot of these weight loss pills say that they have green tea extract or a magic ingredient. It’s like snake oil, like a magic pill.”
Avery put weight loss pills “under the bogus category” and Stoler called them “garbage.” Stoler said no pill or potion can change the basic physiology of the human body. And no amount of weight loss is worth the frequent untoward side effects. She warned against anything marketed as a quick fix, as it has the potential to be dangerous.
“There have been tons of weight loss pills that have been taken off the market because they have actually led to death, like Fen-phen out of the Ephedra class,” Avery said. “It’s a form of Ephedra and that was in a very common diet supplement in the 1990s. Lots of healthy middle-aged people died from cardiovascular complications. It’s very serious. These dietary supplements can be unsafe, ineffective, contaminated.”
The pills that do have some effect are often accompanied by instructions such as “drink three glasses of water with each pill,” Avery said. This would naturally lead to weight loss because consumers would be filling up on water and losing their appetites. “So it’s really the water that’s leading to the weight loss, not the pill,” Avery said.
Step by step, the weight loss program
If it’s not the magic pill, it’s the newest dietary lifestyle fad. A number of weight loss programs promise fast and painless results with minimal effort with clearly structured, easy-to-follow steps.
“If somebody want to lose 10 or 15 pounds for a reunion and you don’t mind gaining all the weight back, sure, go on any diet you want,” Avery said. “If it’s temporary, I’m not going to worry too much about long-term effects. But if you want to actually learn how to lose weight in a very healthy and sustainable way, I would strongly recommend speaking to a dietitian and making lifestyle changes.”
Most recently, for example, diets like the Blood Type Diet and the Paleo Diet generated a lot of controversy regarding their scientific merit or lack thereof. Stoler in particular has been an avid opponent of the Paleo Diet, which focuses on eating a high-protein, high-plant diet devoid of grains, dairy and refined foods.
“You’re trying to apply a theory on different DNA and gastrointestinal tract, a changed physiology,” she said. “The likelihood the caveman was eating much animal meat is pretty slim. You had to catch it and cook it, and I have a hard time believing cavemen didn’t eat things that didn’t run away from them.”
Stoler warned against high-protein diets in general, as they have been highly correlated to cancer. And over-indulging in a nutritional element can be just as bad as deprivation.
“Atkins promotes a high meat intake and very little intake of fruits and vegetables,” Avery said. “You’re not only missing out on those minerals, but on fiber. Those fruits and vegetables have the fiber that makes you feel full and satiated.”
Nutritionists say well-publicized programs like Weight Watchers and Jenny Craig are more well-rounded in terms of nutritional value. They can be a safer bet in avoiding the confusing, contradictory information available on other dietary lifestyles.
“Diet fads come and go, but Weight Watchers has been around for 30 years,” Kubik said. “They’ve stood the test of time, making small, long-term changes. They emphasize portion control and eating more vegetables.”
However, while weight management programs can be very effective, they have their drawbacks, Avery said. In her experience, people on Weight Watchers don’t learn about nutrition or how to read a food label, she said. People who buy Jenny Craig’s pre-packaged meals often find themselves at a loss when they go to a restaurant. They don’t feel confident in their food choices when they are not at home, Avery said.
Weight loss solutions, whether in a bottle or on a list of step-by-step instructions, are a symbol of a culture of instant gratification, nutrition experts agree. In this fast-paced world, people want problems taken care of immediately and definitively. But that’s not the way to go, Stoler said, unless you are prepared to get all your weight back the moment you stray from your diet or miss a pill.
“We live in a society where we think instant is better,” she said. “Instead of cleansing or juicing or following the latest fad, go back to what’s basic. It’s not sexy. What’s tried and true is what you put in your mouth as far as food and beverages versus exercise and what kind you do.”
The rest – diets, pills, supplements – done without proper knowledge of the why’s and how’s, is a waste of money and effort, Avery said.