Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Complementary therapies for reducing body weight: a systematic review

Abstract

The prevalence of obesity is increasing at an alarming rate and a plethora of complementary therapies are on offer claiming effectiveness for reducing body weight. The aim of this systematic review is to critically assess the evidence from randomized controlled trials (RCTs) and systematic reviews of complementary therapies for reducing body weight. Literature searches were conducted on Medline, Embase, Amed, and the Cochrane Library until January 2004. Hand-searches of relevant medical journals and bibliographies of identified articles were conducted. There were no restrictions regarding the language of publication. Trial selection, quality assessment and data abstraction were performed systematically and independently by two authors. Data from RCTs and systematic reviews, which based their findings on the results of RCTs, were included. Six systematic reviews and 25 additional RCTs met our inclusion criteria and were reviewed. The evidence related to acupuncture, acupressure, dietary supplements, homeopathy and hypnotherapy. Except for hypnotherapy, Ephedra sinica and other ephedrine-containing dietary supplements the weight of the evidence is not convincing enough to suggest effectiveness. For these interventions, small effects compared with placebo were identified. In conclusion, our findings suggest that for most complementary therapies, the weight of the evidence for reducing body is not convincing. Hypnotherapy, E. sinica and other ephedrine-containing dietary supplements may lead to small reductions in body weight. However, the intake of E. sinica and ephedrine is associated with an increased risk of adverse events. Interventions suggesting positive effects in single RCTs require independent replication.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. World Health Organization. Obesity: preventing and managing the global epidemic. World Health Organization: Geneva; 1998.

  2. National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity and health risk. Arch Intern Med 2000; 160: 898–904.

  3. Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, Rimm E, Colditz GA . Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med 2001; 161: 1581–1586.

    Article  CAS  PubMed  Google Scholar 

  4. Key TJ, Allen NE, Spencer EA, Travis RC . The effect of diet on risk of cancer. Lancet 2002; 360: 861–868.

    Article  CAS  PubMed  Google Scholar 

  5. Kenchaiah S, Evans JC, Levy D, Wilson PW, Benjamin EJ, Larson MG, Kannel WB, Vasan RS . Obesity and the risk of heart failure. N Engl J Med 2002; 347: 305–313.

    Article  PubMed  Google Scholar 

  6. Flegal KM, Carroll MD, Ogden CL, Johnson CL . Prevalence and trends in obesity among US adults 1999–2000. JAMA 2002; 288: 1723–1727.

    Article  PubMed  Google Scholar 

  7. National Audit Office. Tackling obesity in England. Stationery Office: London; 2001.

  8. Seidell JC, Flegal KM . Assessing obesity: classification and epidemiology. Br Med Bull 1997; 53: 238–252.

    Article  CAS  PubMed  Google Scholar 

  9. Prentice AM, Jebb SA . Obesity in Britain: gluttony or sloth? BMJ 1995; 311: 437–439.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Heini AF, Weinsier RL . Divergent trends in obesity and fat intake patterns: the American paradox. Am J Med 1997; 102: 259–264.

    Article  CAS  PubMed  Google Scholar 

  11. Blanck HM, Khan LK, Serdula MK . Use of nonprescription weight loss products. JAMA 2001; 286: 930–935.

    Article  CAS  PubMed  Google Scholar 

  12. Jadad AR, Moore RA, Carrol D et al. Assessing the quality of reports of randomised clinical trials: is blinding necessary? Controlled Clin Trials 1996; 17: 1–12.

    Article  CAS  PubMed  Google Scholar 

  13. Ernst E . Acupuncture/acupressure for weight reduction? Wien Klin Wochenschr 1997; 109: 60–62.

    CAS  PubMed  Google Scholar 

  14. Mazzoni R, Mannucci E, Rizzello SM, Ricca V, Rotella CM . Failure of acupuncture in the treatment of obesity: a pilot study. Eating Weight Disord 1999; 4: 198–202.

    Article  CAS  Google Scholar 

  15. Sun Qingfu. Simple obesity and obesity hyperlipidemia treated with otoacupoint pellet pressure and body acupuncture. J Trad Chin Med 1993; 13: 22–26.

  16. Steiner RP, Kupper N, Davis AW . Obesity and appetite control: comparison of acupuncture therapies and behavior modification. Proceedings of the International Forum on Family Medicine Education, Society of Teachers of Family Medicine, Kansas City, MO 1983. pp 313–326.

  17. Lacey JM, Terhakovec AM, Foster GD . Acupuncture for the treatment of obesity: a review of the evidence. Int J Obes Relat Metab Disord 2003; 27: 419–427.

    Article  CAS  PubMed  Google Scholar 

  18. Paranjpe P, Patki P, Patwardhan B . Ayurvedic treatment of obesity: a randomised double-blind, placebo-controlled clinical trial. J Ethnopharmacol 1990; 29: 1–11.

    Article  CAS  PubMed  Google Scholar 

  19. Kanauchi O, Deuchi K, Imasato Y, Shizukuishi M, Kobayashi E . Mechanism for the inhibition of fat digestion by chitosan and for the synergistic effect of ascorbate. Biosci Biotech Biochem 1995; 59: 786–790.

    Article  CAS  Google Scholar 

  20. Nauss JL, Thompson JL, Nagyuvary J . The binding of micellar lipids to chitosan. Lipids 1983; 18: 714–719.

    Article  CAS  PubMed  Google Scholar 

  21. Nagyvary JJ, Falk JD, Hill ML, Schmidt ML, Wilkins AK, Bradbury EL . The hypolipidemic activity of chitosan and other polysaccharides in rats. Nutr Rep Int 1979; 20: 677–684.

    CAS  Google Scholar 

  22. Vahouny GV, Satchithanandam S, Cassidy MM, Lightfood FB, Fzirda I . Comparative effects of chitosan and cholestyramine on lymphatic absorption of lipids in the rat. Am J Clin Nutr 1983; 38: 278–284.

    Article  CAS  PubMed  Google Scholar 

  23. Ernst E, Pittler MH . Chitosan as a treatment for body weight reduction? Perfusion 1998; 11: 461–465.

    Google Scholar 

  24. Wuolijoki E, Hirvelä T, Ylitalo P . Decrease in serum LDL cholesterol with microcrystalline chitosan. Methods Find Exp Clin Pharmacol 1999; 21: 357–361.

    Article  CAS  PubMed  Google Scholar 

  25. Schiller RN, Barrager E, Schauss AG, Nichols EJ . A randomized, double-blind, placebo-controlled study examining the effects of a rapidly soluble chitosan dietary supplement on weight loss and body composition in overweight and mildly obese individuals. JANA 2001; 4: 42–49.

    Google Scholar 

  26. Pittler MH, Abbot NC, Harkness EF, Ernst E . Randomised, double blind trial of chitosan for body weight reduction. Eur J Clin Nutr 1999; 53: 379–381.

    Article  CAS  PubMed  Google Scholar 

  27. Ho SC, Tai ES, Eng PHK, Tan CE, Fok ACK . In the absence of dietary surveillance chitosan does not reduce plasma lipids or obesity in hypercholesterolaemic obese Asian subjects. Singapore Med J 2001; 42: 6–10.

    CAS  PubMed  Google Scholar 

  28. Anderson RA . Effects of chromium on body composition and weight loss. Nutr Rev 1998; 56: 266–270.

    Article  CAS  PubMed  Google Scholar 

  29. Offenbacher EG, Pi-Sunyer FX . Chromium in human nutrition. Ann Rev Nutr 1988; 8: 543–563.

    Article  CAS  Google Scholar 

  30. Mertz W . Chromium in human nutrition: a review. J Nutr 1993; 123: 626–633.

    Article  CAS  PubMed  Google Scholar 

  31. Anderson RA . Essentiality of chromium in humans. Sci Total Environ 1989; 86: 75–81.

    Article  CAS  PubMed  Google Scholar 

  32. Crawford V, Scheckenbach R, Preuss HG . Effects of niacin-bound chromium supplementation on body composition in overweight African-American women. Diabetes Obes Metab 1999; 1: 331–337.

    Article  CAS  PubMed  Google Scholar 

  33. Pittler MH, Stevinson C, Ernst E . Chromium picolinate for body weight reduction. Meta-analysis of randomized trials. Int J Obes Relat Metab Disord 2003; 27: 522–529.

    Article  CAS  PubMed  Google Scholar 

  34. Cowburn G, Hillsdon M, Hankey CR . Obesity management by life-style strategies. Br Med Bull 1997; 53: 389–408.

    Article  CAS  PubMed  Google Scholar 

  35. Blumenthal M, Goldberg A, Brinckmann J . Herbal medicine. expanded commission E monographs. American Botanical Council: Austin; 2000.

    Google Scholar 

  36. Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, Rhodes SL, Jungvig L, Gagne J . Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance. JAMA 2003; 289: 1537–1545.

    CAS  PubMed  Google Scholar 

  37. Haller CA, Benowitz NL . Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. NEJM 2000; 343: 1833–1838.

    Article  CAS  PubMed  Google Scholar 

  38. Fontanarosa PB, Rennie D, DeAngelis CD . The need for regulation of dietary supplements – lessons from ephedra. JAMA 2003; 289: 1568–1570.

    Article  PubMed  Google Scholar 

  39. Heymsfield SB, Allison DB, Vasselli JR, Pietrobelli A, Greenfield D, Nunez C . Garcinia cambogia (hydroxycitric acid) as a potential antiobesity agent. JAMA 1998; 280: 1596–1600.

    Article  CAS  PubMed  Google Scholar 

  40. Mattes RD, Bormann L . Effects of (−)-hydroxycitric acid on appetitive variables. Physiol Behav 2000; 71: 87–94.

    Article  CAS  PubMed  Google Scholar 

  41. Thom E . Hydroxycitrate (HCA) in the treatment of obesity. Int J Obes Relat Metab Disord 1996; 20 (Suppl 4): 75.

    Google Scholar 

  42. Doi K . Effect of konjac fibre (glucomannan) on glucose and lipids. Eur J Clin Nutr 1995; 49: S190–S197.

    PubMed  Google Scholar 

  43. Walsh DE, Yaghoubian V, Behforooz A . Effect of glucomannan on obese patients: a clinical study. Int J Obes Relat Metab Disord 1983; 8: 289–293.

    Google Scholar 

  44. Pittler MH, Ernst E . Guar gum for body weight reduction. Meta-analysis of randomized trials. Am J Med 2001; 110: 724–730.

    Article  CAS  PubMed  Google Scholar 

  45. Nissen S, Panton L, Wilhelm R, Fuller Jr JC . Effect of β-hydroxy-β-methylbutyrate (HMB) supplementation on strength and body composition of trained and untrained males undergoing intense resistance training. FASEB J 1996B; 10: A287.

    Google Scholar 

  46. Vukovich MD, Stubbs NB, Bohlken RM, Desch MF, Fuller Jr JC, Rathmacher JA . The effect of dietary β-hydroxy-β-methylbutyrate (HMB) on strength gains and body composition changes in older adults. FASEB J 1997; 11: A376.

    Article  Google Scholar 

  47. Capassso F, Gagniella TS, Grandolini G, Izzo AA . Phytotherapy. Springer: Berlin, Heidelberg; 2003.

    Book  Google Scholar 

  48. Rodríguez-Morán M, Guerrero-Romero F, Laczano-Burciaga G . Lipid- and glucose-lowering efficacy of Plantago psyllium in type II diabetes. J Diabetes Comp 1998; 12: 273–278.

    Article  Google Scholar 

  49. Stanko RT, Reynolds HR, Hoyson R, Janosky JE, Wolf R . Pyruvate supplementation of a low-cholesterol, low-fat diet: effects on plasma lipid concentrations and body composition in hyperlipidemic patients. Am J Clin Nutr 1994; 59: 423–427.

    Article  CAS  PubMed  Google Scholar 

  50. Stanko RT, Arch JE . Inhibition of regain of body weight and fat with addition of 3-carbon compounds to the diet with hyperenergetic refeeding after weight reduction. Int J Obese Relat Metabol Disord 1996; 20: 925–930.

    CAS  Google Scholar 

  51. Kalman D, Colker CM, Wilets I, Roufs JB, Antonio J . The effects of pyruvate supplementation on body composition in overweight individuals. Nutrition 1999; 15: 337–340.

    Article  CAS  PubMed  Google Scholar 

  52. Kalman D, Colker CM, Stark R, Minsch A, Wilets I, Antonio J . Effects of pyruvate supplementation on body composition and mood. Curr Therap Res 1998; 59: 793–802.

    Article  CAS  Google Scholar 

  53. Kucio C, Jonderko K, Piskorska D . Does yohimbine act as a slimming drug? Isr J Med Sci 1991; 27: 550–556.

    CAS  PubMed  Google Scholar 

  54. Sax L . Yohimbine does not affect fat distribution in men. Int J Obes Relat Metab Disord 1991; 15: 561–565.

    CAS  Google Scholar 

  55. Berlin I, Stalla-Bourdillon A, Thuillier Y, Turpin G, Puech J . Lack of efficacity of yohimbine in the treatment of obesity. J Pharmacol 1986; 17: 343–347.

    CAS  PubMed  Google Scholar 

  56. Werk W, Galland F . Helianthus-tuberosus-Therapie bei Übergewicht. Therapiewoche 1994; 44: 34–39.

    Google Scholar 

  57. Schmidt JM, Ostermayr B . Does a homeopathic ultramolecular dilution of Thyroidinum 30cH affect the rate of body weight reduction in fasting patients? A randomized placebo-controlled double-blind clinical trial. Homeopathy 2002; 91: 197–206.

    Article  CAS  PubMed  Google Scholar 

  58. Allison DB, Faith MS . Hypnosis as an adjunct to cognitive-behavioral psychotherapy for obesity: a meta-analytical reappraisal. J Consult Clin Psychol 1996; 64: 513–516.

    Article  CAS  PubMed  Google Scholar 

  59. Kirsch I, Montgomery G, Sapirstein G . Hypnosis as an adjunct to cognitive-behavioral psychotherapy: a meta-analysis. J Consult Clin Psychol 1995; 63: 214–220.

    Article  CAS  PubMed  Google Scholar 

  60. Stradling J, Roberts D, Wilson A, Lovelock F . Controlled trial of hypnotherapy for weight loss in patients with obstructive sleep apnoea. Int J Obes Relat Metab Disord 1998; 28: 278–281.

    Article  Google Scholar 

  61. Allison DB, Fontaine KR, Heshka S, Mentore JL, Heymsfield SB . Alternative treatments for weight loss: a critical review. Crit Rev Food Sci Nutr 2001; 41: 1–28.

    Article  CAS  PubMed  Google Scholar 

  62. Arterburn D, Hitchcock Noël P . Obesity. BMJ 2001; 322: 1406–1409.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Berkowitz RI, Wadden TA, Tershakovec AM, Cronquist JL . Behavior therapy and sibutramine for the treatment of adolescent obesity. JAMA 2003; 289: 1805–1812.

    Article  CAS  PubMed  Google Scholar 

  64. Blanck HM, Khan LK, Serdula MK . Use of nonprescription weight loss products. Results from a multistate survey. JAMA 2001; 286: 930–935.

    Article  CAS  PubMed  Google Scholar 

  65. Egger G, Cameron-Smith D, Stanton R . The effectiveness of popular, non-prescription weight loss supplements. Med J Aust 1999; 171: 604–608.

    CAS  PubMed  Google Scholar 

  66. Hosobuchi C, Rutanassee L, Bassin S-L, Wong N-D . Efficacy of acacia, pectin and guar gum-based fiber supplementation in the control of hypercholesterolaemia. Nutr Res 1999; 19: 643–649.

    Article  CAS  Google Scholar 

  67. Najemnik C, Kritz H, Irsigler K et al. Guar and its effects on metabolic control in type II diabetic patients. Diabetes Care 1984; 7: 215–220.

    Article  CAS  PubMed  Google Scholar 

  68. Wirth A, Middlehoff G, Braeunig C, Schlierf G . Treatment of familial hypercholesterolaemia with a combinations of bezafibrate and guar. Atherosclerosis 1982; 45: 291–297.

    Article  CAS  PubMed  Google Scholar 

  69. Hänsel R, Keller K, Rimpler H, Schneider G (eds) Hagers Handbuch der pharmazeutischen Praxis. Springer: Berlin, Heidelberg; 1992.

    Google Scholar 

  70. Stearns DM, Wise JP, Patierno SR, Wetterhahn KE . Chromium(III) picolinate produces chromosome damage in Chinese hamster ovary cells. FASEB 1995; 9: 1643–1648.

    Article  CAS  Google Scholar 

  71. Anderson RA, Bryden NA, Polansky NN . Lack of toxicity of chromium chloride and chromium picolinate in rats. J Am Coll Nutr 1997; 16: 273–279.

    Article  CAS  PubMed  Google Scholar 

  72. Kato I, Vogelman JH, Karkoszka J et al. Effect of supplementation with chromium picolinate on antibody titers to 5-hydroxymethyl uracil. Eur J Epidemiol 1998; 14: 621–626.

    Article  CAS  PubMed  Google Scholar 

  73. Hepburn DDD, Xiao J, Bindon S, Vincent JB, O’Donnell J . Nutritional supplement chromium picolinate causes sterility and lethal mutations in Drosophila melanogaster. PNAS 2003; 100: 3766–3771.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Martin WR, Fuller R . Suspected chromium picolinate-induced rhabdomyolysis. Pharmacotherapy 1998; 18: 860–862.

    CAS  PubMed  Google Scholar 

  75. Scroggie DA, Harris M, Sakai L . Rhabdomyolysis associated with nutritional supplement use. J Clin Rheumatol 2000; 6: 328–332.

    Article  CAS  PubMed  Google Scholar 

  76. Cerulli J, Grabe DW, Gauthier I, Malone M, McGoldrick MD . Chromium picolinate toxicity. Ann Pharmacother 1998; 32: 428–431.

    Article  CAS  PubMed  Google Scholar 

  77. Young PC, Turiansky GW, Bonner MW, Benson PM . Acute generalized exanthematous pustulosis induced by chromium picolinate. J Am Acad Dermatol 1999; 41: 820–823.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M H Pittler.

Additional information

Conflict of interest: none.

Funding: none external.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pittler, M., Ernst, E. Complementary therapies for reducing body weight: a systematic review. Int J Obes 29, 1030–1038 (2005). https://doi.org/10.1038/sj.ijo.0803008

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0803008

Keywords

This article is cited by

Search

Quick links