Weight Loss Supplements and Heart Health – Know the risk!

After your appointment with your cardiologist or primary care physician, you may have discussed the benefits of lifestyle choices like a balanced diet and regular exercise to support your heart health. However, if you’re thinking of an ‘easier’ approach, you need to understand the risk of weight loss supplements on your heart health.

You may also be interested in losing weight to have an easier time staying active. However, keep in mind the way you lose weight can significantly impact your health than the weight loss itself.

When you are struggling to lose weight with a balanced diet and exercise, you may feel tempted to turn to over-the-counter weight loss pills. In this article, Dr. Alizera Nazeri reviews the research to reveal the dangerous effects of over-the-counter weight loss supplements on your heart health.


Over-the-Counter Weight Loss Drugs and Cardiovascular Health

On a population level, there is an association between obesity and many cardiovascular risk factors. The first line of action for addressing weight is usually a “lifestyle approach” that focuses on adopting a balanced diet and carrying out the recommended weekly exercise amount.
However, when a person faces barriers to adopting a healthy lifestyle or does not see the weight loss results they desire, they may turn to weight loss drugs available without a prescription.
Most of these drugs contain some of the following active ingredients: bitter orange, buckwheat, ginseng, green tea, guarana, caffeine, licorice root, ma huang root, among others.


Summary of the Effects of Active Ingredients of Weight Loss Drugs on Heart Health

In 2009, Dr. Alizera Nazeri and his team published a paper where summarized the negative effects of herbal and natural supplements marketed for weight loss that result in dangerous effects on heart health. Below is a summary of the effects:


Ma huang (Chinese ephedra, Ephedra distachya, and Ephedra vulgaris)
Ephedra promotes weight loss and enhances athletic performance. However, ephedra is associated with life-threatening heart-related adverse events, such as;

Hypersensitivity myocarditis
Chest tightness
Myocardial infarction
Cardiac arrest
Cardiac arrhythmias
Sudden cardiac death


Bitter orange (green orange, Citrus aurantium, aurantium, synephrine HCl and synephrine)

Several serious side effects have been reported, most of which have an association with cardiovascular issues, especially when combining bitter orange with caffeine or ephedrine. Serious cardiac side effects include;
QT prolongation
Variant angina
Myocardial infarction
Cardiac arrest
Ventricular fibrillation


Green tea (Camellia sinensis and Camellia thea)

While green tea contains components generally considered healthy, such as polyphenols and catechins, green tea also contains caffeine. Large doses of caffeine taken through consuming large amounts of highly concentrated green tea, green tea extract, or green tea in combination with bitter orange or other caffeine-containing herbs can cause;
Catecholamine release – resulting in hypokalemia
Chest pain
Sinus tachycardia
Premature contractions


Ginseng (Panax ginseng, Korean ginseng)

Ginseng may have properties that help individuals adapt to environmental stress in addition to other properties, which may be beneficial. However, Ginseng taken together with bitter orange or ephedra can cause;

Furthermore, there are no studies on the effect of Ginseng on people with cardiovascular disease and, thus, should be avoided.


Licorice root (Glycyrrhiza glabra, Gan Cao, glycyrrhizinic acid, or isoflavone)

Licorice is a common ingredient for weight loss, but research on its effectiveness is conflicting. It can induce fluid retention, and thus;
Increases blood pressure
Worsens congestive heart failure
Increase the risk of irregular or extremely fast heartbeat (arrhythmias)



Caffeine (Caffeine anhydrous, or 1,3,7-trimethylxanthine)

It is found in OTC medications for weight loss and for treating type 2 diabetes. In very large doses, like those found in OTC medications, or combined with other stimulants, caffeine can cause;
Metabolic acidosis
and, in rare cases, death from ventricular fibrillation


Guarana (Paullinia cupana, or Brazilian cocoa)

Often used for weight loss or for enhancing athletic performance, Guarana has potentially dangerous effects on heart health due to the caffeine it contains. When taken together with other caffeine-containing supplements or bitter orange, it can increase;
Blood pressure
Heart rate
Temporary loss of consciousness
and other adverse reactions

Guarana may also interact with other drugs.


Overall Review

The review above demonstrates that natural ingredients and extracts still have the potential to have dangerous effects on your heart health, especially when combined or taken with other drugs.
However, it is important to note that many OTC studies on investigative safety do not include people with current cardiovascular risk or diagnoses. Therefore, such studies do not consider the effects weight loss supplements have on people with specific cardiovascular conditions, other diagnoses, and weights. So, for this reason, if you currently have cardiovascular disease, your cardiologist will probably strongly recommend against the use of over-the-counter weight loss drugs.

Weight Loss Does Not Mean You Will Be Healthier

There is a long-standing correlation between weight and health, but keep in mind that a weight-centric approach to health is often misguided. Your laboratory tests, including lipid panels, electrocardiograms (ECG), troponin, blood cultures, and others, contain much more relevant information about your health than the scale.
Therefore, if health is your goal, prioritize working with your primary care team. So, you can gain access to the information and tools that will help you build a healthier lifestyle and learn about the potential benefits of treatment and medication rather than weight loss.
If weight loss is healthy and safe for you, talk to your healthcare team about building a realistic, sustainable plan for you.


Main Takeaways

Over-the-counter weight-loss drugs work in different ways with the primary goal of “treating obesity” or inducing weight loss. Such drugs artificially alter the metabolism in people who have a weight that correlates with overweight or obese weight categories. In general, weight loss drugs are not designed to improve heart health and should not be taken with that goal in mind.
If your goal is to improve your health, such as cardiovascular or otherwise, it is essential to discuss your current health status beyond your weight with your healthcare team. Speak with your primary care physician and cardiologist to build a comprehensive health management plan before taking any over-the-counter medication.


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