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Should you (would you) pop a diet pill?

Best Health / September 2016

Another season, another fad diet

This year, if you believe pop culture and Internet ads, the cure du jour is garcinia cambogia, a small green Indonesian fruit that is said to hold the secret to lasting weight loss. It’s how Kim Kardashian allegedly power-shed her baby weight and what Jessica Simpson may have used to finally lose the pounds that Weight Watchers couldn’t touch. It’s what Dr. Oz called “the newest, fastest fat buster” – a claim that warranted investigation by Congress. (The doc has been suspiciously quiet ever since.) Still, with my scale reading my post-all-inclusive-vacation weight as up five whole pounds, this diet pill is what I’ll be popping twice a day for the sake of journalism.

The first thing to know about this new miracle supplement is that it’s not really new at all. “Garcinia cambogia is a tropical fruit with traditional culinary roots,” says Dr. Sarah Penney, a naturopathic doctor in Hamilton. For centuries, garcinia has been used in spice form in Thai soups and Indian curries and to cure fish in Sri Lankan cooking. In the East, garcinia is known as a preserver and an anti-inflammatory and for this slightly less savoury reason: “It’s a purgative to cure intestinal worms,” says Dr. Penney. But foodborne intestinal parasites don’t make for good television, so I’ll bet that this delicious detail wasn’t mentioned on Dr. Oz.

On this side of the world, though, garcinia is known almost exclusively as a weight loss aid and too-good-to-be-true maybe-scam. The brand I’m taking, Purely Inspired Garcinia Cambogia+ with Green Coffee, claims that subjects lose an average of almost 11 pounds in 60 days – twice as much as the placebo group. The dosage varies slightly by brand but is otherwise a one-size-fits-all prescription: Take one serving (in my case, three tablets containing 1,600 milligrams of garcinia in total) twice daily (before meals with a big glass of water) to lose weight fast.

Now available over the counter on pharmacy shelves, garcinia is tempting dieters with an age-old promise: double the results with minimal effort. Here’s how the magic (supposedly) happens: The extract’s active ingredient, hydroxycitric acid (HCA), is said to suppress appetite and “block fat” by inhibiting a key enzyme that the body uses to convert fat from carbohydrates. It is also said to boost serotonin, the feel-good brain chemical that, when running low, tells your mind that mac and cheese will make you feel better. A daily dose is even said to reduce cholesterol while increasing lean muscle mass and improving overall health.

But studies in labs are mixed, at best. A 2008 review from a Mexican university found that, of alternative weight loss methods, only garcinia and green tea showed a significant difference in effect, performing 25 percent better than the competition. A 2015 trial from Brazil echoed these results but suggested that the ideal dosage has not been well established yet. The Journal of Obesity reviewed 12 trials in 2011 and found that none showed a significant effect, and a 2013 Australian study called the evidence “not compelling.” Still, buried among the rest are some promising results: One study from the School of Life Science and Technology in China found that HCA reduced abdominal fat – in chickens.

That’s maybe good enough for me, so I start on a Monday morning by swallowing two pills with a bottle of Perrier. An hour later, as per my instructions, I can eat as long as it’s healthy food. In fact, my “best results will come in conjunction with diet and exercise,” which, of course, complicates results. “A lot of the people in these studies are put on calorie-restrictive diets,” says Dr. Penney. “If you’re eating better and working out, whether you’re taking the supplement or not, you’ll lose weight.” Still, though she has seen a few patients popping garcinia, Dr. Penney doesn’t recommend it to her clients.

Neither does Dr. Joe Gillis, a family doctor in Yarmouth, NS. “If a patient told me she was taking this, I’d first say to be careful, both of how much you’re taking (how much is actually in the supplement) and your expectations,” he says. “Different products from different companies contain different amounts of the supplement, so you may not be getting as much or as little as desired.”

Dr. Gillis groups this product with most other weight loss supplements, which are often considered a “quick fix in our drive-thru society where we want everything easy and fast.” Like most doctors, Dr. Gillis sees no good alternative to healthy eating and exercise.

For Dr. Natasha Turner, New York Times bestselling author of The Supercharged Hormone Diet, weight loss can, indeed, be aided by supplements. “I’ve never recommended garcinia because I have concerns with the dosing required, plus there are other more effective and proven things to take,” she says. Among them are resveratrol (the antioxidant found in red wine), green tea extract (proven to help weight loss without a change in diet or exercise) and probiotics (proven to reduce belly fat through the positive effects on insulin and blood sugar). And don’t disregard fibre, says Dr. Penney, which will make you feel full longer and has been shown to help you lose weight.

That said, for a certain kind of patient who has tried everything and maybe can’t shed the last few pounds, garcinia could be an option. “I can’t say something won’t work for you,” says Dr. Gillis. But, like anything else, you should discuss your plan with your doctor first. “If it works for you, that’s great, provided that it’s safe,” he says.

This is a very important and complicated caveat. In fact, since garcinia is officially a supplement, not a drug, it’s not regulated for safety or effectiveness by Health Canada or the U.S. Food and Drug Administration. Though almost 900 subjects in 18 clinical trials are enough to validate the safety of HCA for the public, certain side effects have been reported, including nausea, dizziness, dry mouth, diarrhea and headache. None of these is listed on my bottle or the Purely Inspired website.

So I learn the hard way. On day one, following a half-hour workout and a healthy veggie-filled lunch, I am feeling lightheaded by 2 p.m. and have a headache by 4. After my dinner dose of garcinia, my head still pounding, I go to bed early and hope that tomorrow is better. When day two gives me stomach aches and day three makes me bloated, I decide that garcinia isn’t working for me and take Dr. Gillis’s advice: “If you have any symptoms at all, stop taking it.” So I do and, for good measure, I step back onto the scale. I’m exactly the same weight I was, with one-quarter of a pound to boot – I’d like to think it’s water weight.