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Diet Pills - Why This Fad Deserves to Fade

We’ve all been through a lot this past year and COVID19 has created barriers to maintaining a physically active lifestyle with gym closures across the province and country! With the arrival of spring and summer just around the corner many people are looking at getting in shape without a gym …… and quick! So you jump on your computer and search for the best “get slim quick fix”. What is the first thing you stumble across, magical “skinny pills” and you wonder - are these safe and do they actually work? There is a general consensus in the medical field - NO! “If weight loss came in a bottle, the world would be slim” says Dr. Yoni Freedhoff a family doctor and the founder of Ottawa’s Bariatric Medical Institute, a leading centre for medically supervised obesity treatment (1). Although some weight loss pills may allow an individual to experience results on a short term basis, there is still not a single effective and safe pill for long term weight loss.

To understand why weight loss pills are not safe for long term sustainable weight loss we need to learn how these pills actually work. Weight loss pills normally work through one or a combination of 3 strategies to achieve the weight loss goals. These strategies include: appetite suppressants, powerful laxatives or stimulants.

Appetite suppressants are a very common method for weight loss in diet pills. These types of pills will contain ingredients that will increase your satiety levels throughout the day making you feel more full. In turn, the hope is that if you feel more full you will reduce the amount of food you are consuming in a day and therefore restricting caloric intake until a deficit is created. Over time the caloric deficit will cause your body to utilize its stored energy (ie. fat cells) resulting in weight loss. This is the same process that healthcare professionals suggest to patients for weight loss however it is recommended to do so in a natural way through nutritional education, consciously monitoring your food intake and increased exercise. While these pills may be an effective method for suppressing your appetite causing you to consume less calories and in turn lose weight, as soon as you stop taking the diet pills your appetite will return. The unfortunate part is that your appetite also normally comes back increased from before as your body has been in a caloric deficit for so long that it is now depleted of nutrients. This increased appetite can result in feeling out of control around food and increase the chances of eating in a caloric surplus.

Dieting pills that are based off of powerful laxatives and diuretics claim to flush or cleanse the body and significantly decrease body fat percentage will ultimately lead you to spending enormous amounts of time in the bathroom. Many of these pills include natural laxatives such as psyllium, rhubarb powder, cascara, fennel powder, senna, goldenseal and others in addition or natural diuretics such as ginger, fennel, vinegars and teas. Again, these pills will lead to weight loss as your body is not able to absorb as many nutrients as it normally would with your bodily waste is excreted at a quicker rate causing leaving less time for you to absorb the necessary nutrients during digestion.

Although this leads to a caloric deficit and eventually weight loss from the decreased nutrient consumption/absorption can also lead to nutrient deficiencies that cause long term health concerns very easily. Another worry with these types of pills is becoming extremely dehydrated. If you are constantly excreting waste from your system you are constantly losing water as well. If you are not consuming additional water to counteract the amount lost during the excessive excretion then you are continually becoming more dehydrated. Water is a necessary component in almost every chemical reaction in your body and therefore with dehydration you are decreasing the efficiency of how well your body can function.

The third form of dieting pills are stimulants. This type of pill normally will contain some sort of chemical, such as caffeine, to increase your metabolism while at rest and burn further calories throughout the day. These pills are effective to increase how many calories you burn during a day however the long term health consequences are much worse than the weight loss you could achieve. Stimulants will increase your resting heart rate to increase your caloric burn rate, however this increased resting heart rate also puts extra stress on your heart. As many people know, a lower resting heart rate indicates an increased cardiovascular health and heart health. If you have a low resting heart rate this means that your heart is able to produce a stronger contraction to circulate your blood throughout your body more efficiently. Long term use of stimulants will cause your heart rate to always be in an elevated state causing your heart to constantly be working harder than necessary.

As mentioned above, diet pills usually come in the form of one or a combination of these treatment methods. Most pills that claim to be extremely effective will have a combination of the three treatment methods. Although this may increase their effectiveness in the short term to achieve your weight loss goal, the negative long term effects will become even greater in addition to the possible weight gain following completion of taking the pills.

In the end the healthiest and safest way to lose weight is through increased exercise and daily activity in combination with a slight caloric restriction. Adjusting your activity levels and diet to create a daily caloric deficit of about 500Cal from you total energy expenditure daily will lead to a healthy and safe weight loss of about 1lbs of fat per week. Consider increasing your fruit and vegetable intake, ensure you’re getting enough fibre and protein to help you feel satisfied and reflect on your portion sizes throughout the day to aid in your weight loss journey while maintaining over health. It takes about 3500Cal to burn 1lbs of fat, therefore creating a 500Cal deficit each day of the week will create a 3500 calorie deficit by week's end results in 1lbs of fat loss. Keep in mind, your body does NOT see the caloric deficits on a daily basis but is a constant running total. This means if you are restricting calories and increasing exercise

from Monday to Friday however you indulge on weekends consuming more calories than you do during the week you can cancel out all of the hard work you put in during the week. This does not mean that you have to be completely strict to your diet and that you cannot indulge every once in a while. Being completely strict on your diet and exercise may also eventually lead to decreased adherence to one’s goals and increase the risk of binge eating, a poor relationship with food and exercise and a reduced chance of weight loss. A simple rule to try and follow is the 80/20 rule - focus on consuming nutrient dense foods that offer your body the macro and micro nutrients required 80% of the time and enjoy food that may offer less nutritional value 20% of the time.

What are the take home messages to help put this all together?

1. Diet pills come in the form of one or a combination of diuretics/laxatives, appetite suppressants and/or stimulants.

2. Diet pills can be effective for short term weight loss however they can have serious negative long term health effects.

3. Diet pills only work while taking them and normally lead to increased weight gain following completion of taking the pills.

4. Losing more than 1-2lbs of fat per week can cause liver damage from the increased rate of fat metabolism.

5. Long term effective and safe weight loss solutions come from small daily adjustments of intake and increased physical activity creating a daily caloric deficit of about 500Cal.

6. Consistency is key to successful weight loss and the 80/20 rule is a simple method to help adhere to a long term weight management plan!

If you are wondering where to start and how to create an effective plan for yourself, a great starting point would be talking to a regulated healthcare professional such as a Registered Dietitian or a Registered Kinesiologist at Medpoint Healthcare Centre!

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