Weight management: Should I use over-the-counter diet aids?

1. Get the Facts

Your options

Use an over-the-counter diet aid to help you lose weight.
Get to a healthy weight by eating right and exercising.

Key points to remember

No over-the-counter diet aids have been proven to be both safe and effective for everyone.
When a diet aid does work, it’s usually because the person followed the manufacturer’s recommendations to follow a healthy eating plan and get more exercise while taking the supplement.
It's wise to talk to your doctor before you take any over-the-counter diet aid.
Most over-the-counter diet aids and other supplements are not regulated, so makers can make any claims they want to about how well their products work.
Are you at a healthy weight? If you are, you're better off forgetting about weight loss. Instead, learn healthy eating and activity habits that will help you stay at a healthy weight. For more information, see the topic Weight Management.

FAQs

Are you at a healthy weight?

Before you consider whether to use any over-the-counter diet aid, find out if you really need to lose weight. A healthy weight is a weight that lowers your risk for health problems. For most people, body mass index (BMI) and waist size are good ways to tell if they are at a healthy weight.

If you practice healthy eating habits and are active enough to stay healthy, then weighing a few extra pounds is not bad for your health unless you have other medical problems. On the other hand, dieting canbe bad for your health. Diets almost never work, and they can cause many people to fall into an unhealthy cycle of losing and gaining weight. This is often called yo-yo dieting. It may be harder on the body than just being overweight.

If you are thinking about losing weight, ask your doctor whether it's a good idea for you.

What are over-the-counter diet aids?

There are many products for weight loss that you can buy without a prescription at drugstores and supermarkets and over the Internet. Many of these have never been proven to work, and those that do work usually come with warnings.

See a list of popular over-the-counter diet aids.

What about Alli?

Alli (say "AL-eye") is a lower-dose version of the prescription drug orlistat (Xenical), which is used to treat obesity. You can buy Alli without a prescription.

Orlistat has been proven to help people lose weight.¹ It works by preventing fat absorption, so that the fat you eat moves through your intestines undigested. But the weight loss amounts to only a few pounds, and the drug's side effects can be very unpleasant.

The side effects include sudden loose stools and oily spotting on your underwear. The more fat you eat, the worse the side effects are, so it's best to limit fat while you are taking this drug.

Do not take Alli if you:

Have had an organ transplant.
Are pregnant or breast-feeding.

Talk to your doctor before you take Alli, but especially if you:

Take blood-thinning medicines.
Have diabetes or thyroid disease.

What are the risks or side effects of over-the-counter diet aids?

Most over-the-counter diet aids don't have to pass government tests for safety or effectiveness.

Long-term studies are the only way to tell if a medicine or supplement works and is safe. And there are very few such studies of diet aids. But we know about the following risks:

Over-the-counter appetite suppressants shouldn't be used by people who have heart disease, high blood pressure, diabetes, kidney problems, thyroid problems, glaucoma, or depression.
Appetite suppressants are only intended for use for a short time (8 to 12 weeks). But staying at a healthy weight is a lifelong effort. It is costly and possibly dangerous to depend on these medicines to control your weight for long periods of time. If you are going to use these drugs to help you lose weight, be sure to also make healthy changes to your diet and get regular exercise.
Water-loss pills (diuretics, such as Aqua-Ban) only get rid of water and do not reduce the amount of fat in your body. Using water-loss pills to lose weight is not recommended and can be dangerous.
Because diet supplements are not regulated, manufacturers sometimes make claims that aren't true. For example, just because the label says the supplement is “all natural” doesn't mean it’s safe. Many things that are "natural" can still hurt you. And manufacturers may cite only their own studies to show how well their products work.
Many products contain 20 or more ingredients, so it’s really hard to know how all the ingredients will interact with each other in your body and how they will interact with any other medicines or supplements you may be taking.
You shouldn't take cough or cold medicines while you take some of these diet pills. They contain some of the same medicine, and you could get too much. Ask your pharmacist if it's safe to take cold medicine with the diet pills you are taking.

The U.S. Food and Drug Administration (FDA) warns people not to use certain diet aids that are known to be tainted with drugs or chemicals. You can find the FDA's warning list, which includes many popular diet aids, at www.fda.gov/cder/consumerinfo/weight_loss_products.htm.

The FDA has banned the sale of ephedra because of concerns about safety. The product has been linked to heart attacks, strokes, and some deaths. Ephedra and ephedrine—the active ingredient in ephedra—decrease appetite by increasing metabolic rate.

It's wise to talk to your doctor before you take any over-the-counter diet aid.

Why might your doctor recommend an over-the-counter diet aid?

Your doctor is not likely to recommend that you use an over-the-counter diet aid in your efforts to reach a healthy weight and stay there. The best way to get to a healthy weight and stay there is to eat right and exercise regularly.

To be safe, always talk to your doctor before using any weight-loss product.

2. Compare Options

	Use an over-the-counter diet aid	Don't use an over-the-counter diet aid
What is usually involved?	You buy a diet aid at a store and follow the instructions on the package.	You manage your weight by eating healthy foods and getting the right amount of physical activity.
What are the benefits?	Some diet aids may help you feel less hungry so you don't eat as much. Studies show that Alli helps some people lose a small amount of weight.	Learning to eat healthy foods and getting the right amount of physical activity is the best way to control your weight. You avoid the possible risks and side effects of diet aids.
What are the risks and side effects?	There is no proof that most over-the-counter diet aids work. You shouldn't use them if you have heart disease, high blood pressure, diabetes, kidney problems, thyroid problems, glaucoma, or depression. Using water-loss pills to lose weight can be dangerous. Most diet aids don't have to pass government safety tests.	You won't lose weight unless you learn to eat healthy foods and get the right amount of physical activity.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

If you need more information, see the topic Weight Management.

Personal stories about using over-the-counter diet aids

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

" I have a lot of weight to lose, and I want to try an over-the-counter diet aid. I'm not technically obese, but my weight is definitely not healthy. I've tried to make healthy eating and exercise work, but I think I need more help. "

— Nathalie, age 51

" I thought about using a diet aid to help myself lose weight, but I've decided against it. I know that I'm overweight because of some bad habits I've developed. I plan to improve my eating and activity habits by taking a few small steps at a time. "

— Mohammed, age 32

" I plan to use an over-the-counter diet aid. I talked to my doctor about it, and she wasn't too enthusiastic. But we agreed on a plan where I will check in with her often so she can monitor my progress and any side effects I may have. "

— Jada, age 44

" I was all set to start using a diet aid, but my doctor talked me out of it. He told me how the research just doesn't support using these supplements, especially considering some of the possible side effects. He said changing my lifestyle habits would be better for my health in the long run. "

— Nadia, age 29

3. Your Feelings

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to use over-the-counter diet aids

Reasons not to use over-the-counter diet aids

I'm desperate and have to try something else, even though I know that diet aids don't usually work.

I don't feel so desperate that I have to try something that I know probably won't work.

More important

Equally important

More important

I'm not worried about spending money on diet pills that may not work.

I don't want to spend money on something that I know may not work.

More important

Equally important

More important

I'm willing to have my doctor monitor my progress while I use a diet aid.

I'm not willing to have my doctor monitor my progress.

More important

Equally important

More important

I'm not worried about using supplements that may have unknown side effects.

I'm very worried about using supplements that may have unknown side effects.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Your Decision

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Using over-the-counter diet aids

NOT using over-the-counter diet aids

Leaning toward

Undecided

Leaning toward

5. Quiz Yourself

Check the facts

1. Are most diet aids safe for anyone to use?

Yes
No
I'm not sure

You're right. No over-the-counter diet aids have been proven to be both safe and effective for everyone.

2. Do I need to make any lifestyle changes while I'm using a diet aid?

Yes
No
I'm not sure

That's right. Even with a diet aid, you probably won't lose weight unless you also follow a healthy eating plan and get more exercise.

Decide what's next

1. Do you understand the options available to you?

Yes
No

2. Are you clear about which benefits and side effects matter most to you?

Yes
No

3. Do you have enough support and advice from others to make a choice?

Yes
No

Certainty

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.