No supplement has been shown to work like prescription weight-loss medicines. At best, reviews of trials find small losses. A 2021 review of 67 placebo-controlled trials concluded there is not enough evidence to recommend any of the supplements it studied for weight loss.
- Glucomannan (konjac fibre). A 2014 review of nine trials found no significant weight loss versus placebo. Later reviews found a loss of about 1.3 kg. One review judged that too small to matter clinically. Glucomannan swells in water, and case reports describe it blocking the gullet. Never take it dry.
- Psyllium. Trials show it lowers LDL cholesterol. In people with type 2 diabetes, it also lowered blood sugar. Results on body weight conflict, and several reviews found no effect.
- Green tea extract. A Cochrane review found a small weight loss that was not statistically significant and unlikely to be clinically important. Liver injury has been reported, mostly with extract capsules. A US Pharmacopeia review linked case reports to EGCG intakes from 140 mg to about 1,000 mg a day. It advises taking extracts with food. Green tea can also interact with some heart, cholesterol and bone medicines.
- Caffeine. Lab studies show weak, short-lived effects on how much people eat. A 2018 trial concluded caffeine is not an effective appetite suppressant.
- 5-HTP. A few small trials from 1989 to 1998, with about 20 people each, found people ate less. They used 750–900 mg a day or weight-based doses. Tested commercial 5-HTP has contained "peak X" impurities, which have been linked to a serious blood and muscle disorder (eosinophilia-myalgia syndrome). Do not combine it with antidepressants without medical advice.
- Names or ads that suggest a product works like Ozempic, Wegovy or Mounjaro. Those are prescription drugs. The FDA says unapproved versions of these drugs are not reviewed for safety, effectiveness or quality. It has called claims that a product is "the same as" an approved drug misleading.
- Claims the FTC says cannot be true: weight loss without diet or exercise, loss no matter what you eat, permanent loss after you stop, or big losses for everyone.
- "All-natural" diet pills from unknown sellers. The FDA warns that many weight-loss products sold as supplements contain hidden drug ingredients.
- Green tea extract with no advice to take it with food.
- Treat any supplement as a small extra to diet and activity.
- If you take any medicine, ask a pharmacist before starting.
- If your weight is affecting your health, ask a doctor about approved treatments.
Sources: Bessell 2021, supplements meta-analysis · Onakpoya 2014, glucomannan · Vanderbeek 2007, glucomannan obstruction · Jovanovski 2018, psyllium and LDL · Xiao 2020, psyllium in diabetes · Darooghegi Mofrad 2020, psyllium and weight · Jurgens 2012, Cochrane green tea · NCCIH, Green tea · Oketch-Rabah 2020, USP green tea review · Panek-Shirley 2018, caffeine · Cangiano 1992, 5-HTP · Klarskov 1999, 5-HTP contaminants · FDA, unapproved GLP-1 drugs · FDA, weight loss product notifications · FTC, Gut Check