The National Center for Complementary Medicine reports that nonvitamin, nonmineral natural products are the most complementary therapy used in the United States. Almost 20% of the US population uses natural products, spending $14.8 billion on food supplements and herbal therapies that include fish oils, glucosamine, St. John's wort, ginger, and peppermint. Natural products are most commonly used to prevent disease and illness (cardiovascular and musculoskeletal ailments) and promote wellbeing and health (stress reduction and weight loss).1
Herbs for Weight Loss
Nurse practitioners (NPs) frequently recommend weight loss as a health promotion/risk reduction strategy. Herbal products are widely marketed for their weight loss properties, and patients often query practitioners about their effectiveness and safety. While herbs are not a panacea, they can be used as foods or medicines to complement and support diet and exercise interventions.
Herbs as Food
Herbs are used as spices, supplements, foods, and teas to assist in weight control. Spices used in cooking (ginger, cayenne, and fennel) augment digestion, stimulate salivation and gastric secretions, and are antispasmodic. Bitter herbs (chamomile, gentian, or dandelion root) taken as liquids or teas prior to eating stimulate gastric secretions and promote fat and cholesterol breakdown. Herbs added as food increase fiber and expand dietary plant base. Dried nettle leaf (a nutritive) can be added to spaghetti sauce, sprouted fenugreek (modifies blood sugar), and dandelion leaf (balanced diuretic) to salads.
Teas provide another way to incorporate herbs into the diet. Herbs can be combined, iced or hot, mild or strong. Quality green tea is a mild appetite suppressant, diuretic, antioxidant, and metabolic enhancer.2 Herbal teas can also support weight loss and minimize the power of poor dietary choices. Herbal teas increase fluid intake while decreasing the consumption of sweetened juices, sodas, or power beverages. Herbal teas can also be used in soup bases or as foods. Herbal teas as soup stock enhance the weight loss value of the soup.
Further, the act of making tea is both calming and a participation in wellness. A diet infused with herbs provides a foundation for weight loss, something frequently overlooked in the mass marketing focus on the use of herbal supplements for weight loss.
Herbs as Medicine
Whole herb formulations or supplements for weight loss should include herbs with specific actions. Good weight loss formulations include adaptogenic herbs, herbs with anti-anxiety properties, and herbs that support elimination (digestives, diuretics, and laxative). Adaptogens are herbs that have a “normalizing influence” on the body. These moderate the stress response and thus support immune function, normalize glucose metabolism, increase energy, and improve resistance.3 Adaptogenic herbs in weight loss formulations include Siberian, American, and Chinese ginsengs; holy basil; schizandra; ashwaganda; licorice; and codonoposis.
The role of stress in weight loss cannot be minimized. Chronic stress contributes to abdominal weight gain, exhaustion, and imbalances in insulin release and blood sugar. Making changes that minimize both chronic and acute stress and facilitate coping is as important as modifying diet and exercise patterns. Herbs to reduce stress (Valerian, passionflower, California poppy, hops, lemon balm, and skullcap) are often used in weight loss formulations. St. John's wort is useful with mild mood disturbances and may be included in weight loss formulations but should be avoided by persons on medications with narrow therapeutic windows.
Digestive herbs used in weight loss formulations that stimulate gastric and bile secretions and bowel motility or are antispasmodic include fennel, licorice, chamomile, lemon balm, peppermint, catnip, aniseed, and damiana. Laxative or cathartic herbs in weight loss formulations (aloe resin, senna, cascara, rhubarb, and yellow dock) should be approached cautiously. Diuretic herbs may include linden, gravel root, dandelion, or boldo. The best herbal weight loss formula should be individually constituted and compounded for the whole person.
Weight Loss Supplements
The supplement industry has focused on thermogenic or metabolic herbs in concentrated dose extracts. These formulations suppress appetite, increase energy in the short term, and potentially modulate carbohydrate metabolism. Commonly, they contain caffeine, pseudoephedrine, or phenylephrine.4 There is a high potential for abuse, misuse, and adverse reactions, as seen with the misuse and subsequent market removal of ephedra (or ma huang) as a diet herb. Therefore, weight loss supplements with concentrated dose extracts of guarana, bitter orange, green tea, and yerba mate are not recommended for lasting, healthy weight loss. Herbs that modulate carbohydrate metabolism, found in concentrated dose extracts for weight loss, may include bitter melon, fenugreek, garcinia, and gymnema.
Any thermogenic supplement should be used with extreme caution. In contrast to herbal medicine, the manufacturing of concentrated dose extracts fails to address individual health needs for lasting weight loss.
Summary
Although no herbs or herbal combinations simply melt away excess fat, some herbs complement diet and exercise and support weight loss. Herbs as food or whole plant formulations can assist with weight loss through modification of stress, support for healthy gastric and elimination function, and promotion of normal metabolism. Herbs used as food, quality teas, or as herbal medicines are ways practitioners can incorporate herbs in therapeutic lifestyle changes for weight loss.
For additional resources that NPs can use in practice, consider turning to the Natural Medicine Database (http://www.naturaldatabase.com), the American Botanical Council (http://www.herbalgram.org), or Natural Standard (http://www.naturalstandard.com).
Acknowledgments
This publication was made possible by grants from the National Center for Complementary and Alternative Medicine (NCCAM) [T32 AT001287 and R13 AT005189-01]. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCCAM, or the National Institutes of Health.
Biography
References
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