Beyond Ephedra

By Sanjay Gupta

Just in time for any New Year's weight-loss resolutions, the Food and Drug Administration (FDA) last week announced its intention to ban dietary supplements that contain any of six stimulants collectively known as ephedra alkaloids. Folks who don't mind risking their health in a desperate attempt to cut a few pounds (you know who you are) may be upset, but the rest of us should be pleased. The FDA has received more than 16,000 reports of complications--ranging from dizziness to strokes--that may have been triggered by the supplement, and it has linked ephedra to as many as 155 deaths, including that of Baltimore Orioles pitcher Steve Bechler, 23, last February.

Studies show that ephedra can promote modest short-term weight loss (an extra pound per month), apparently by somewhat suppressing appetite and boosting metabolism. In combination with caffeine, it may also jolt the muscles enough to enhance athletic performance for brief spurts.

The FDA has been trying to restrict ephedra supplements for the past six years, only to be beaten back by industry and political pressure. Thanks to the 1994 Dietary Supplement Health and Education Act, the FDA has to go through all sorts of legal hoops to restrict dangerous supplements and can act only after they have gone on the market. By contrast, the agency carefully vets prescription drugs long before they ever reach consumers.

The drumbeat of bad publicity about ephedra has taken its toll. Sales were reportedly down even before the FDA's announcement. Many supplement enthusiasts have started taking other so-called natural stimulants--like synephrine and octopamine, found in bitter orange--which are not as potent as ephedra. But even with these products, information on safety is sparse--thanks once again to the 1994 dietary-supplements law.

In the meantime, if you need to lose weight, the sooner you accept that stimulants are not the answer, the better off you'll be. A good diet and plenty of exercise will do more to improve your health than just about any dietary supplement--FDA approved or not.

Sanjay Gupta is a neurosurgeon and CNN medical correspondent