Effectiveness of herbal medicines for weight loss: A systematic review and meta-analysis of randomized controlled trials.

2020-02-15
Diabetes, obesity & metabolism 22(6)
- Alison Maunder
- Erica Bessell
- Romy Lauche
- Jon Adams
- Amanda Sainsbury
- Nicholas R Fuller

PubMed: 31984610
DOI: 10.1111/dom.13973

Study Design

Type: Meta-Analysis
Sample size: n = 54
Population: healthy overweight or obese adults
Methods: systematic review and meta-analysis of randomized placebo-controlled trials; searched four electronic databases from inception until August 2018; meta-analyses for herbal medicines with ≥4 studies
Duration: commonly ≤12 weeks

Aim

To update the available evidence on the efficacy and safety of complementary medicines to assist in weight loss by conducting a systematic review and meta-analysis of herbal medicines for weight loss.

Methods

Four electronic databases (Medline, Embase, CINAHL and Web of Science) were searched from inception until August 2018. A total of 54 randomized placebo-controlled trials of healthy overweight or obese adults were identified. Meta-analyses were conducted for herbal medicines with ≥4 studies available. Weight differences of ≥2.5 kg were considered clinically significant.

Results

As a single agent, only Phaseolus vulgaris resulted in a statistically significant weight loss compared to placebo, although this was not considered clinically significant. No effect was seen for Camellia sinensis or Garcinia cambogia. Statistically, but not clinically, significant differences were observed for combination preparations containing C. sinensis, P. vulgaris or Ephedra sinica. Of the herbal medicines trialled in ≤3 randomized controlled trials, statistically and clinically significant weight loss compared to placebo was reported for Irvingia gabonensis, Cissus quadrangularis, and Sphaeranthus indicus combined with Garcinia mangostana, among others, but these findings should be interpreted cautiously because of the small number of studies, generally poor methodological quality, and poor reporting of the herbal medicine interventions. Most herbal medicines appeared safe for consumption over the short duration of the studies (commonly ≤12 weeks). Some warrant further investigation to determine effect size, dosage and long-term safety.

Conclusion

There is currently insufficient evidence to recommend any of the herbal medicines for weight loss included in the present review.

Research Insights

African Mango→Reduced Body Weight
Of the herbal medicines trialled in ≤3 randomized controlled trials, statistically and clinically significant weight loss compared to placebo was reported for Irvingia gabonensis, Cissus quadrangularis, and Sphaeranthus indicus combined with Garcinia mangostana, among others
Effect
Beneficial
Effect size
Large
Black Bean→Reduced Body Weight
Of the herbal medicines trialled in ≤3 randomized controlled trials, statistically and clinically significant weight loss compared to placebo was reported for Irvingia gabonensis, Cissus quadrangularis, and Sphaeranthus indicus combined with Garcinia mangostana, among others
Effect
Beneficial
Effect size
Large
Cissus quadrangularis→Reduced Body Weight
Of the herbal medicines trialled in ≤3 randomized controlled trials, statistically and clinically significant weight loss compared to placebo was reported for Irvingia gabonensis, Cissus quadrangularis, and Sphaeranthus indicus combined with Garcinia mangostana, among others
Effect
Beneficial
Effect size
Large
Garcinia→Reduced Body Weight
Of the herbal medicines trialled in ≤3 randomized controlled trials, statistically and clinically significant weight loss compared to placebo was reported for Irvingia gabonensis, Cissus quadrangularis, and Sphaeranthus indicus combined with Garcinia mangostana, among others
Effect
Beneficial
Effect size
Large
Indian Sphaeranthus→Reduced Body Weight
Of the herbal medicines trialled in ≤3 randomized controlled trials, statistically and clinically significant weight loss compared to placebo was reported for Irvingia gabonensis, Cissus quadrangularis, and Sphaeranthus indicus combined with Garcinia mangostana, among others
Effect
Beneficial
Effect size
Large
Mangosteen→Reduced Body Weight
Of the herbal medicines trialled in ≤3 randomized controlled trials, statistically and clinically significant weight loss compared to placebo was reported for Irvingia gabonensis, Cissus quadrangularis, and Sphaeranthus indicus combined with Garcinia mangostana, among others
Effect
Beneficial
Effect size
Large
Tea→Reduced Body Weight
Of the herbal medicines trialled in ≤3 randomized controlled trials, statistically and clinically significant weight loss compared to placebo was reported for Irvingia gabonensis, Cissus quadrangularis, and Sphaeranthus indicus combined with Garcinia mangostana, among others
Effect
Beneficial
Effect size
Large

Adverse Events Reported

Black Bean→Overall tolerability
Most herbal medicines appeared safe for consumption over the short duration of the studies (commonly ≤12 weeks).
Finding
Reported
Indian Sphaeranthus→Overall tolerability
Most herbal medicines appeared safe for consumption over the short duration of the studies (commonly ≤12 weeks).
Finding
Reported
Mangosteen→Overall tolerability
Most herbal medicines appeared safe for consumption over the short duration of the studies (commonly ≤12 weeks).
Finding
Reported
Tea→Overall tolerability
Most herbal medicines appeared safe for consumption over the short duration of the studies (commonly ≤12 weeks).
Finding
Reported
African Mango→Overall tolerability
Most herbal medicines appeared safe for consumption over the short duration of the studies (commonly ≤12 weeks).
Finding
Reported
Cissus quadrangularis→Overall tolerability
Most herbal medicines appeared safe for consumption over the short duration of the studies (commonly ≤12 weeks).
Finding
Reported
Garcinia→Overall tolerability
Most herbal medicines appeared safe for consumption over the short duration of the studies (commonly ≤12 weeks).
Finding
Reported