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Ephedra gained popularity as a weight loss supplement in the 1990s, but safety concerns arose. This article reviews ephedra’s weight loss effects, potential dangers, and legal status.
Researchers concluded that ephedrine may be beneficial to obese patients, however close heart rate monitoring should be done by a doctor. While ephedrine can increase the likelihood of short-term weight loss, there is no evidence that it will offer any gains over the long term.
Overall, the effects on weight loss of synthetic ephedrine plus caffeine and ephedra plus herbs containing caffeine were equivalent: weight loss of approximately 2 pounds/month more than was associated with placebo for up to 4 or 6 months of use.
Supplements containing ephedra are often marketed for athletic performance and weight loss. The active chemical in ephedra, ephedrine, can cause serious, life-threatening side effects.
Ephedra, derived from an evergreen shrub, was used widely for weight loss due to its noradrenaline-releasing effects, but it was associated with severe side effects, including increased heart rate, elevated blood pressure, and even death.
The role of ephedrine and ephedra supplements in weight loss is likely related to increased fatty acid release from fat stores (adipose) and increased whole-body fat oxidation and energy expenditure.
Over the short term (four to six months), ephedrine, ephedrine plus caffeine, and supplements containing ephedra or ephedra plus caffeine promoted modest increases in weight loss, about two pounds per month more than the weight loss of persons taking the placebo.
The authors of one analysis concluded that supplements containing ephedra and ephedrine trigger modest short-term weight loss (about 2 pounds per month more than placebo). But none of the 52 trials they looked at lasted more than six months, so there is no evidence to support ephedra use for long-term weight loss.
Ephedrine and ephedra promote modest short-term weight loss. However, there were no data regarding long-term weight loss. The use of ephedra or ephedrine and caffeine was associated with an increased risk of heart palpitations or psychiatric, autonomic, or upper gastrointestinal symptoms.
Prior to the ban, research showed that dietary supplements containing ephedra/ephedrine (usually in combination with caffeine) had modest short-term effects on weight loss. However, this benefit was considered insufficient to outweigh the serious risks of these supplements.