Will you be

The Department of Health and Human Services (HHS) recently announced a plan to review the existing science on ephedra, the dietary supplement commonly marketed in the US as an aid for weight loss and sports performance. The report, to be completed early next fall, is expected to squelch the heated debate on the safety of ephedra.

The Food and Drug Association (FDA) has increasingly received reports of health complications possibly related to the herbal supplement. Although the reports do not prove ephedra to be the cause of the problems, they do suggest that safety may be an issue. The HHS hopes to provide a scientific basis for making a decision about whether to keep ephedra on the market and if so, how to ensure that it is safe.

Ephedra goes by many names, including ma huang, Chinese ephedra and epitonin. But ephedra is actually the general name for herbal supplements containing ephedrine alkaloids, which are stimulant, drug-like compounds similar to those found in cold medications. Many fat burning dietary supplements contain ephedra, such as Dexatrim Natural Green Tea Formula, Xenedrine RFA-1 (maximum strength), Optidrene, Metabolife 356, Diet Pep, Stacker 2, Diet Boost, Metab-O-LITE Thermadrene, Sure Trim, Metabolift, and Ripped Fuel.

Scientific evidence suggests that ephedra does indeed promote weight loss. One study from the March 2001 issue of the International Journal of Obesity showed that people taking ephedra lost about 6.5 more pounds on average than the people receiving an inactive supplement. Another recent study showed that taking herbal ephedrine with caffeine supplements may be beneficial for weight loss.

But although ephedra promotes weight loss, the safety of the fat burner is controversial. The number of people who have experienced adverse side effects as reported to the FDA has increased since 1993 to over 1,300 cases. Side effects include rapid or irregular heartbeat, chest pain, severe headache, shortness of breath, dizziness, loss of consciousness, sleeplessness, nausea, and even heart attack, stroke and death. Some studies have suggested that supplements containing ephedra may be risky for certain individuals. For example, people with high blood pressure, heart or thyroid disease, a seizure disorder, depression, or diabetes should consult a doctor before taking ephedra. Still other researchers have suggested that the risk of taking ephedra may be worthwhile since it appears to help people lose weight and avoid the complications of obesity.

Since 1994, several historical events have fueled the safety debate. First of all, since the Dietary Supplement Health and Education Act (DSHEA) of 1994 passed, the FDA has lost its authority to ensure that dietary supplements are safe before they are placed on the market. As a result of an increase in complaints of side effects relating to ephedra, the FDA proposed to provide warnings on a supplemental label.

But before the proposal was implemented, dietary supplement trade associations banned together to petition the FDA to modify the 1997 proposal in order to protect the billion-dollar supplement industry. To counter this move, Public Citizen, a consumer advocacy interest group, lobbied and petitioned the FDA to ban all ephedra products.

HHS is now evaluating over 1,300 reports of adverse effects to decide if further research is necessary. In addition, the largest ephedra manufacturer, Metabolife, is under investigation by the Department of Justice for allegedly concealing reports of adverse effects from the FDA.

While ephedra is still on the market, several organizations highly discourage its use, such as the American Medical Association and the United States military, while the National Football League and the National Collegiate Athletic Association prohibit their athletes from taking it.

Medical experts also generally agree ephedra is harmful. Dr. Miriam Nelson, author of Strong Women Stay Slim and Director of the Center for Physical Activity at Tufts University warns, "ephedra, because it goes by many names, is especially deceptive and dangerous."

In the long run, the safest and most effective way to lose weight and keep it off is with a combination of physical activity and good nutrition, according to Dr. Nelson. "Ephedra appears to promote weight loss, but its safety remains questionable _ it is clearly not for everyone," Nelson said. "In fact, I wouldn't recommend it to anyone."