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by Sara Hover, RPh, FAARM, PCCA Director of Clinical Services
Berberine, a deep-yellow bioactive agent found in several plants like barberry, goldenseal and tree turmeric, has gained attention for its potential role in weight loss.1 Studies indicate that berberine may influence various metabolic processes, such as promoting insulin secretion, improving insulin resistance, inhibiting formation of fat, alleviating adipose tissue fibrosis, reducing fatty liver disease and improving gut microbiota disorders. The specific mechanism for enhancing insulin sensitivity and regulating blood glucose levels is thought to be by activating AMP-activated protein kinase (AMPK). It is well known that improving glucose control could support weight loss efforts.2 In addition to these proposed mechanisms, berberine may influence gut microbiota composition, promoting a balanced and diverse microbial community. A healthy gut microbiome has been recognized as crucial for overall well-being, including weight management.3 The health of the gut continues to be of vital importance.
Alpha-lipoic acid (ALA) is mainly considered for its role as an antioxidant. It is found naturally in the body and can also be obtained through certain foods and supplements. Some studies suggest that ALA may have a positive impact on weight loss by improving insulin sensitivity and enhancing the utilization of glucose for energy.4
ALA has been considered an insulin mimetic agent because of its effects on the insulin-regulated glucose transporter, GLUT4, which is the gatekeeper that allows glucose to enter the cell. However, it is still unclear exactly how ALA interacts with the insulin receptor and insulin receptor cascade. It is possible that ancillary effects of ALA on mitochondria can improve insulin sensitivity. In addition to the insulin-like effect of glucose transport, some evidence suggests that it also acts on beta-cells.4 Additionally, ALA as a powerful antioxidant may help reduce oxidative stress and inflammation, contributing to an overall healthier metabolic environment. More research is needed to fully understand ALA's role in weight management, but initial findings are promising.4
Oxytocin, often referred to as the "love hormone" or "bonding hormone," is primarily associated with social bonding, childbirth and lactation. Recent research has explored its potential role in weight regulation and appetite control. Oxytocin is a hormone peptide of nine amino acids produced by neurons in the hypothalamus, secreted directly into brain regions involved in energy homeostasis and appetite regulation, and released into the bloodstream by the posterior pituitary gland.5
Oxytocin affects appetite by decreasing intake and promoting the breakdown and oxidation of fats. It also increases thermoregulation and energy consumption. It may also play a role in glucose and metabolic homeostasis, which can improve insulin sensitivity.6
Oxytocin decreases food intake by affecting hedonic eating, which is one's desire or drive to consume food for pleasure, in the absence of caloric need. It can also cause satiety signaling in the brain. A positive relationship was found between oxytocin levels, body mass index, visceral fat mass and metabolic syndrome.6 Some studies suggest that oxytocin may help reduce overall food consumption, especially in response to stress-induced eating. While oxytocin is not yet widely used as a weight-loss agent, ongoing research is needed to uncover its potential applications.
Originally developed as an antiepileptic medication, topiramate has also shown promise in the field of weight management. Although the mechanism behind topiramate-induced weight loss is not well described, a possible mechanism includes lowering calorie intake, decreasing fat gain, triglycerides and cholesterol levels. A study reported the possibility that topiramate reduces binge-eating behavior by altering the reward pathway associated with the food. A reduction in leptin levels was seen while patients were on topiramate, which directly correlated with weight reduction.7
Clinical trials have demonstrated that topiramate can lead to significant weight loss in certain individuals, particularly when used in combination with other weight loss strategies. However, it's essential to note that topiramate can have side effects, and its use should be supervised by a healthcare professional.
While berberine, alpha-lipoic acid, oxytocin and topiramate show promise as alternative options for weight loss, it's crucial to approach these agents with caution. Before incorporating any new supplement or medication into a weight loss regimen, it's advisable to consult with a healthcare professional. Additionally, these alternatives should complement, not replace, a healthy diet and regular exercise. As research continues to unravel the complexities of these agents, the potential for innovative and personalized approaches to weight management grows. Always stay informed and work closely with healthcare providers to make informed decisions on your weight loss journey.
These statements are provided for educational purposes only. They have not been evaluated by the Food and Drug Administration, and are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care or encourage its abandonment.