By Peggy O'Farrell
The Cincinnati Enquirer

The Food and Drug Administration's decision Tuesday to ban ephedra will leave many consumers wondering what options they have for weight loss.

Though hundreds of supplements promise to speed up weight loss, consumers have two simple, safe options, experts say: eating less and exercising more.

"Diet and exercise are the primary sources of weight loss," says Shelly Dusing, director of the clinical pharmacy program for the Health Alliance. "I don't want to say all the over-the-counter products are gimmicks, but there's not a lot to support their use."

Prescription medications, including phentermine, Xenical and Meridia, are available, but should be used only if diet and exercise don't work, Dusing said.

Ephedra, also known as ma huang, is an herb that aids weight loss by suppressing the appetite and speeding up the metabolism. But it can cause consumers' blood pressure and core body temperature to spike dangerously high, putting them at risk for stroke, heart attack and seizures, Dusing said.

Ephedra is effective for weight loss, said Dr. Tom Imhoff, clinical safety and effectiveness officer for TriHealth, but its risky side effects outweigh its benefits. "I've seen patients in their 30s who've been in the hospital with heart attacks because of it," he said.

Ephedra has been linked to about 155 deaths. But because it wasn't regulated by the FDA, there was no formal system for reporting harmful results, as there are with regulated medications, Imhoff said. "There's probably a real lack of reporting of adverse events. It could be a much higher prevalence of problems," he said.

Products containing ephedra have been harder to find in the last several months as the scrutiny of the herb increased. Newer products available in drug stores and health-food stores boast that they're "ephedra-free."

But that doesn't mean they're safe or effective, Imhoff said.

Over-the-counter weight-loss aids such as Zantrex-3 and Diet Lift rely on ingredients like guarana, yerba mate and green tea.

Because they're all herbs, none of the ingredients is regulated by the FDA, so there's little guarantee that supplements contain enough of the herbs to be effective. There's also little oversight of the quality and purity of herbal components.

Consumers who use herbal products often don't understand what they're getting, Dusing said. Many herbal weight-loss products rely on ingredients that are high in caffeine - like yerba mate and guarana - or that are diuretics - like green tea.

E-mail pofarrell@enquirer.com