Following the FDA's ban of ephedra-containing products in April 2004, "Citrus aurantium," or bitter orange, quickly gained popularity as a safe over-the-counter weight-loss aid. Bitter orange contains substances that are similar to ephedrine, the active ingredient in plants from the "Ephedra" genus. Bitter orange was traditionally used to treat nausea, indigestion and constipation, and Western herbalists use it to stimulate appetite, which flies in the face of its inclusion in weight-loss products.
Constituents
According to scientists at Georgetown University in Washington, D.C., the most notable ingredients in bitter orange are synephrine and octopamine, which are similar to epinephrine and norepinephrine, respectively. Epinephrine and norepinephrine are two neurotransmitters found in your nervous system and adrenal glands. Synephrine and octopamine are naturally produced in your body in small amounts, as well. Synephrine and octopamine are stimulating in nature, as is ephedrine, and all have been purported to decrease appetite and increase fat breakdown.
Effects on Appetite
A September 2004 review in "Experimental Biology and Medicine" reports that bitter orange's active constituents could theoretically suppress your appetite and promote fat breakdown, but there is little convincing evidence to support the use of bitter orange for weight loss in humans. A study published in the winter issue of "Journal of Medicinal Food" showed that food intake and hunger ratings did not change in individuals who took bitter orange.
Safety
Most studies have not demonstrated any safety issues from the use of bitter orange, although many experts cite concerns over synephrine's similarity to ephedrine, which was believed to increase your risk for heart attack and stroke. Traditional uses of bitter orange do not employ concentrated extracts of the plant, unlike many weight-loss preparations. Concentrated formulations contain higher doses of synephrine than are present in raw plant products. In 2009, physicians at Walter Reed Army Medical Center in Washington, D.C., reported the case of a 24-year-old previously healthy man who suffered a heart attack after taking a synephrine-containing dietary supplement.
Considerations
"Citrus aurantium," or bitter orange, does not appear to exert any significant appetite-suppressant effects in humans. Most studies demonstrating bitter orange's ability to promote weight loss have been performed in animals, whose body fat differs from that in people. In fact, octopamine, one of bitter orange's primary ingredients, does not promote fat breakdown in human fat cells, and synephrine -- the other active constituent -- only does so at doses that are likely to cause side effects, such as high blood pressure or increased heart rate.
References
- U.S. Food and Drug Administration: FDA Acts to Remove Ephedra-Containing Dietary Supplements from Market
- National Center for Complementary and Alternative Medicine: Bitter Orange
- "Experimental Biology and Medicine"; Citrus aurantium, an Ingredient of Dietary Supplements Marketed for Weight Loss: Current Status of Clinical and Basic Research; A. Fugh-Berman, A. Myers; September 2004
- "Journal of Medicinal Food"; Dietary Herbal Supplements with Phenylephrine for Weight Loss; F. Greenway, et al.; 2006
- "Texas Heart Institute Journal"; STEMI in a 24-Year-Old Man after Use of a Synephrine-Containing Dietary Supplement: A Case Report and Review of the Literature; J.E. Thomas, et al.; 2009
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