Nutrition Journal volume 20 , Article number: 72 Cite this article. Metrics details. Given the high prevalence of dietary and herbal supplement DHS use in tandem with the growing ease of internet access, patients commonly search online for consumer health information about these products.

One common reason for DHSs use includes weight loss. Healthcare providers need to be aware of the quality of online information about DHSs for weight loss so they can adequately counsel their patients and provide them with guidance surrounding the identification of high-quality information resources.

After applying exclusion criteria, eligible websites were quality assessed using the DISCERN instrument. This tool is comprised of 16 questions, each evaluated on a 5-point scale. The averages and standard deviations for each DISCERN instrument item, in addition to overall summed scores between 15 and 75 were calculated.

Across 87 eligible websites, the mean summed score was In general, websites detailed and achieved their specified aims and described treatment benefits. However, most websites failed to describe the impact of treatment on overall quality of life and the impact of a no treatment option.

The highest-scoring websites were largely government or health portal websites, while the lowest-scoring websites were largely commercial in nature. High variability in DISCERN instrument scores was found across all websites assessed. Healthcare providers should be aware of the fact that their patients may be accessing misinformation online surrounding the use of DHSs for weight loss.

Therefore, it is important for healthcare providers to ensure that they are providing their patients with guidance on how to identify high-quality resources online, in order that safe, effective, and evidence-based decisions are made surrounding the use of DHSs for weight loss.

Peer Review reports. In , an estimated Significant medical and psychosocial impacts are associated with obesity, including difficulty in making major dietary and lifestyle improvements [ 3 ].

Thus, patients often turn to dietary and herbal supplements DHSs to help achieve their weight loss goals [ 4 ]. According to the National Institutes of Health, DHSs are oral products that supplement the diet and contain ingredients such as vitamins, minerals, herbs, botanicals, amino acids, enzymes, and extracts [ 5 ].

In fact, the sales revenue of weight loss supplements is reported to be the fastest growing segment of the dietary supplement industry, with Americans spending over 2 billion dollars in [ 7 ]. These supplements are widely marketed and readily available without a prescription at pharmacies, retail outlets, health food stores, and online retailers [ 8 ].

Many of these DHSs are marketed with claims of increasing satiety, metabolism, lipolysis, and thermogenesis while reducing appetite, body fat, and overall weight [ 9 ].

Ingredients commonly found in DHSs for weight loss include green tea, chromium picolinate, ephedra, ginger root Zingiber officinale , guarana Paullinia cupana , caffeine, hydroxycitric acid, Siberian ginseng Eleutherococcus senticosus , cayenne Capsicum annuum , and bitter orange Citrus aurantium [ 10 ].

In a study of the nine most commonly advertised weight loss supplements on Google and Amazon, it was suggested that many weight loss supplements are associated with the potential for physical harm, with side-effects as severe as liver and kidney failure being observed [ 10 ].

Thus, patients need scientifically accurate information about safety and efficacy to help guide their choices about weight loss supplements. Information about DHSs for weight loss is widely available online.

Due to this increase in accessibility, consumer health information is becoming increasingly sought after by patients browsing the the internet.

A study found that 1 in 3 American adults use the internet to learn about a health concern [ 12 ]. A problem that has arisen from the minimal regulation and standardization of internet resources is the infrequent assessment of online health information quality [ 14 ]. An abundance of incomplete and inaccurate information is prevalent online, with millions of accessible resources accumulating daily [ 14 ].

Consumers can easily find information about DHSs on the internet, but the veracity of this information is often questionable [ 15 ]. Given the high incidence of DHS use and ease of internet access, consulting web-based resources may lead patients to replace or decrease conventional medication use in favour of DHSs [ 16 ].

Therefore, the purpose of this study is to assess the quality of web-based information related to DHSs for weight loss based on the current online landscape, and thereby fill this void in the literature.

A cross-sectional survey of websites providing DHSs consumer health information for weight loss was conducted. Six search terms were used to generate the first 20 websites on Google search engines in four countries: Australia google.

au , Canada google. ca , the United Kingdom google. uk , and the United States google. Search terms were generated based on terms commonly-used to refer to DHSs [ 8 , 17 ].

Thus, only the first two pages of search results were reviewed in this study. Searches were conducted using the Google Chrome browser in Incognito mode to prevent prior search history and cached information from affecting search results.

All searches were completed on the same day to ensure consistency. This search strategy was designed by JYN and carried out by SA. SA and CJZ reviewed the search results, and duplicate websites across searches were removed.

Websites were screened for eligibility and included if they contained at least one webpage that detailed consumer health information related to DHSs for weight loss. Moreover, Wikipedia articles, webpages with only videos e.

YouTube , webpages from the same website, Amazon links, invalid addresses, peer-reviewed articles, non-English language websites, eBooks, forums, advertised and sponsored links, and websites that require paid membership to access relevant information were excluded from the study.

The DISCERN instrument is a standardized quality index of written consumer health information [ 20 ]. It was developed with the input of an expert panel, health information providers, and patients in collaboration with the National Health Service, British Library, and Oxford Research and Development Programme.

The DISCERN instrument questions are divided into three categories: the reliability of the publication, the specific details of the information about treatment choices, and the overall quality rating of the source of information. It is important to note that DISCERN instrument cannot be used to assess the accuracy of scientific evidence, as this would necessitate checking the information against other sources.

Rather, the DISCERN instrument is used to assess the reliability of the website as a source for consumer health information. Furthermore, the DISCERN instrument cannot be used to assess the presentation of information readability, graphics, layout, etc.

as many assessment tools already exist for this purpose. Instead, the DISCERN instrument fills a gap by examining what consumer health information is being provided, rather than how it is being provided. Through 15 quality criteria, the DISCERN instrument helps pinpoint common causes of inaccurate or unreliable information such as bias.

Additional details about the DISCERN instrument can be found at: www. Prior to conducting data extraction and quality assessing eligible websites using the DISCERN instrument, a pilot test designed by JYN was completed by two independent reviewers — SA and CJZ.

In this pilot test, data pertaining to three separate websites was extracted and assessed using the DISCERN instrument; both SA and CJZ met with JYN to discuss the data extraction and the scoring of each DISCERN instrument item in detail to standardize its use.

After completing the pilot test, SA and CJZ independently completed the data extraction and quality assessment of eligible websites using the DISCERN instrument.

SA and CJZ then met with JYN to compare their scores and discuss discrepancies. Next, the means and standard deviations for each DISCERN instrument item, as well as the mean and standard deviation across all 16 items were calculated and assessed.

Unique URLs that led to the same website were collapsed into one search result for the purpose of quality assessment using the DISCERN instrument. Thus, assessment criteria were applied to each full website, not just a single webpage.

Of the websites retrieved across all searches, duplicates were removed. The 87 websites that remained were deemed eligible for assessment. This process is depicted in Fig.

The 87 eligible websites were categorized into six groups. The most common category was commercial websites, with 41 results.

All eligible websites discussed at least one of the four categorizations of DHSs by the U. Food and Drug Administration FDA : vitamin and mineral products, botanical and herbal products, amino acid products, and enzyme supplements [ 21 ].

Some common examples of these products found on commercial websites included ephedra, glucomannan, and 5-hydroxytryptophan. Seventy-five websites discussed only DHS therapies, while only 12 websites discussed non-DHSs therapies, such as surgical procedures and pharmaceutical medications.

Some commonly discussed examples of these included bariatric surgery and orlistat. Fifty-five websites appeared in more than one search. General characteristics of eligible websites are displayed in Table 1.

The mean total DISCERN instrument score across all assessed websites was The mean overall DISCERN instrument score Question 16 of each individual website was 2. Large variability was present, with individual overall scores ranging from 1. Question 1, 2, and 10 of the DISCERN instrument had the highest mean total scores of 4.

Question 1 asks whether the aims are clear, question 2 asks whether the website achieves its aims, and Question 10 asks whether the website describes the benefits of each treatment. Question 12 and 13 of the DISCERN instrument had the lowest mean total scores of 1.

Question 12 asks whether the website describes what would happen if no treatment is used, and Question 13 asks whether the website describes how the treatment choices affect overall quality of life.

A summary of DISCERN instrument ratings by website category is presented in Table 2. The DISCERN instrument scores for each individual website included and assessed in this study is available in Supplementary File 1. Question 10 whether the website describes the benefits of each treatment had the highest mean total score across all DISCERN instrument items, with 82 websites scoring a 4.

Similarly high scores were not observed for Question 11 whether the website describes the risks of each treatment , which was especially pronounced among commercial websites. Question 1 whether the aims clear and Question 2 whether the website achieves its aims had the next highest mean total scores across all DISCERN instrument items.

Sixty-three and 71 websites scored a 4 or above for Question 1 and Question 2, respectively. This resulted in consistently high scores for Question 1 and 2 across most websites. Question 12 whether the website describes what would happen if no treatment is used and Question 13 whether the website describes how treatment choices affect overall quality of life had the lowest mean total scores across all DISCERN instrument items.

A score of 1. Most websites discussed alternatives to DHSs but did not explicitly mention the effect of having no treatment. While the majority of websites included descriptions of risks and benefits, they failed to mention the overall impact of a treatment choice or choices on day-to-day living, leading to low scores on Question Across all six websites categories, government websites had the highest mean DISCERN instrument score at Government and health portal websites provided appropriate research citations, less biased assessments of DHSs for weight loss, and generally adequately comprehensive DHS information.

In contrast, commercial websites frequently lacked information surrounding the risks and benefits of DHSs for weight loss, and provided more biased assessments of DHSs. Ten out of twelve of the highest scoring websites were health portals and government websites, all with total DISCERN instrument scores above If you take dietary supplements and medications on a regular basis, be sure to talk about this with your health care provider.

Weight-loss supplements can be expensive, and they might not work. The best way to lose weight and keep it off is to follow a healthy eating pattern, reduce calories, and exercise regularly under the guidance of your health care provider.

As a bonus, lifestyle changes that help you lose weight might also improve your mood and energy level and lower your risk of heart disease, diabetes, and some types of cancer. This fact sheet by the National Institutes of Health NIH Office of Dietary Supplements ODS provides information that should not take the place of medical advice.

We encourage you to talk to your healthcare providers doctor, registered dietitian, pharmacist, etc. about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.

Updated: March 22, History of changes to this fact sheet. Dietary Supplements for Weight Loss Fact Sheet for Consumers. Consumer Datos en español Health Professional Other Resources. Table of Contents What are weight-loss dietary supplements and what do they do?

What are the ingredients in weight-loss dietary supplements? Common ingredients in weight-loss dietary supplements Ephedra, an ingredient banned from dietary supplements How are weight-loss dietary supplements regulated?

Can weight-loss dietary supplements be harmful? Choosing a sensible approach to weight loss Where can I find out more? African mango. African mango African mango seed extract is claimed to curb the formation of fat tissue.

Does it work? African mango might help you lose a very small amount of weight. Is it safe? It can cause headache, sleeping problems, flatulence, and gas. Beta-glucans Beta-glucans are soluble dietary fibers in bacteria, yeasts, fungi, oats, and barley.

They might slow down the time it takes for food to travel through your digestive system, making you feel fuller.

Beta-glucans don't seem to have any effect on body weight. Beta-glucans seem to be safe at up to 10 grams [g] a day for 12 weeks. They can cause flatulence. Bitter orange. Bitter orange Bitter orange contains synephrine a stimulant.

Products with bitter orange usually also contain caffeine and other ingredients. Bitter orange is in some weight loss dietary supplements that used to contain ephedra, another stimulant-containing herb that was banned from the U. market in see the section on Ephedra. Bitter orange might slightly increase the number of calories you burn.

It might also reduce your appetite a little, but whether it can help you lose weight is unknown. Bitter orange might not be safe.

Supplements with bitter orange can cause chest pain, anxiety, headache, muscle and bone pain, a faster heart rate, and higher blood pressure. Caffeine Caffeine is a stimulant that can make you more alert, give you a boost of energy, burn calories, and increase fat breakdown. Often added to weight-loss dietary supplements, caffeine is found naturally in tea, guarana, kola cola nut, yerba mate, and other herbs.

The labels of supplements that contain caffeine don't always list it, so you might not know if a supplement has caffeine. Weight-loss dietary supplements with caffeine might help you lose a little weight or gain less weight over time. When you use caffeine regularly, however, you become tolerant of it.

This tolerance might lessen any effect of caffeine on body weight over time. It can also affect your sleep. At higher doses, it can cause nausea, vomiting, rapid heartbeat, and seizures. Combining caffeine with other stimulant ingredients can increase caffeine's effects.

Calcium Calcium is a mineral you need for healthy bones, muscles, nerves, blood vessels, and many of your body's functions. It's claimed to burn fat and decrease fat absorption.

Calcium—either from food or in weight-loss dietary supplements—probably doesn't help you lose weight or prevent weight gain.

Calcium is safe at the recommended amounts of 1, to 1, mg a day for adults. Too much calcium more than 2,—2, mg a day can cause constipation and decrease your body's absorption of iron and zinc.

Also, too much calcium from supplements but not foods might increase your risk of kidney stones. Capsaicin Capsaicin comes from chili peppers and makes them taste hot. It's claimed to help burn fat and calories and to help you feel full and eat less.

Capsaicin hasn't been studied enough to know if it will help you lose weight. Capsaicin is safe at up to 33 mg a day for 4 weeks or 4 mg a day for 12 weeks , but it can cause stomach pain, burning sensations, nausea, and bloating.

Carnitine Your body makes carnitine, and it's also found in meat, fish, poultry, milk, and dairy products. In your cells, it helps break down fats. Carnitine supplements might help you lose a small amount of weight. Carnitine supplements seem to be safe at up to 2 g a day for 1 year or 4 g a day for 56 days.

They can cause nausea, vomiting, diarrhea, abdominal cramps, and a fishy body odor. Chitosan Chitosan comes from the shells of crabs, shrimp, and lobsters. Office of Dietary Supplements and the National Center for Complementary and Integrative Health. Also be sure to talk with your doctor before taking any supplement.

This is especially important if you have health problems, take prescription drugs, or are pregnant or breast-feeding.

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Request Appointment. Healthy Lifestyle Weight loss. Sections Basics Weight-loss basics Diet plans The Mayo Clinic Diet Diet and exercise Diet pills, supplements and surgery In-Depth Expert Answers Multimedia Resources News From Mayo Clinic What's New.

Products and services. Dietary supplements for weight loss Melt away fat. Lose weight naturally. Tempting claims, but do the products deliver? By Mayo Clinic Staff. Thank you for subscribing!

Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Show references Dietary supplements for weight loss. Office of Dietary Supplements. Accessed Oct. Perreault L.

Obesity in adults: Drug therapy. Dietary supplements. Food and Drug Administration. Barrea L, et al. Nutritionist and obesity: Brief overview on efficacy, safety, and drug interactions of the main weight-loss dietary supplements.

International Journal of Obesity Supplements. Bray GA, et al. The science of obesity management: An Endocrine Society scientific statement.

Due to this increase in accessibility, consumer health information is becoming increasingly sought after by patients browsing the the internet. A study found that 1 in 3 American adults use the internet to learn about a health concern [ 12 ].

A problem that has arisen from the minimal regulation and standardization of internet resources is the infrequent assessment of online health information quality [ 14 ]. An abundance of incomplete and inaccurate information is prevalent online, with millions of accessible resources accumulating daily [ 14 ].

Consumers can easily find information about DHSs on the internet, but the veracity of this information is often questionable [ 15 ].

Given the high incidence of DHS use and ease of internet access, consulting web-based resources may lead patients to replace or decrease conventional medication use in favour of DHSs [ 16 ]. Therefore, the purpose of this study is to assess the quality of web-based information related to DHSs for weight loss based on the current online landscape, and thereby fill this void in the literature.

A cross-sectional survey of websites providing DHSs consumer health information for weight loss was conducted. Six search terms were used to generate the first 20 websites on Google search engines in four countries: Australia google. au , Canada google.

ca , the United Kingdom google. uk , and the United States google. Search terms were generated based on terms commonly-used to refer to DHSs [ 8 , 17 ]. Thus, only the first two pages of search results were reviewed in this study.

Searches were conducted using the Google Chrome browser in Incognito mode to prevent prior search history and cached information from affecting search results. All searches were completed on the same day to ensure consistency. This search strategy was designed by JYN and carried out by SA. SA and CJZ reviewed the search results, and duplicate websites across searches were removed.

Websites were screened for eligibility and included if they contained at least one webpage that detailed consumer health information related to DHSs for weight loss. Moreover, Wikipedia articles, webpages with only videos e. YouTube , webpages from the same website, Amazon links, invalid addresses, peer-reviewed articles, non-English language websites, eBooks, forums, advertised and sponsored links, and websites that require paid membership to access relevant information were excluded from the study.

The DISCERN instrument is a standardized quality index of written consumer health information [ 20 ]. It was developed with the input of an expert panel, health information providers, and patients in collaboration with the National Health Service, British Library, and Oxford Research and Development Programme.

The DISCERN instrument questions are divided into three categories: the reliability of the publication, the specific details of the information about treatment choices, and the overall quality rating of the source of information.

It is important to note that DISCERN instrument cannot be used to assess the accuracy of scientific evidence, as this would necessitate checking the information against other sources.

Rather, the DISCERN instrument is used to assess the reliability of the website as a source for consumer health information.

Furthermore, the DISCERN instrument cannot be used to assess the presentation of information readability, graphics, layout, etc. as many assessment tools already exist for this purpose.

Instead, the DISCERN instrument fills a gap by examining what consumer health information is being provided, rather than how it is being provided. Through 15 quality criteria, the DISCERN instrument helps pinpoint common causes of inaccurate or unreliable information such as bias.

Additional details about the DISCERN instrument can be found at: www. Prior to conducting data extraction and quality assessing eligible websites using the DISCERN instrument, a pilot test designed by JYN was completed by two independent reviewers — SA and CJZ.

In this pilot test, data pertaining to three separate websites was extracted and assessed using the DISCERN instrument; both SA and CJZ met with JYN to discuss the data extraction and the scoring of each DISCERN instrument item in detail to standardize its use.

After completing the pilot test, SA and CJZ independently completed the data extraction and quality assessment of eligible websites using the DISCERN instrument.

SA and CJZ then met with JYN to compare their scores and discuss discrepancies. Next, the means and standard deviations for each DISCERN instrument item, as well as the mean and standard deviation across all 16 items were calculated and assessed. Unique URLs that led to the same website were collapsed into one search result for the purpose of quality assessment using the DISCERN instrument.

Thus, assessment criteria were applied to each full website, not just a single webpage. Of the websites retrieved across all searches, duplicates were removed.

The 87 websites that remained were deemed eligible for assessment. This process is depicted in Fig. The 87 eligible websites were categorized into six groups.

The most common category was commercial websites, with 41 results. All eligible websites discussed at least one of the four categorizations of DHSs by the U. Food and Drug Administration FDA : vitamin and mineral products, botanical and herbal products, amino acid products, and enzyme supplements [ 21 ].

Some common examples of these products found on commercial websites included ephedra, glucomannan, and 5-hydroxytryptophan. Seventy-five websites discussed only DHS therapies, while only 12 websites discussed non-DHSs therapies, such as surgical procedures and pharmaceutical medications.

Some commonly discussed examples of these included bariatric surgery and orlistat. Fifty-five websites appeared in more than one search.

General characteristics of eligible websites are displayed in Table 1. The mean total DISCERN instrument score across all assessed websites was The mean overall DISCERN instrument score Question 16 of each individual website was 2.

Large variability was present, with individual overall scores ranging from 1. Question 1, 2, and 10 of the DISCERN instrument had the highest mean total scores of 4. Question 1 asks whether the aims are clear, question 2 asks whether the website achieves its aims, and Question 10 asks whether the website describes the benefits of each treatment.

Question 12 and 13 of the DISCERN instrument had the lowest mean total scores of 1. Question 12 asks whether the website describes what would happen if no treatment is used, and Question 13 asks whether the website describes how the treatment choices affect overall quality of life.

A summary of DISCERN instrument ratings by website category is presented in Table 2. The DISCERN instrument scores for each individual website included and assessed in this study is available in Supplementary File 1.

Question 10 whether the website describes the benefits of each treatment had the highest mean total score across all DISCERN instrument items, with 82 websites scoring a 4. Similarly high scores were not observed for Question 11 whether the website describes the risks of each treatment , which was especially pronounced among commercial websites.

Question 1 whether the aims clear and Question 2 whether the website achieves its aims had the next highest mean total scores across all DISCERN instrument items. Sixty-three and 71 websites scored a 4 or above for Question 1 and Question 2, respectively.

This resulted in consistently high scores for Question 1 and 2 across most websites. Question 12 whether the website describes what would happen if no treatment is used and Question 13 whether the website describes how treatment choices affect overall quality of life had the lowest mean total scores across all DISCERN instrument items.

A score of 1. Most websites discussed alternatives to DHSs but did not explicitly mention the effect of having no treatment. While the majority of websites included descriptions of risks and benefits, they failed to mention the overall impact of a treatment choice or choices on day-to-day living, leading to low scores on Question Across all six websites categories, government websites had the highest mean DISCERN instrument score at Government and health portal websites provided appropriate research citations, less biased assessments of DHSs for weight loss, and generally adequately comprehensive DHS information.

In contrast, commercial websites frequently lacked information surrounding the risks and benefits of DHSs for weight loss, and provided more biased assessments of DHSs. Ten out of twelve of the highest scoring websites were health portals and government websites, all with total DISCERN instrument scores above These websites commonly included an abundance of references to primary research literature, and links to additional sources of reading; in contrast; this was rarely present across commercial websites.

Healthcare practitioners may find value in recommending these high-scoring websites to their patients. Additional details surrounding these recommended websites are depicted in Table 3.

This study assessed the quality of websites containing DHSs consumer health information for weight loss. With the increasingly popular use of DHSs and ease of web-based health information access [ 6 , 7 , 11 , 12 ], this study helped to identify the overall quality of information patients may access on this topic.

Our findings suggest the importance for healthcare providers to take an active role in understanding the types of websites typically accessed by patients in order to help them navigate mis information and refer them to high-quality resources.

Across 87 unique websites, most succeeded in describing the benefits of DHSs, and detailing and achieving their specified aims, while generally failing to describe the impact of treatment on overall quality of life, as well as the impact of a no treatment option.

The highest-scoring websites were overwhelmingly categorized as health portals and government websites, while the majority of the lowest-scoring websites were commercial websites.

While to our knowledge, few studies that have investigated the quality of DHS consumer health information for weight loss have been published over the past 5 years, older studies and studies published on related topics can serve as comparative literature.

In a study [ 22 ], researchers analysed the quality and comprehensiveness of online information related to weight loss. They concluded that web-based weight loss information was often of substandard quality because most comprehensive and high-quality websites ranked too low in the search results.

Researchers attributed this to low search-engine optimization amongst medical, government, and university organization websites [ 22 ]. Previous studies have used the DISCERN instrument to assess web-based information surrounding chronic pain, gastrointestinal diseases, anxiety disorders, back pain, rheumatoid arthritis, and postherpetic neuralgia [ 23 , 24 , 25 , 26 , 27 , 28 ].

The quality of information found on these websites across all studies were moderate to poor; the vast majority of websites yielded by search results were commercial in nature. These studies also noted that higher-scoring websites tended to cite the research literature and provided a clear statement of purpose.

High DISCERN instrument score variability across websites was also a common trend. All of these patterns similarly reflect what was observed in the present study.

One strength included the use of the DISCERN instrument, which has been found to be reliable and valid for assessing the quality of consumer health information on the internet. Conducting a pilot test standardized the application of the DISCERN instrument between individual reviewers.

Another strength included searching in more than one country, which allowed for a more internationally representative sample of websites. This also allowed the results of this study to be more applicable to healthcare practitioners in multiple countries.

A notable limitation i that the internet is dynamic and constantly changing, thus the websites assessed in this study will not necessarily reflect information readily available to patients at another point in time.

Additionally, conducting the pilot test with only three websites may not have been sufficient in standardizing assessments between each independent reviewer. As a result, this may have caused greater variation between DISCERN instrument scores for each website. Furthermore, the present study did not account for non-English language websites.

Another limitation includes the fact that only six search terms were utilized across all regional searches. Therefore, it is very possible that a slight change in the wording of search terms could lead to variation in search results.

The purpose of our study was to assess the quality of DHSs consumer health information for weight loss. High-scoring websites were largely health portals and government websites, while low-scoring websites were overwhelmingly commercial websites.

Most websites described treatment benefits, and detailed and achieved their specified aims, but were lacking in their descriptions for overall impact on quality of life, and impact of a no treatment option.

Large variability in DISCERN instrument scores exist between the assessed subset of websites, with a relatively equal distribution between high and low overall scores. Our findings suggest that the quality of websites being accessed by patients is likely of varying quality, thus healthcare providers need to be actively aware of this to guide patient information-seeking behaviour, as well as safe, effective, and evidence-informed decision making relating to DHSs use.

Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, — [Internet]. Centers for Disease Control and Prevention; [cited Sep 14].

Childhood Obesity Facts [Internet]. Centers for disease control and prevention; [cited May 8]. Sarwer DB, Polonsky HM. The psychosocial burden of obesity. Endocrinol Metab Clin. Article Google Scholar. Barrea L, Altieri B, Polese B, De Conno B, Muscogiuri G, Colao A, Savastano S.

Nutritionist and obesity: brief overview on efficacy, safety, and drug interactions of the main weight-loss dietary supplements. Int J Obes Suppl.

Article PubMed PubMed Central Google Scholar. Dietary and Herbal Supplements [Internet]. National Center for Complementary and Integrative Health. Department of Health and Human Services; [cited Sep 14]. Blanck HM, Serdula MK, Gillespie C, Galuska DA, Sharpe PA, Conway JM, Khan LK, Ainsworth BE.

Use of nonprescription dietary supplements for weight loss is common among Americans. J Am Diet Assoc. Article PubMed Google Scholar. Is sports nutrition its own worst enemy? Nutr Bus J. Natural Health Products [Internet]. Government of Canada; [cited Sep 14]. Saldanha LG, Dwyer JT, Andrews KW, Bailey RL, Gahche JJ, Hardy CJ, Holden JM, Picciano MF, Roseland JM, Thomas PR, Wolf WR.

Online dietary supplement resources. Wharton S, Bonder R, Jeffery A, Christensen RA. The safety and effectiveness of commonly marketed natural supplements for weight loss in populations with obesity: a critical review of the literature from to Critical reviews in food science and nutrition.

Pew Research Center: Internet, Science Tech; [cited Sep 14]. Fox S, Duggan M. Health online. Pew Internet and American Life Project. Google Scholar. Prescott C. Internet access — households and individuals, Great Britain: [Internet].

Office for National Statistics; [cited Sep 14]. Diviani N, van den Putte B, Giani S, van Weert JC. Low health literacy and evaluation of online health information: a systematic review of the literature. J Med Internet Res. Kalichman SC, Cherry C, White D, Kalichman MO, Detorio MA, Caliendo AM, Schinazi RF.

AIDS Res Ther. Article CAS PubMed PubMed Central Google Scholar. De Smet PA. Herbal remedies. Also be sure to talk with your doctor before taking any supplement. This is especially important if you have health problems, take prescription drugs, or are pregnant or breast-feeding. There is a problem with information submitted for this request.

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Appointments at Mayo Clinic Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Request Appointment. Healthy Lifestyle Weight loss. Sections Basics Weight-loss basics Diet plans The Mayo Clinic Diet Diet and exercise Diet pills, supplements and surgery In-Depth Expert Answers Multimedia Resources News From Mayo Clinic What's New.

Products and services. Dietary supplements for weight loss Melt away fat. Lose weight naturally. Tempting claims, but do the products deliver? By Mayo Clinic Staff. Thank you for subscribing!

Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Show references Dietary supplements for weight loss. Office of Dietary Supplements. Accessed Oct. Perreault L. Obesity in adults: Drug therapy.

Dietary supplements. Food and Drug Administration. Barrea L, et al. Nutritionist and obesity: Brief overview on efficacy, safety, and drug interactions of the main weight-loss dietary supplements. International Journal of Obesity Supplements. Bray GA, et al. The science of obesity management: An Endocrine Society scientific statement.

Endocrinology Review. Raynor HA, et al. Position of the Academy of Nutrition and Dietetics: Interventions for the treatment of overweight and obesity in adults.

Journal of the Academy of Nutrition and Dietetics. Esteghamati A, et al. Complementary and alternative medicine for the treatment of obesity: A critical review. International Journal of Endocrinology and Metabolism. Using dietary supplements wisely. National Center for Complementary and Integrative Health.

The truth behind weight loss ads. Federal Trade Commission. Bauer BA expert opinion. Mayo Clinic. Products and Services The Mayo Clinic Diet Online A Book: The Mayo Clinic Diet Bundle.

Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Mayo Clinic on Incontinence - Mayo Clinic Press Mayo Clinic on Incontinence The Essential Diabetes Book - Mayo Clinic Press The Essential Diabetes Book Mayo Clinic on Hearing and Balance - Mayo Clinic Press Mayo Clinic on Hearing and Balance FREE Mayo Clinic Diet Assessment - Mayo Clinic Press FREE Mayo Clinic Diet Assessment Mayo Clinic Health Letter - FREE book - Mayo Clinic Press Mayo Clinic Health Letter - FREE book.

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