”The man who removes a mountain begins by carrying away small stones.” — Chinese Proverb
Recently, a newspaper reporter asked me about the use of Garcinia Cambogia for weight loss. I told her that I knew it was safe but probably not dramatically effective. I would do more research and get back to her.

Still, since so many patients come to me for natural solutions to their problems, including weight loss, I figured it was time to dig into the subject more deeply. In the spirit of medical education, I turned the project over to my diligent medical students Amanda Vela and Jaime Eller, who were taking our complementary and integrative medicine elective. I asked them to investigate the medical literature on herbal weight loss supplements and to check the Google claims against the scientific validity. They did a great job looking up the data on about a dozen supplements currently in use for weight loss. Dr. Oz seemed to show up frequently, which explained why we doctors get these episodic bursts of questions about such things as green coffee bean extract and raspberry ketones suddenly hot on the market. Mostly these do not pan out.

A common question I hear is, “Doc, do you have a pill to help me lose weight?”

I have little enthusiasm for pharmaceutical weight loss drugs. They are not only expensive, but there’s risk of serious side effects. Studies show they offer limited benefits in terms of weight loss, usually less than 10 pounds — often not sustained.

Weight loss is a major challenge for many of us. Even getting 5 or 10 pounds off can be a seemingly insurmountable challenge. It can be difficult to set aside time to take care of ourselves. Many folks are constantly on the lookout for the new diet, new gym equipment or a new pill that will help shave off some pounds easily. Natural herbs and botanicals, used for thousands of years for a variety of ailments, are now also being marketed for weight loss.

Suffice it to say, as in the proverb, moving a mountain requires starting by moving pebbles. If you are among the more than 60 percent of Americans that is obese or overweight, that mountain of extra pounds didn’t occur overnight and will take time, patience and steady work to remove. Our extra weight resulted from consistent and repeated choices in daily habits of eating, drinking and exercise.

Like the pebble analogy, even small changes in daily caloric intake can help. Cutting just 500 calories a day can lead to losing as much as a pound a week. This only works if you increase your exercise to simultaneously boost your metabolism, promoting fitness over fatness. Someone who is active and fit, though still overweight, will be at lower risk of heart disease, cancer, diabetes and other diseases than a normal weight but inactive person.

Next week, we’ll cover the evidence, risks and benefits of the most popular dietary supplements for weight loss.
In the meantime, one pebble at a time.

Dr. Victor S. Sierpina is the WD and Laura Nell Nicholson Family Professor of Integrative Medicine and Professor of Family Medicine at UTMB.