Googling Guggul for Weight Loss

Guggul, or rather guggulsterone, is the active ingredient in an age-old Indian Ayurvedic remedy derived from the gum resin of the guggul tree (Commiphora mukul), which has been shown to lower lipid and cholesterol levels. Claims have also been made regarding its usefulness as an antiobesity drug, although the data on this is far from consistent.

A recent paper by Yang and colleagues from the University of Georgia, published in a recent issue of OBESITY, demonstrates that guggelsterone in fact does substantially inhibit adipogenic differentiation of cultured 3T3-L1 cells (a widely used in vitro model of fat cells). In this model, guggulsterone also promotes lipolysis as well as induces apoptosis of fat cells, albeit at higher concentrations. (link to abstract)

Together, these findings appear to provide a biological mechanism to support the anti-obesity health claims for this compound.

However, this does not mean that we now have a new natural "solution" to the obesity problem (although, as a brief excursion to Google confirms, guggul is already widely promoted and available for exactly that).

Here are my reservations:

1) Fat cells are the safest place to store excess calories. Limiting the growth or destroying fat cells, without also targeting the state of caloric excess raises the issue of where those extra calories should go. Because they are in excess of what the body needs, they are not simply "burnt off". Rather, the body now has to store them somewhere else, i.e. in non-fat tissue (for e.g. liver, muscle, etc.) - also referred to as "ectopic" fat deposition. There is now ample evidence that it is in fact this ectopic fat that causes the metabolic problems (e.g. diabetes) that are often associated with obesity. So if guggul prevents the formation of fat cells or destroys them (by apoptosis) the big question is: what happens with all the excess energy? If this now ends up in the form of fat stores in other organs like your liver or muscle, you are more likely to cause harm rather than reap any benefits.

2) Obviously, extrapolating from an in vitro finding to clinical benefits in patients is a long shot. While the data on guggul's clinical antilipid effects appears well-documented, I am not convinced of any weight-loss effects thus far. Destroying fat cells, to me does not necessarily translate into weight loss unless the extra calories stored in those cells are actually burnt. For that guggul would either have to promote burning of calories, for which to my knowledge there is no indication. Alternatively, guggul would have to also reduce energy intake for which I have also seen no evidence.

The bottom line is that, despite this elegant laboratory work demonstrating biological action of guggelsterone in vivo, health claims should be based on demonstration of clinically significant health benefits in rigorously conducted clinical trials. As the issue in obesity treatment is not short-term weight loss but rather long-term weight-loss maintenance, these studies would have to be long enough (i.e. 12 months or longer).

Is this going to stop people from selling and buying guggul because of its now "proven ability to destroy fat cells"?

Not likely.

Will I be recommending guggulsterone as obesity treatment to my patients?

Definitely not!

AMS