A systematic review of anti-obesity medicinal plants - an update

  • Shirin Hasani-Ranjbar1, 2,

    Affiliated with

    • Zahra Jouyandeh2 and

      Affiliated with

      • Mohammad Abdollahi3Email author

        Affiliated with

        Journal of Diabetes and Metabolic Disorders201312:28

        DOI: 10.1186/2251-6581-12-28

        Received: 8 April 2013

        Accepted: 17 June 2013

        Published: 19 June 2013


        Obesity is the most prevalent health problem affecting all age groups, and leads to many complications in the form of chronic heart disease, diabetes mellitus Type 2 and stroke. A systematic review about safety and efficacy of herbal medicines in the management of obesity in human was carried out by searching bibliographic data bases such as, PubMed, Scopus, Google Scholar, Web of Science, and IranMedex, for studies reported between 30th December 2008 to 23rd April 2012 on human or animals, investigating the beneficial and harmful effects of herbal medicine to treat obesity. Actually we limited our search to such a narrow window of time in order to update our article published before December of 2008. In this update, the search terms were “obesity” and (“herbal medicine” or “plant”, “plant medicinal” or “medicine traditional”) without narrowing or limiting search items. Publications with available abstracts were reviewed only. Total publications found in the initial search were 651. Total number of publications for review study was 33 by excluding publications related to animals study.

        Studies with Nigella Sativa, Camellia Sinensis, Crocus Sativus L, Seaweed laminaria Digitata, Xantigen, virgin olive oil, Catechin enriched green tea, Monoselect Camellia, Oolong tea, Yacon syrup, Irvingia Gabonensi, Weighlevel, RCM-104 compound of Camellia Sinensis, Pistachio, Psyllium fibre, black Chinese tea, sea buckthorn and bilberries show significant decreases in body weight. Only, alginate-based brown seaweed and Laminaria Digitata caused an abdominal bloating and upper respiratory tract infection as the side effect in the trial group. No other significant adverse effects were reported in all 33 trials included in this article.

        In conclusion, Nigella Sativa, Camellia Synensis, Green Tea, and Black Chinese Tea seem to have satisfactory anti-obesity effects. The effect size of these medicinal plants is a critical point that should be considered for interpretation. Although there was no report for side effect in these trials, we believe that safety of these plants still remains to be elucidated by further long-term studies.

        Herbal medicine Obesity Systematic review


        Obesity is becoming one of the most prevalent health concerns among all populations and age groups worldwide, resulting into a significant increase in mortality and morbidity related to coronary heart diseases, diabetes type 2, metabolic syndrome, stroke and cancers [13]. Prevention and treatment of this problem are an important deal for health systems, whose aim is to reduce the obesity and overweight prevalence, and related complications over the world [4]. Both lifestyle and pharmacotherapy interventions have been considered by physicians and other health care professionals as obesity treatment modalities. Studies show that only 5-10% subjects can maintain their weight loss over the years [5]. The complex pathogenesis of obesity indicates the need of different intervention strategies to confront this problem with a simple drug therapy which is more acceptable to patients [4]. Disappointing results, after cessation the lifestyle modification or pharmacotherapy indicated the need of other treatment modalities to produce better and long-lasting results, in terms of weight loss [6]. Herbal supplements and diet-based therapies for weight loss are among the most common n complementary and alternative medicine [CAM] modalities [7]. A vast range of these natural products and medicinal plants, including crude extracts and isolated compounds from plants can be used to induce weight loss and prevent diet-induced obesity. In the recent decades, these have been vastly used in management of obesity [4, 8] due to containing a large variety of several components with different anti-obesity and anti-oxidant effects on body metabolism and fat oxidation. Medicinal plants have been investigated and reported to be useful in treatment of obesity, diabetes and other chronic diseases [9, 10].

        To date, some reviews on anti-obesity agents have been accomplished including, our systematic review on efficacy and safety of herbal plants in the treatment of obesity that published 4 years ago [11]. Because of the increasing number of randomized clinical trials conducted in the recent years, we felt the need for a new systematic review on this topic with a special focus on clinical trials. Therefore, the aim of the present review was to update data on potential anti-obesity herbal plants, and review the scientific data, including experimental methodologies, active components, and mechanisms of action against obesity in human.


        PubMed, Scopus, Google Scholar, Web of Science, and IranMedex databases were searched for studies reported between 30th December 2008 to 23rd April 2012 on human or animals investigating the benefits and harms of herbal medicines to treat obesity. The search terms were “obesity” and (“herbal medicine” or “plant”, “plant medicinal” or “medicine traditional”) without narrowing or limiting search items. Publications with available abstracts were reviewed. The main outcome measures were defined as body weight, body fat, including fat mass/fat weight or fat percentage/visceral adipose tissue weight, waist or hip circumference, triceps thickness and appetite, and the amount of food/energy intake.

        Abstracts of publications on human studies with the main outcome as mentioned above were included. In vitro studies, review articles and letters to the editor were excluded. The articles were reviewed for abstracts and title by two reviewers. Due to our inclusion and exclusion criteria, the duplicate articles were eliminated.


        Body weight

        Significant decrease in body weight was seen by Nigella Sativa, Camellia sinensis, Crocus sativus L, seaweed laminaria digitata, Xantigen, virgin olive oil, Catechin enriched green tea, Monoselect Camellia, Oolong tea, Yacon syrup, Irvingia Gabonensi, Weighlevel, RCM-104 compound of Camellia, Sinensis, Pistachio, Psyllium fibre, black Chinese tea, sea buckthorn and bilberries.

        Body fat

        Significant decrease in body fat was seen by Xantigen [16], Catechin-enriched green tea [18], Irvingia gabonensis a West African plant [22], RCM-104 a compound of Camellia Sinensis, Semen Cassiae and Flos Sophorae [23], Psyllium Fibre [25], and black Chinese tea [Pu-Erh tea] [26]. Oolong tea showed a decrease in subcutaneous fat content not total body fat [20]. Debese showed a reduction in triceps skin folds in a trial [28].

        Waist and hip circumference

        There was a significant decrease in waist and hip circumferences with Nigella Sativa [12], Xantigen [16], Catechin enriched green tea [18], Yacon Syrup [21], Irvingia gabonensis [22], Debese [28], Whole grain [29], Lycium barbarum [30], black Chinese Tea [26], Sea buckthorn, and bilberries [27]. Monoselect Camellia from green tea extract reduced the waistline only in men [19]. Pu’er tea [black Chinese tea] decreased the waist-hip ratio significantly [31].

        Food intake

        A significant decrease in appetite was shown in trials by Trigonella Foenum-graecum L. [32], Fungreek fiber [33]. An extract of Blueberry Bioactives [34], Epigallocatechin of green tea [35], Northern Berries [36], alginate-based brown seaweed Laminaria Difitata [15], and RCM-104 compound of Camellia Sinensis [23] did not show any relevant decrease in appetite.

        Other effects

        Anti-hyperglycemic, anti-hyperlipidemic, and anti-oxidant effects were detected in these trials [see Table 1].
        Table 1

        Human studies considering herbal medicines for treatment of obesity



        Herbs [scientific name]




        Main outcome

        Other relevant effects & complications

        Weight Before/Placebo

        Weight After/Treatment


        Datau et al 2010 [12]

        Obese male [n = 50]

        Nigella sativa

        RCT [double blind]

        Two Cap of 750 mg NS twice daily/3 mo

        I: extract C: flour

        Very Sig. reduction of BW, WC, and SBP

        Non-Sig. reduction in serum free testosterone, DBP, FBS, TG and HDL-chol, uric acid, hs-CRP, and non-Sig. increase of adiponectin

        77.11 ± 4.86

        72.60 ± 5.41


        Stull et al 2010 [34]

        Obese, non-diabetic & insulin resistant [n = 32]

        Blueberry composed of [Tifblue Vaccinium ashei and Rubel Vaccinium corymbosum].

        RCT [double blind]

        22.5 g BB twice daily/6 wk

        I: extract C: placebo

        Sig. improvement in insulin sensitivity, No Sig. changes in adiposity, energy intake, and inflammatory biomarkers


        98.7 ± 3.1

        99.1 ± 3.1


        Godard et al 2010 [49]

        Obese, pre-diabetic [n = 29]

        Opuntia ficus-indica

        RCT [double blind]

        200 mg/16 wk

        I: extract C: placebo

        Statistically Sig. decrease in blood glucose concentration, no Sig. changes in body composition variables

        Non-Sig. changes in blood chemistry parameters [insulin, proinsulin, hs-CRP, adiponectin, HbA1C]

        107.13 ± 22.24

        108.39 ± 24.90


        Basu et al 2011 [13]

        Obese with Metsyn [n = 35]

        Camellia Sinensis


        4 cups/d green tea or 2cap and 4 cups water/d/8 wk

        I: green tea or extract C: water

        Sig. decrease in BW and BMI

        A decreasing trend In LDL-chol and LDL/HDL ratio

        96.4 ± 4.7

        94.5 ± 4.5


        Gout et al 2010 [14]

        Mildly over wt. women [n = 60]

        Satiereal, [Crocus sativus L extract]

        RCT [double blind]

        176.5 mg/d/8 wk

        I: extract C: placebo

        A Sig. BW reduction

        Decrease in mean snacking frequency

        Placebo 73.9 ± 1.7

        Treatment 73.2 ± 1.1


        Thielecke et al 2010 [35]

        Obese male [n = 10]

        Epigallocatechin-3-gallate [EGCG] of green tea

        RCT [double blind]

        Low EGCG 300mg, high EGCG 600mg/3 d

        I: EGCG [low/ high + caffeine], caffeine C: placebo

        Increase in fat oxidation





        Mirmiran et al 2010 [50]

        Hyperlipidemic [n = 51]

        Pomegranate seed oil [PSO]

        RCT [double blind]

        400 mg PSO twice daily/4 wk

        I: extract C: placebo

        Unchanged body composition variables, decreased TG and the TG: HDL-chol ratio

        Unchanged Serum TC, LDL-chol and glucose concentrations

        (No significant change in BMI seen)



        Lehtonen et al 2010 [36]

        Healthy women volunteers [n = 61]

        Northern berries


        163 g/20 wk

        I: extract C: control

        Non-Sig. change in calorie intake, WC, increase in plasma adiponectin level

        High decrease in the ALAT value, no change in HOMA-IR, Fasting plasma insulin, fasting plasma TC, TG, hs-CRP, TNF-α or ORAC, small increase in fasting plasma HDL




        Egert et al 2010 [51]

        Obese [n = 93]


        RCT [double blind]

        150 mg/d/6 wk

        I: extract C: control

        No change in nutritional status [BW, WC, fat mass, fat-free mass]

        Decreased serum HDL- chol, apoA1, increased the LDL/HDL ratio




        Chevassus et al 2010 [32]

        Healthy over wt. male volunteers [n = 39]

        Trigonella foenum-graecum L.

        RCT [double blind]

        1176 mg [approximately 14 mg.kg-1]/d /6 wk

        I: extract C: control

        Decrease daily fat consumption, Non-Sig. effect on wt., Appetite/satiety scores or oxidative parameters

        Decrease in the insulin/glucose ratio




        Gurrola-Díaz et al 2010 [52]


        Hibiscus sabdariffa


        100 mg/d [1.4 mg/kg]/1 mo

        I: HSEP, HSEP + preventive diet [±metsyn] C: Preventive diet

        Sig. reduced glucose and TC levels, increased HDL-chol levels





        Odunsi et al 2009 [15]

        Obese [n = 48]

        Alginate based on brown seaweed Laminaria digitata


        6 Cap per d /10 d

        I: compound C: placebo

        No effect on gastric motor functions, satiation, appetite, or gut hormones

        Abdominal bloating, upper respiratory tract infections




        Abidov et al 2010 [16]

        Obese, premenopausal women [n = 151]

        Xanthigen [brown marine algae fucoxanthin + pomegranate seed oil [PSO]]

        RCT [double blind]

        600/2.4 mg, 400/1.6 mg /16 wk

        I: Extract C: control

        Sig. reduction of BW, WC, body and liver fat content

        Reduction in liver enzymes, serum TG and CRP, increase REE in NAFLD

        92.5 ± 1.5

        88.2 ± 1.9


        Razquin et al 2009 [17]

        Human [n = 187]

        Virgin olive oil, nuts

        RCT [Randomized dietary trial : PREDIMED trial]

        3 yr

        I: Mediterranean diet C: control

        Reduction in BW

        Higher levels of plasma total antioxidant capacity

        71.98 ± 11.59

        78.46 ± 12.11


        Wang et al 2009 [18]

        Moderately over wt. [n = 182]

        Catechin enriched green tea


        458 mg, 468 mg, 886 mg /90 d

        I: extract C: Placebo

        Decrease in estimated intra-abdominal fat [IAF] area, in WC, BW, reduction in total body fat


        69.8 ± 9.1

        69.9 ± 12.1


        Di Pierro et al 2009 [19]

        Obese [n = 100]

        Monoselect Camellia [containing green tea extract: GreenSelect Phytosome]


        150 mg/90 d

        I: hypocaleric diet + extract C: hypocaleric diet

        Sig. wt. loss and decreased BMI

        Reduce leptin, reduce waistline only in men, decrease TC & TG levels

        96.142 ± 18.012

        82.298 ± 15.326


        Qidwai et al 2009 [53]

        Human [n = 123]

        Nigella Sativa

        RCT [double blind]


        I: extract C: placebo

        Non-Sig. change in BW

        Non-Sig. change in serum lipid levels, BS, BP




        Mathern et al 2009 [33]

        Healthy obese [n = 18]

        Fenugreek fiber

        RCT [Single blind]

        4 or 8 gr/3.5 hr

        I: extract C: control

        Increased mean ratings of satiety and fullness, reduced ratings of hunger and prospective food consumption, reduce energy intake

        No difference for AUC blood glucose, increase in AUC for insulin levels




        He et al 2009 [20]

        Diet induced obese or over wt. [n = 102]

        Oolong tea


        8 g/6 wk

        I: extract C: control

        Sig. decrease in BW, decrease in subcutaneous fat content

        Decrease TC & TG plasma levels

        74.1 ± 8.2

        71.2 ± 8.1


        Genta et al 2009 [21]

        Obese & slightly dyslipidemic pre-menopausal women

        Yacon syrup

        RCT [double blind]

        0.29 g and 0.14 g Fructo-oligosaccharides/kg/d/120 d

        I: extract C: control

        Sig. decrease in BW, WC, BMI

        Decrease in fasting serum insulin and HOMA-IR, increased defecation frequency and satiety sensation

        91.2 ± 8.4

        76.2 ± 6.1a


        Ngondi et al 2009 [22]

        Over wt. &/or obese [n = 102]

        West African Plant [Irvingia gabonensis]


        150 mg /10 wk

        I: extract C: placebo

        Sig. improvements in BW, body fat, and WC

        Sig. improvements in plasma TC, LDL-chol, BS, CRP, adiponectin and leptin levels

        97.9 ± 9.1

        85.1 ± 3.1


        Snitker et al 2009 [41]

        Healthy [n = 80]


        RCT [double blind]

        6 mg/d/12 wk

        I: powder C: placebo

        Decrease in abdominal adiposity, non-Sig. change in REE, higher fat oxidation, No difference in overall percentage body fat


        (Weight change) –0.49 6 2.37

        –0.92 6 3.12


        Rehman Riaz et al 2011 [28]

        Obese [ n = 100]



        2 yr

        I: Debese C: Sibutramine

        Decrease in BMI, WC

        Reduction of triceps skin fold




        Omar Said et al 2011 [54]

        Healthy [n = 66]

        Weighlevel [The leaves of lady’s mantle, olive and wild mint, the seeds of cumin]


        310 mg tablet−1 [containing: 60 mg A. Vulgaris L., 50 mg O. europaea L., 20 mg Mentha longiforiaL., 25 mg C. cyminumL., 7 mg vitamin C and 148 mg tricalciumphosphate]/before each meal/3 mo

        I: Tablets [before each meal] C: Tablets [before just 3 main meals]

        Reduced BMI, Sig. and progressive wt. reduction

        No Minor or major adverse effect

        90.5 ± 1.2

        78.5 ± 1.4


        Lenon et al 2012 [23]

        Obese [n = 117]

        RCM-104: Compound of Camellia Sinensis [Lu Cha Ye—Green tea], Semen Cassiae [Jue Ming Zi], and Flos Sophorae [Huai Hua].

        RCT [double blind]

        500 mg granule extract 4 Cap per time, 3 times per d /12 wk

        I: extract C: placebo

        Reduced wt., BMI and body fat, non-Sig. changes in food intake

        Sig. improvements in quality of life of participants

        99.5 ± 15.1

        98.0 ± 15.4


        Venn et al 2010 [29]

        Healthy volunteers [n = 113]

        Whole grain


        2 serves of pulses and 4 serves of wholegrain foods per d/18 mo

        I: wholegrain C: control

        No Sig. wt. loss

        Decreased WC

        100 ±20.7

        94 ±22.8


        Direling et al 2010 [55]

        Over wt. & obese [n = 130]

        Pine bark

        RCT [double blind]

        200mg/d/12 wk

        I: extract tablets C: placebo

        No Sig. change in BMI

        Non-Sig. change in levels of insulin, lipid profile, FBS and lipoprotein chol particle size, liver transaminase test results, high-sensitivity CRP and BP




        Li et al 2010 [24]

        Human [n = 59]



        53g/12 wk

        I: pistachio C: pretzels

        Wt. loss, reduced BMI

        Lower TG levels

        86.0 6 1.4

        82.3 6 1.6


        Pal et al 2011 [25]

        Over wt. & Obese

        Psyllium Fibre


        12 wk

        I: healthy diet + fibre, fibre C: placebo, healthy diet + placebo

        Significant decrease in wt., BMI & %total body fat

        Reduction in TG, insulin,TC & LDL-chol



        <0 · 001

        Amagase et al 2011 [30]

        Healthy over wt.

        Lycium barbarum


        30, 60, and 120 ml/14 d

        I: extract C: control

        Increase of postprandial energy expenditure, Sig. decrease in WC

        Increase in metabolic rate




        Kubota et al 2011 [26]

        Pre-obese male [n = 36]

        Black Chinese [Pu-Erh] tea [BTE]

        RCT [double blind]

        333 mg before each of 3 daily meal/12 wk

        I: extract C: control

        Decrease in BW and BMI, Sig. effects in reducing the mean WC and visceral fat values

        No adverse effects




        Chu et al 2011 [31]

        Human with Metsyn [n = 90]

        Pu'er tea

        RCT [double blind]

        4 Cap each time, twice per d/3 mo

        I: extract C: placebo

        Decrease in BMI, waist-hip ratio

        Decreased fasting and 2 h postprandial blood glucose, serum TC, TG, LDL-chol and apolipoprotein B-100




        Lehtonen et al 2011 [27]

        Over wt. & obese women [n = 80]

        Sea buckthorn [SB], and bilberries [BBs]

        Comparative study

        followed four different berry diets with wash out periods: [BB, SB, SB phenolic extract [SBe] and SB oil [SBo]/33-35 d


        Sig decrease in WC after BB and SB periods and also a small decrease in BW after BB diet

        Vascular cell adhesion molecule decreased significantly after BB and SBo periods, and in intercellular adhesion molecule [ICAM] after SBe diet




        Abbreviations: NS Nigella Sativa, ALAT Alanine aminotransferase, HSEP Hibiscus sabdariffa extract powder, TC Total Cholestrol, TG Trigelycerides, BMI Body Mass Index, RCT Randomized Clinical Trials, Sig Significant, WC Waist Circumference, BW Body weight, BP Blood Pressure, SBP Systolic Blood Pressure, DBP Diastolic Blood Pressure, BS Blood Sugar, FBS Fasting Blood Sugar, Chol Cholestrol, Cap Capsule, Metsyn Metabolic syndrome, ORAC oxygen radical absorbance capacity, REE Resting Energy Expenditure, NAFLD non-alcoholic fatty liver disease, AUC Area Under the Curve, HDL-chol High density lipoprotein cholesterol, LDL-chol Low density lipoprotein cholesterol, HOMA-IR homeostasis model assessment-estimated insulin resistance index, ICAM intercellular adhesion molecule, dday, mo month, wk week, yr year, hr hour.

        Adverse effects

        Only alginate-based brown seaweed Laminaria digitata caused an abdominal bloating and upper respiratory tract infection as a side effect in the trial group [15]. There were no other significant adverse effects reported in all 33 trials included in this article.


        Many studies reported the anti-obesity effects of different herbal plants containing minerals or chemical extracts of plants. All herbal plants with anti-obesity effects are summarized in Table 1 with information of their active components and effects on the body. Anti-obesity effects such as decreasing body weight, body mass index or waist circumference in humans was seen in most of these studies. Some of them showed an anti-obesity effect by decreasing total body fat [16, 18, 20, 22, 23, 25, 26, 28].

        A study showed a significant decrease in body weight by Cissus Quadrangularis (CQ), Sambucus Nigra, Asparagus Officinalis, Garcinia Atroviridis, Ephedra and Caffeine, Slimax (extract of several plants, including Zingiber officinale and Bofutsushosan) [11]. In this study, the effect of Epigallocatechin-3-gallate in combination with caffeine was evaluated, with no important changes in body weight or energy expenditure. However, anti-obesity effects of green tea components were reported in many trials.

        Anti-obesity mechanisms for herbal plants included reduction in lipid absorption, reduced energy intake, increased energy expenditure, decreased pre-adipocyte differentiation and proliferation, or decreased lipogenesis and increased lipolysis [37]. Decreased energy intake from the gastrointestinal tract is caused by distinct types of tea [e.g. green, oolong, and black tea] acting on pancreatic lipase. In this review, weight loss by different tea components containing catechin and epigallocatechin-3-gallate polyphenols isolated from unlike kinds of teas was observed [18, 26, 35]. Polyphenols of different types obtained from tea extracts (e.g. L-epicatechin, epicatechin-3-gallate, epigallocatechin, epigallocatechin-3-gallate), showed strong inhibitory activity against pancreatic lipase, which led to weight loss [38, 39].

        Nigella Sativa showed a significant weight loss and reduced waist circumference with a mild reduction in fasting blood sugar, triglycerides and low-density lipoprotein levels [12]. Pistachio [24], Psyllium Fibre [25], black Chinese Tea [26], Camellia Sinensis [23], Yacon Syrup [21], Oolong Tea [20], Xantigen [16] and olive oil [17] showed the same effects on the body. A systematic review on medicinal plants useful in diabetes mellitus showed that some herbal plants possess anti-hyperlipidemic effects, and this property is statistically significant in the treatment of obesity [40].

        Some components affect body weight by changes in body-fat metabolism and oxidation or increasing metabolic rate, which was shown in trials by Epigallocatechin-3-gallate of green tea [35], virgin olive oil [17], Capsinoids [41] and Lycium Brbarum [30] causing a higher fat oxidation in human. These compounds act by activating lipid metabolism, acceleration of oxidation, suppression of fatty acid synthesis and PPARc agonistic activity [37].

        A systematic review done on potential herbal sources effective in oxidant-related diseases showed some potential of some plants like Nigella sativa and green tea to decrease lipid peroxidation in plasma or liver, which seem a mechanism of anti-obesity effect. Higher anti-oxidant and anti-obesity activity was shown by green tea due to its high concentration of catechins, including epicatechin (EC), epicatechin-3-gallate (ECG) and epigallocatechin-3-gallate (EGCG) [13, 18, 23]. The anti-oxidative role of herbal plants in different kinds of human diseases, such as diabetes mellitus, obesity and hyperlipidemia has been already reported in literature [40, 4244]. Those articles focused on herbal plants effective on obesity while lifestyle changes or dietary regimens were not included. However whole grain, pistachio, virgin olive oil and nuts were investigated solely and found efficient in reduction of obesity [17, 24, 29].

        The alginate-based brown seaweed Laminaria Digitata [15] caused abdominal bloating and upper respiratory tract infections as a side effect but no other studies reported the same adverse effect.

        In the included studies, only few has reported adverse effects, but it is notable that some kind of adverse effects may only happen when drugs used in higher sample size or when approved for marketing widely. Therefore, we cannot conclude that use of these herbals is without adverse effects. We believe that safety of these plants remains to be elucidated by further long-term studies.


        Different methods have been used to reduce body weight and its complications for many years. Disappointing results after cessation the lifestyle modification or pharmacotherapy compelled the researchers and physicians to rethink to find a new, safe, and striking therapeutic alternative for this global health concern. Herbal medicines have been in attention as an effective option to reduce body weight and body fat. Taking all results collectively, Nigella sativa, Camellia synensis, green tea, and black Chinese tea were found to have acceptable anti-obesity effects. Furthermore, there have been some reports on anti-oxidative stress effects of some of these plants which may be important in the management of other diseases accompanying with obesity like cardiovascular diseases and diabetes [9, 45]. By now, only one anti-obesity drug called orlistat have been approved by the US food and drug administration for long-term treatment in obese patients. Recent researches show different medications having anti-obesity effects by several mechanisms, including exenatide a glucagon-like peptide [GLP] acting as an incretin hormone [46], Lorcaserin a novel selective serotonin 2C (5-HT2C) receptor agonist that modulates food intake in hypothalamus [47] and PYY 3–36 and oxyntomodulin, a glucagon-like peptide 1(GLP-1) receptor agonist that regulate food intake [48]. The need to discover anti-obesity drugs having better efficacy and lower adverse effect is still felt. The results of this kind of studies can be helpful for pharmaceutical industries to study on the components of these herbs and investigate further to find a mixture of those components with higher efficacy. Furthermore, further well-designed clinical trials are still needed to focus on both safety and efficacy of these herbal medicines.



        This paper is the outcomes of an in-house financially non-supported study.

        Authors’ Affiliations

        Obesity & Eating Habits Research Center, Endocrinology & Metabolism Research Institute, Shariati Hospital, Tehran University of Medical Sciences
        Endocrinology & Metabolism Research Center, Endocrinology & Metabolism Research Institute, Tehran University of Medical Sciences
        Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences


        1. Eckel RH, York DA, Rössner S, Hubbard V, Caterson I, St Jeor ST, Hayman LL, Mullis RM, Blair SN, American Heart Association: Prevention conference VII obesity, a Worldwide epidemic related to heart disease and stroke: executive summary. Circulation 2004, 110:2968–2975.PubMedView Article
        2. Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, Rimm E, Colditz GA: Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med 2001, 161:1581–1586.PubMedView Article
        3. Expert panel on the identification, evaluation, and treatment of overweight in adults: Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Am J Clin Nutr 1998, 68:899–917.
        4. Moro C, Basile G: Obesity and medicinal plants. Fitoterapia 2000, 71:S73-S82.PubMedView Article
        5. Howard A: The historical development, efficacy and safety of very-low-calorie diets. Int J Obes 1981, 5:195–208.PubMed
        6. Abdollahi M, Afshar-Imani B: A review on obesity and weight loss measures. Middle East Pharmacy 2003, 11:6–10.
        7. Barnes PM, Powell-Griner E, McFann K, Nahin RL: Complementary and alternative medicine use among adults: United States, 2002. Adv Data 2004, 343:1–19.PubMed
        8. Han L, Kimura Y, Okuda H: Anti-obesity effects of natural products. Studies in Natural Products Chemistry 2005, 30:79–110.View Article
        9. Hasani-Ranjbar S, Larijani B, Abdollahi M: A systematic review of the potential herbal sources of future drugs effective in oxidant-related diseases. Inflamm Allergy Drug Targets 2009, 8:2–10.PubMedView Article
        10. Hasani-Ranjbar S, Nayebi N, Moradi L, Mehri A, Larijani B, Abdollahi M: The efficacy and safety of herbal medicines used in the treatment of hyperlipidemia; a systematic review. Curr Pharm Design 2010, 16:2935–2947.View Article
        11. Hasani-Ranjbar S, Nayebi N, Larijani B, Abdollahi M: A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity. World J Gastroenterol 2009, 15:3073–3085.PubMedView Article
        12. Datau E, Surachmanto EE, Pandelaki K, Langi J: Efficacy of Nigella sativa on serum free testosterone and metabolic disturbances in central obese male. Acta Med Indones 2010, 42:130–134.PubMed
        13. Basu A, Du M, Sanchez K, Leyva MJ, Betts NM, Blevins S, Wu M, Aston CE, Lyons TJ: Green tea minimally affects biomarkers of inflammation in obese subjects with metabolic syndrome. Nutrition 2011, 27:206–213.PubMedView Article
        14. Gout B, Bourges C, Paineau-Dubreuil S: Satiereal, a crocus sativus L-extract, reduces snacking and increases satiety in a randomized placebo-controlled study of mildly overweight, healthy women. Nutr Res 2010, 30:305–313.PubMedView Article
        15. Odunsi ST, Vázquez-Roque MI, Camilleri M, Papathanasopoulos A, Clark MM, Wodrich L, Lempke M, McKinzie S, Ryks M, Burton D, Zinsmeister AR: Effect of alginate on satiation, appetite, gastric function, and selected gut satiety hormones in overweight and obesity. Obesity 2009, 18:1579–1584.PubMedView Article
        16. Abidov M, Ramazanov Z, Seifulla R, Grachev S: The effects of Xanthigen™ in the weight management of obese premenopausal women with non-alcoholic fatty liver disease and normal liver fat. Diabetes Obes Metab 2010, 12:72–81.PubMedView Article
        17. Razquin C, Martinez J, Martinez-Gonzalez M, Mitjavila M, Estruch R, Marti A: A 3 years follow-up of a Mediterranean diet rich in virgin olive oil is associated with high plasma antioxidant capacity and reduced body weight gain. Eur J Clin Nutr 2009, 63:1387–1393.PubMedView Article
        18. Wang H, Wen Y, Du Y, Yan X, Guo H, Rycroft JA, Boon N, Kovacs EM, Mela DJ: Effects of catechin enriched green tea on body composition. Obesity 2009, 18:773–779.PubMedView Article
        19. Di Pierro F, Menghi AB, Barreca A, Lucarelli M, Calandrelli A: Greenselect phytosome as an adjunct to a low-calorie diet for treatment of obesity: a clinical trial. Altern Med Rev 2009, 14:154–160.PubMed
        20. He R, Chen L, Lin B, Matsui Y, Yao X, Kurihara H: Beneficial effects of oolong tea consumption on diet-induced overweight and obese subjects. J Chin Integr Med 2009, 15:34–41.View Article
        21. Genta S, Cabrera W, Habib N, Pons J, Carillo IM, Grau A, Sánchez S: Yacon syrup: beneficial effects on obesity and insulin resistance in humans. Clin Nutr 2009, 28:182–187.PubMedView Article
        22. Ngondi JL, Etoundi BC, Nyangono CB, Mbofung CMF, Oben JE: IGOB131, A novel seed extract of the west African plant irvingia gabonensis, significantly reduces body weight and improves metabolic parameters in overweight humans in a randomized double-blind placebo controlled investigation. Lipids Health Dis 2009, 8:7.PubMedView Article
        23. Lenon GB, Li KX, Chang YH, Yang AW, Da Costa C, Li CG, Cohen M, Mann N, Xue CC: Efficacy and safety of a chinese herbal medicine formula [RCM-104] in the management of simple obesity: a randomized, placebo-controlled clinical trial. Evid Based Complement Alternat Med 2012, 435702.
        24. Li Z, Song R, Nguyen C, Zerlin A, Karp H, Naowamondhol K, Thames G, Gao K, Li L, Tseng CH, Henning SM, Heber D: Pistachio nuts reduce triglycerides and body weight by comparison to refined carbohydrate snack in obese subjects on a 12-week weight loss program. J Am Coll Nutr 2010, 29:198–203.PubMedView Article
        25. Pal S, Khossousi A, Binns C, Dhaliwal S, Ellis V: The effect of a fibre supplement compared to a healthy diet on body composition, lipids, glucose, insulin and other metabolic syndrome risk factors in overweight and obese individuals. Br J Nutr 2011, 105:90–100.PubMedView Article
        26. Kubota K, Sumi S, Tojo H, Sumi-Inoue Y: Improvements of mean body mass index and body weight in preobese and overweight Japanese adults with black Chinese tea [Pu-Erh] water extract. Nutr Res 2011, 31:421–428.PubMedView Article
        27. Lehtonen HM, Suomela JP, Tahvonen R, Yang B, Venojärvi M, Viikari J, Kallio H: Different berries and berry fractions have various but slightly positive effects on the associated variables of metabolic diseases on overweight and obese women. Eur J Clin Nutr 2011, 65:394–401.PubMedView Article
        28. Rehman RU, Usmanghani K, Nazar H, Uddin S, Akram M, Asif HM: Clinical study on the management of obesity with certain natural medicine. J Med Plants Res 2011, 5:4094–4098.
        29. Venn BJ, Perry T, Green TJ, Skeaff CM, Aitken W, Moore NJ, Mann JI, Wallace AJ, Monro J, Bradshaw A, Brown RC, Skidmore PM, Doel K, O'Brien K, Frampton C, Williams S: The effect of increasing consumption of pulses and wholegrains in obese people: a randomized controlled trial. J Am Coll Nutr 2010, 29:365–372.PubMedView Article
        30. Amagase H, Nance DM: Lycium barbarum increases caloric expenditure and decreases waist circumference in healthy overweight men and women: pilot study. J Am Coll Nutr 2011, 30:304–309.PubMedView Article
        31. Chu SL, Fu H, Yang JX, Liu GX, Dou P, Zhang L, Tu PF, Wang XM: A randomized double-blind placebo-controlled study of Pu'er tea extract on the regulation of metabolic syndrome. Chin J Integr Med 2011, 17:492–498.PubMedView Article
        32. Chevassus H, Gaillard JB, Farret A, Costa F, Gabillaud I, Mas E, Dupuy AM, Michel F, Cantié C, Renard E, Galtier F, Petit P: A fenugreek seed extract selectively reduces spontaneous fat intake in overweight subjects. Eur J Clin Pharmacol 2010, 66:449–455.PubMedView Article
        33. Mathern JR, Raatz SK, Thomas W, Slavin JL: Effect of fenugreek fiber on satiety, blood glucose and insulin response and energy intake in obese subjects. Phytother Res 2009, 23:1543–1548.PubMedView Article
        34. Stull AJ, Cash KC, Johnson WD, Champagne CM, Cefalu WT: Bioactives in blueberries improve insulin sensitivity in obese, insulin-resistant men and women. J Nutr 2010, 140:1764–1768.PubMedView Article
        35. Thielecke F, Rahn G, Böhnke J, Adams F, Birkenfeld AL, Jordan J, Boschmann M: Epigallocatechin-3-gallate and postprandial fat oxidation in overweight/obese male volunteers: a pilot study. Eur J Clin Nutr 2010, 64:704–713.PubMedView Article
        36. Lehtonen HM, Suomela JP, Tahvonen R, Vaarno J, Venojärvi M, Viikari J, Kallio H: Berry meals and risk factors associated with metabolic syndrome. Eur J Clin Nutr 2010, 64:614–621.PubMedView Article
        37. Yun JW: Possible anti-obesity therapeutics from nature–a review. Phytochemistry 2010, 71:1625–1641.PubMedView Article
        38. Thielecke F, Boschmann M: The potential role of green tea catechins in the prevention of the metabolic syndrome–a review. Phytochemistry 2009, 70:11–24.PubMedView Article
        39. Nakai M, Fukui Y, Asami S, Toyoda-Ono Y, Iwashita T, Shibata H, Mitsunaga T, Hashimoto F, Kiso Y: Inhibitory effects of oolong tea polyphenols on pancreatic lipase in vitro. J Agric Food Chem 2005, 53:4593–4598.PubMedView Article
        40. Hasani-Ranjbar S, Larijani B, Abdollahi M: A systematic review of Iranian medicinal plants useful in diabetes mellitus. Arch Med Sci 2008, 4:285–292.
        41. Snitker S, Fujishima Y, Shen H, Ott S, Pi-Sunyer X, Furuhata Y, Sato H, Takahashi M: Effects of novel capsinoid treatment on fatness and energy metabolism in humans: possible pharmacogenetic implications. Am J Clin Nutr 2009, 89:45–50.PubMedView Article
        42. Hasani-Ranjbar S, Nayebi N, Larijani B, Abdollahi M: A systematic review of the efficacy and safety of Teucrium species; from anti-oxidant to anti-diabetic effects. Int J Pharmacol 2010, 6:315–325.View Article
        43. Hasani-Ranjbar S, Khosravi S, Nayebi N, Larijani B, Abdollahi M: A Systematic review of the efficacy and safety of anti-aging herbs in animals and human. Asian J Anim Vet Adv 2012, 7:621–640.View Article
        44. Mozaffari S, Hasani-Ranjbar S, Abdollahi M: The mechanisms of positive effects of melatonin in dyslipidemia: a systematic review of animal and human studies. Int J Pharmacol 2012, 8:496–509.View Article
        45. Hosseini A, Abdollahi M: Diabetic neuropathy and oxidative stress: therapeutic perspectives. Oxid Med Cell Longev 2013,201(3):168039.
        46. Rosenstock J, Klaff LJ, Schwartz S, Northrup J, Holcombe JH, Wilhelm K, Trautmann M: Effects of exenatide and lifestyle modification on body weight and glucose tolerance in obese subjects with and without pre-diabetes. Diabetes Care 2010, 33:1173–1175.PubMedView Article
        47. Fidler MC, Sanchez M, Raether B, Weissman NJ, Smith SR, Shanahan WR, Anderson CM: A one-year randomized trial of lorcaserin for weight loss in obese and overweight adults: the BLOSSOM trial. J Clin Endocrinol Metab 2011, 96:3067–3077.PubMedView Article
        48. Field BC, Wren AM, Peters V, Baynes KC, Martin NM, Patterson M, Alsaraf S, Amber V, Wynne K, Ghatei MA, Bloom SR: PYY3–36 and oxyntomodulin can be additive in their effect on food intake in overweight and obese humans. Diabetes 2010, 59:1635–1639.PubMedView Article
        49. Godard MP, Ewing BA, Pischel I, Ziegler A, Benedek B, Feistel B: Acute blood glucose lowering effects and long-term safety of OpunDia™ supplementation in pre-diabetic males and females. J Ethnopharmacol 2010, 130:631–634.PubMedView Article
        50. Mirmiran P, Fazeli MR, Asghari G, Shafiee A, Azizi F: Effect of pomegranate seed oil on hyperlipidaemic subjects: a double-blind placebo-controlled clinical trial. Br J Nutr 2010, 104:402–406.PubMedView Article
        51. Egert S, Boesch-Saadatmandi C, Wolffram S, Rimbach G, Müller MJ: Serum lipid and blood pressure responses to quercetin vary in overweight patients by apolipoprotein E genotype. J Nutr 2010, 140:278–284.PubMedView Article
        52. Gurrola-Díaz C, García-López P, Sánchez-Enríquez S, Troyo-Sanromán R, Andrade-González I, Gómez-Leyva J: Effects of Hibiscus sabdariffa extract powder and preventive treatment [diet] on the lipid profiles of patients with metabolic syndrome [MeSy]. Phytomedicine 2010, 17:500–505.PubMedView Article
        53. Qidwai W, Hamza HB, Qureshi R, Gilani A: Effectiveness, safety, and tolerability of powdered Nigella sativa [kalonji] seed in capsules on serum lipid levels, blood sugar, blood pressure, and body weight in adults: results of a randomized, double-blind controlled trial. J Altern Complement Med 2009, 15:639–644.PubMedView Article
        54. Said O, Saad B, Fulder S, Khalil K, Kassis E: Weight loss in animals and humans treated with weighlevel, a combination of four medicinal plants used in traditional Arabic and Islamic medicine. Evid Based Complement Alternat Med 2011, 874538.
        55. Drieling RL, Gardner CD, Ma J, Ahn DK, Stafford RS: No beneficial effects of pine bark extract on cardiovascular disease risk factors. Arch Intern Med 2010, 170:1541–1547.PubMedView Article

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