It’s no wonder so many Americans are overweight or obese. We have easy access to all sorts of tempting food day and night but fewer opportunities to build physical activity into our daily routines, not to mention soaring stress levels — all of which contribute to our growing girth.

Many people blame themselves or feel ashamed about their weight. Don’t despair, because it is possible to lose weight and keep it off over time. This report offers a range of solutions that have worked for many people and can be tailored to your specific needs. Take this challenge seriously, though, because overweight and obesity can lead to serious medical problems.

Successful weight loss depends largely on becoming more aware of your behaviors and starting to change them. Rather than willpower, this process demands skill power, which is good news because you can learn new skills. The special section of this report, “10 habits to help you lose weight,” details these skills. Other chapters explore the health hazards of excess weight, as well as the latest information about diets, exercise plans, structured programs, medications, and surgery to foster weight loss. This report also includes a week’s worth of healthy, calorie-controlled menus (including a handful of recipes) to get you started.

Over-the-counter weight loss supplements: Not worth the risk

Have you been tempted by the vast array of dietary supplements available without prescription that promise to burn fat, curb your appetite, and help you melt away the pounds? After all, they’re made from herbs and other natural ingredients, and they’re readily available in local stores or via the Internet, so there’s no harm in trying one, right? Wrong.

Most popular weight-loss supplements are inadequately tested for safety. Unlike the studies done on prescription drugs to gain approval by the FDA , studies on supplements typically include small numbers of volunteers and don’t last very long. And supplements are far less closely regulated than approved medications. Yet dozens contain undisclosed prescription drugs — some of which are not approved for use in this country, and many of which have serious, sometimes life-threatening side effects, as reported by the FDA ’s Initiative Against Contaminated Weight Loss Products.

Weight-loss aids fall into a gray area in FDA regulation. They’re classified as dietary supplements, a category regulated more like food than drugs, created in response to public pressure to loosen the FDA ’s tight control over a variety of products. As a result, individual nutrients, herbs, and “phytomedicinals” (plants supposed to have medicinal value) can be sold without being tested for effectiveness or safety, so long as they do not make direct health or therapeutic claims. Within these limits, manufacturers cannot say that their weight-loss aids will cure obesity or make you lose weight, but they can make indirect claims—and this has led to a wide array of unfounded assertions on labels and in advertisements.

But the FDA cannot take a product off the market unless it is found to be unsafe. Because the agency cannot test every one of the thousands of supplements on the market, most face no danger of being removed. In 2004, however, the FDA banned the sale of ephedra (ma huang in Chinese) after the compound was linked to a number of deaths and very serious side effects, including heart attacks, strokes, and seizures. In 2001, ephedra products constituted fewer than 1% of all dietary supplement sales, yet they were responsible for 64% of all herb-related complications reported to the U.S. Poison Control Centers during the same year. Despite the fact that ephedra-containing supplements are the only dietary supplements shown to help people lose weight (at least for up to six months), the potential risks far outweigh the benefits.

Despite the ban on ephedra itself, supplements containing ephedra-like compounds (which include ephedrine, norephedrine, and methylephedrine) are widely available over the Internet and in stores. They are often found in combination with caffeine or plant sources of caffeine, such as guarana and yerba mate, in weight-loss supplements. Note that two other ingredients found in some supplements, bitter orange and country mallow, contain chemicals related to ephedra and should also be avoided.

In 2009, the FDA warned people to stop using Hydroxy Cut products, which contain a variety of ingredients and were marketed in various forms, including caplets and drink packets. The agency received 23 reports of serious liver injuries, including one death, in people who took Hydroxycut products. Other reported health issues included heart problems, seizures, and serious muscle damage.

Prepared by the editors of Harvard Health Publications in consultation with Miquel Alonso-Alonso, M.D., Instructor in Neurology, Harvard Medical School Division of Cognitive Neurology, Beth Israel Deaconess Medical Center; and Kathy McManus, M.S., R.D., L.D.N., Director of Nutrition, Brigham and Women’s Hospital, Harvard Medical School. 49 pages. (2011)

thyroid and memory