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Herbal Pharmacist

The Future of Weight Management: Body Composition and Multi-Pathway Solutions

by | Jan 6, 2025 | Aging Gracefully, Exercise & Fitness, Gastrointestinal, General Health, Gut Health, Heart Health, weight management, Weight Mangament

Beyond the Scale

Weight management is no longer about simply reducing numbers on the scale. It’s about creating sustainable, healthy changes in body composition—reducing fat mass while preserving or increasing lean mass. Recent developments in medicine and dietary supplements have highlighted the importance of addressing the deeper physiological mechanisms behind weight management, moving away from “quick-fix” solutions to a science-backed, multi-pathway approach.

Unpacking the Challenges of Weight Management

Weight loss often results in significant muscle mass loss, whether through GLP-1 agonists or calorie-restrictive diets. This loss of lean mass, essential for strength and metabolic health, can lower basal metabolic rate (BMR), making long-term weight maintenance harder. A holistic understanding of body composition, which measures fat mass and fat-free mass, provides a more comprehensive view of health and fitness goals.  Excess fat, especially visceral fat, poses health risks, while lean mass contributes to metabolic efficiency and physical vitality. Addressing these distinctions can shift weight management strategies toward more meaningful and lasting health improvements.

The Underlying Mechanisms Driving Weight Management

Achieving effective and lasting weight management requires addressing a variety of physiological and biochemical factors:

Hormonal Regulation:

Leptin and Ghrelin: Balancing these “hunger hormones” is crucial for appetite control. Leptin is a hormone that fat cells produce to regulate body weight by signaling satiety and appetite suppression in the brain.  It also influences the regulation of blood sugar levels and metabolism.[i] In some cases, people who are overweight may develop leptin-resistance[ii] i.e., the body is producing leptin, but it doesn’t get utilized or recognized.  When this occurs, it will trigger the desire to eat even though a person should be satiated. Ghrelin Is made by the stomach when it is empty.  Therefore, Ghrelin increases food intake and fat deposition and plays a role in decreasing energy production.[iii]  Since it starts in the gut, the microbiome also plays a vital role in ghrelin production.

Cortisol (Stress): Cortisol (the primary stress hormone) stimulates fat and carbohydrate metabolism.  It also increases appetite and cravings.  However, cortisol also impacts other hormones in weight, affecting insulin and insulin resistance.[iv]

Adiponectin: Adiponectin is a hormone your adipose (fat) tissue releases that helps insulin sensitivity, glucose metabolism, and inflammation.  Low adiponectin levels are associated with several conditions, including obesity, Type 2 diabetes, and atherosclerosis.[v] [vi]

Insulin: Insulin helps get blood sugar into the cells for energy and signals the liver to store glucose for later energy use or excess sugar as fat for future energy use.  Proper amounts of insulin without insulin resistance will help burn sugar for energy and not be stored as fat.

Metabolic Pathways:

AMPK Activation: AMPK influences glucose utilization, oxidation, and appetite (increases energy production).[vii]  In short, boosting AMPK activity results in a healthier metabolic status, which can lead to less fat production.

Insulin Sensitivity: Insulin Resistance is when cells become too resistant to insulin; this results in elevated blood sugar levels, leading to weight gain, prediabetes, and type 2 diabetes.

  • Losing weight with insulin resistance is more difficult because the body stores excess blood sugar as fat.[viii]

Inflammatory and Oxidative Stress:

Inflammatory Cytokine Production: Elevated cytokines like TNF-α and IL-6 can worsen insulin resistance and fat storage. These two cytokines may significantly influence the development of obesity, type 2 diabetes, and metabolic disorders.  TNF-α plays an influential role in insulin resistance and the production of more IL-6. [ix] Neutralizing TNF-α improves insulin sensitivity by increasing the insulin receptor tyrosine kinase activity, specifically in muscle and fat tissues.  Elevated levels of circulating TNF-α have been linked to various diseases, including arthritis, diabetes, and Crohn’s disease.[x]

Oxidative Stress: High levels of reactive oxygen species (ROS) are intricately linked to obesity and notably insulin resistance and type 2 diabetes[xi]

Gut-Brain Axis and Sleep:

Microbiome Connection: The production of hunger hormones (Ghrelin and leptin) and an unhealthy gut microbiome can increase inflammatory markers, which may lead to weight gain and metabolic disease.[xii]

  • The feelings of appetite and satiety involve complex interactions between hormones from the gastrointestinal tract to the hypothalamus and subsequent feedback (Ghrelin/leptin).[xiii] [xiv]

Poor Sleep Connection: Sleep loss creates a hormone imbalance that promotes overeating and weight gain.

  • Leptin and Ghrelin are altered to create increased feelings of hunger. [xv]

Cutting-Edge Ingredients for Weight Management

The following are a few of my favorite ingredients that will fill the gaps in the categories mentioned above:

Hormonal Regulation:

Leptin and Ghrelin:

  • African mango (IGOB131)- increases levels of adiponectin, promotes healthy levels of leptin[xvi]
  • To date, no supplements have shown an impact on ghrelin directly

Cortisol (Stress):

  • Caralluma (Slimaluma®)- reduction of stress and cortisol[xvii]
  • Saffron (Supresa)- Enhancing serotonin[xviii]

Adiponectin:

  • Eriomin®: Elevated adiponectin levels, decreased insulin resistance, and increased GLP-1 production.[xix]
  • Lychee (Oligonol)- elevates adiponectin levels (also decreases insulin resistance) [xx]
  • Polyphenols (Curcumin, Green Tea, etc.) increase adiponectin levels[xxi]

Metabolic Pathways:

AMPK Activation

  • Jiaogulan (ActivAMP®)- reduction in (TNF)-α and activate an enzyme called AMP-activated protein kinase (AMPK) [xxii]

Insulin Sensitivity/Maintenance:

  • Garcinia cambogia (SuperCitriMax)- ROS, decreases insulin resistance, cytokines, leptin[xxiii]
  • Berberine (Berbevis®)- improves insulin resistance, increases AMPK[xxiv]
  • Cinnamon (Cinnulin PF®)- reduces insulin resistance and improves insulin sensitivity[xxv]

Inflammatory and Oxidative Stress:

Inflammatory Cytokine Production:

  • Eriomin®- decreased TNFα and IL-6 [xxvi]
  • Lemon Verbena and Hibiscus Flower Extract (Metabolaid®)- adiponectin and leptin were significantly increased and decreased, respectively, while the inflammatory-related factors tumor necrosis factor (TNF)-α and interleukin (IL)-6 were downregulated. [xxvii]
  • Omega-3s- increased adiponectin concentrations and decreased TNFα and IL-6. [xxviii]

Oxidative Stress:

  • Moro red oranges (Morosil)- impact on ROS[xxix]
  • Brown Seaweed (ID-aLG)- effect on ROS[xxx]

Gut-Brain Axis:

Microbiome Connection:

Probiotics can help with insulin resistance, intestinal permeability, increase leptin, etc. [xxxi]

  • curvatus HY7601 & L. plantarum KY1032 (FatSlim)
  • Bifidobacterium animalis ssp. Lactis (BB-12) [xxxii]
  • Gasseri BNR17[xxxiii]

Body Composition: The Area of Focus

We must discuss weight management goals to decrease body fat while maintaining or increasing lean mass. For decades, the dietary supplement and functional food and beverage market has taken advantage of consumers with quick-fix ingredients that did little to improve their body composition. Now is the time to lean on new science and some fantastic scientifically substantiated ingredients for weight management that have shown a positive impact on body composition:

  • Chromium picolinate (as Chromax® from Nutrition 21)- Research with Chromax® shows it helps reduce body fat, improve lean body mass, and positively impact body composition.[xxxiv]
  • Citrus sinensis (L.) Osbeck (as MOROSIL from BIONAP)—Research with MOROSIL in a six-month study showed improvements in body weight, BMI, waist and hip circumference, and body composition.[xxxv]
  • Dichrostachys glomerata (as Dyglomera® from Gateway Health Alliance)- Dyglomera® has improved body composition in 12 weeks. The percentage of body fat measured by DEXA showed a 22.85% reduction in the percentage of body fat.[xxxvi]
  • Gynostemma pentaphyllum leaf extract (as ActivAMP® from Gencor Pacific)- A 16-week study with ActivAMP® showed via DEXA positive changes In body composition, including fat mass, lean mass, and mass distribution—also improvements in hip and waist circumference.[xxxvii]
  • Irvingia gabonensis (as IGOB131® from Gateway Health Alliance)- Multiple clinical studies have shown the benefits of IGOB131® and its impact on metabolic health. One study showed statistically significant improvements in body weight and composition after ten weeks, including an 18.4% reduction in body fat. (Study included 102 overweight subjects)[xxxviii]
  • Limosilactobacillus fermentum strains K7-Lb1, K8-Lb1, and K11-Lb3 (as SlimBiotic from SlimBiotics)—A recent study involving 180 subjects over three months showed improvements in body fat mass, body weight, visceral adipose tissue, waist circumference, and hip-to-waist circumference.[xxxix]

Multi-Pathway Formulations: A Smarter Approach

Instead of relying on a single ingredient, combining ingredients with complementary mechanisms can amplify efficacy. By leveraging multi-pathway solutions, consumers can realize improvements that address weight management and related health concerns like insulin resistance, oxidative stress, and gut health. The next frontier in weight management lies in prioritizing body composition over weight loss. As awareness of muscle loss risks grows, the industry has an opportunity to champion science-backed approaches that promote fat loss, preserve lean mass, and improve metabolic health. By embracing this paradigm, we can redefine what success looks like in weight management—achieving not just a lighter body but a healthier one.

References:

[i] Yeung AY, Tadi P. Physiology, Obesity Neurohormonal Appetite And Satiety Control.  [Updated 2022 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.  Available from: https://www.ncbi.nlm.nih.gov/books/NBK555906/

[ii] Myers MG Jr, Leibel RL, Seeley RJ, Schwartz MW. Obesity and leptin resistance: distinguishing cause from effect.  Trends Endocrinol Metab. 2010 Nov;21(11):643-51. doi: 10.1016/j.tem.2010.08.002. Epub 2010 Sep 16.  PMID: 20846876; PMCID: PMC2967652.

[iii] Poher AL, Tschöp MH, Müller TD. Ghrelin regulation of glucose metabolism.  Peptides.  2018 Feb;100:236-242.

[iv] Rucker P, Ikuta T. Pituitary Gland Functional Connectivity and BMI.  Front Neurosci.  2019 Mar 1;13:120. doi: 10.3389/fnins.2019.00120. PMID: 30881281; PMCID: PMC6405688.

[v] Sikaris KA.  The clinical biochemistry of obesity.  Clin Biochem Rev. 2004 Aug;25(3):165-81.  PMID: 18458706; PMCID: PMC1880830.

[vi] Janiszewska J, Ostrowska J, Szostak-Węgierek D. The Influence of Nutrition on Adiponectin-A Narrative Review. Nutrients. 2021 Apr 21;13(5):1394. doi: 10.3390/nu13051394. PMID: 33919141; PMCID: PMC8143119.

[vii] Long YC, Zierath JR. AMP-activated protein kinase signaling in metabolic regulation.  J Clin Invest.  2006 Jul;116(7):1776-83. doi: 10.1172/JCI29044. PMID: 16823475; PMCID: PMC1483147.

[viii] Kahn BB, Flier JS.  Obesity and insulin resistance.  J Clin Invest.  2000 Aug;106(4):473-81. doi: 10.1172/JCI10842. PMID: 10953022; PMCID: PMC380258.

[ix] Popko K, Gorska E, Stelmaszczyk-Emmel A, Plywaczewski R, Stoklosa A, Gorecka D, Pyrzak B, Demkow U. Proinflammatory cytokines Il-6 and TNF-α and the development of inflammation in obese subjects.  Eur J Med Res. 2010 Nov 4;15 Suppl 2(Suppl 2):120-2. doi: 10.1186/2047-783x-15-s2-120. PMID: 21147638; PMCID: PMC4360270.

[x] De SK, Devadas K, Notkins AL.  Elevated tumor necrosis factor alpha (TNF-alpha) in human immunodeficiency virus type 1-transgenic mice: prevention of death by antibody to TNF-alpha. J Virol. 2002 Nov;76(22):11710-4. doi: 10.1128/jvi.76.22.11710-11714.2002. PMID: 12388730; PMCID: PMC136749.

[xi] Tangvarasittichai S. Oxidative stress, insulin resistance, dyslipidemia, and type 2 diabetes mellitus.  World J Diabetes.  2015 Apr 15;6(3):456-80. doi: 10.4239/wjd.v6.i3.456. PMID: 25897356; PMCID: PMC4398902.

[xii] Petraroli M, Castellone E, Patianna V, Esposito S. Gut Microbiota and Obesity in Adults and Children: The State of the Art. Front Pediatr. 2021 Mar 19;9:657020. doi: 10.3389/fped.2021.657020. PMID: 33816411; PMCID: PMC8017119.

[xiii] Leeuwendaal NK, Cryan JF, Schellekens H. Gut peptides and the microbiome: focus on ghrelin. Curr Opin Endocrinol Diabetes Obes. 2021 Apr 1;28(2):243-252. doi: 10.1097/MED.0000000000000616. PMID: 33481425; PMCID: PMC7924980.

[xiv] Rajala MW, Patterson CM, Opp JS, Foltin SK, Young VB, Myers MG Jr. Leptin acts independently of food intake to modulate gut microbial composition in male mice.  Endocrinology.  2014 Mar;155(3):748-57. doi: 10.1210/en.2013-1085. Epub 2014 Jan 1. PMID: 24424041; PMCID: PMC3929727.

[xv] Cooper CB, Neufeld EV, Dolezal BA, Martin JL. Sleep deprivation and obesity in adults: a brief narrative review.  BMJ Open Sport Exerc Med. 2018 Oct 4;4(1):e000392. doi: 10.1136/bmjsem-2018-000392. PMID: 30364557; PMCID: PMC6196958.

[xvi] Ngondi JL, Etoundi BC, Nyangono CB, Mbofung CM, 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 Mar 2;8:7. doi: 10.1186/1476-511X-8-7. PMID: 19254366; PMCID: PMC2651880.

[xvii] Kuriyan R, Raj T, Srinivas SK, Vaz M, Rajendran R, Kurpad AV. Effect of Caralluma fimbriata extract on appetite, food intake and anthropometry in adult Indian men and women.  Appetite.  2007 May;48(3):338-44. doi: 10.1016/j.appet.2006.09.013.  Epub 2006 Nov 13.  PMID: 17097761.

[xviii] 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 May;30(5):305-13. doi: 10.1016/j.nutres.2010.04.008. PMID: 20579522.

[xix] Ribeiro CB, Ramos FM, Manthey JA, Cesar TB. Effectiveness of Eriomin® in managing hyperglycemia and reversal of prediabetes condition: A double-blind, randomized, controlled study. Phytother Res. 2019 Jul;33(7):1921-1933. doi: 10.1002/ptr.6386. Epub 2019 Jun 11. PMID: 31183921; PMCID: PMC6618084.

[xx] Bahijri SM, Ajabnoor G, Hegazy GA, Alsheikh L, Moumena MZ, Bashanfar BM, Alzahrani AH. Supplementation with Oligonol, Prevents Weight Gain and Improves Lipid Profile in Overweight and Obese Saudi Females. Curr Nutr Food Sci. 2018 Apr;14(2):164-170. doi: 10.2174/1573401313666170609101408. PMID: 29853817; PMCID: PMC5907059.

[xxi] Janiszewska J, Ostrowska J, Szostak-Węgierek D. The Influence of Nutrition on Adiponectin-A Narrative Review. Nutrients. 2021 Apr 21;13(5):1394. doi: 10.3390/nu13051394. PMID: 33919141; PMCID: PMC8143119.

[xxii] Park, S., et al., 2013. Antiobesity effect of Gynostemma pentaphyllum extract: A randomized, double-blind, placebo-controlled trial.

Obesity Journal, DOI:10.1002/oby.20539.

[xxiii] Hayamizu K, Hirakawa H, Oikawa D, Nakanishi T, Takagi T, Tachibana T, Furuse M. Effect of Garcinia cambogia extract on serum leptin and insulin in mice.  Fitoterapia. 2003 Apr;74(3):267-73. doi: 10.1016/s0367-326x(03)00036-4. PMID: 12727492.

[xxiv] Cao C, Su M. Effects of berberine on glucose-lipid metabolism, inflammatory factors, and insulin resistance in patients with metabolic syndrome.  Exp Ther Med. 2019 Apr;17(4):3009-3014.  doi: 10.3892/etm.2019.7295.  Epub 2019 Feb 22.  PMID: 30936971; PMCID: PMC6434235.

[xxv] Ziegenfuss TN, Hofheins JE, Mendel RW, Landis J, Anderson RA. Effects of a water-soluble cinnamon extract on body composition and features of the metabolic syndrome in pre-diabetic men and women. J Int Soc Sports Nutr. 2006 Dec 28;3(2):45-53. doi: 10.1186/1550-2783-3-2-45.  PMID: 18500972; PMCID: PMC2129164.

[xxvi] Ribeiro CB, Ramos FM, Manthey JA, Cesar TB. Effectiveness of Eriomin® in managing hyperglycemia and reversal of prediabetes condition: A double-blind, randomized, controlled study. Phytother Res. 2019 Jul;33(7):1921-1933. doi: 10.1002/ptr.6386. Epub 2019 Jun 11. PMID: 31183921; PMCID: PMC6618084.

[xxvii] Lee YS, Yang WK, Kim HY, Min B, Caturla N, Jones J, Park YC, Lee YC, Kim SH.  Metabolaid® Combination of Lemon Verbena and Hibiscus Flower Extract Prevents High-Fat Diet-Induced Obesity through AMP-Activated Protein Kinase Activation.  Nutrients.  2018 Sep 1;10(9):1204. doi: 10.3390/nu10091204. PMID: 30200432; PMCID: PMC6165361.

[xxviii] Spencer M, Finlin BS, Unal R, Zhu B, Morris AJ, Shipp LR, Lee J, Walton RG, Adu A, Erfani R, Campbell M, McGehee RE Jr, Peterson CA, Kern PA.  Omega-3 fatty acids reduce adipose tissue macrophages in human subjects with insulin resistance.  Diabetes.  2013 May;62(5):1709-17. doi: 10.2337/db12-1042.  Epub 2013 Jan 17.  PMID: 23328126; PMCID: PMC3636648.

[xxix] Briskey D, Malfa GA, Rao A. Effectiveness of “Moro” Blood Orange Citrus sinensis Osbeck (Rutaceae) Standardized Extract on Weight Loss in Overweight but Otherwise Healthy Men and Women-A Randomized Double-Blind Placebo-Controlled Study. Nutrients. 2022 Jan 18;14(3):427. doi: 10.3390/nu14030427. PMID: 35276783; PMCID: PMC8838101.

[xxx] Terpend K, Bisson JF, Le Gall C, Linares E. Effects of ID-alG™ on weight management and body fat mass in high-fat-fed rats.  Phytother Res. 2012 May;26(5):727-33. doi: 10.1002/ptr.3619. Epub 2011 Oct 28.  PMID: 22034228.

[xxxi] Mao K, Gao J, Wang X, Li X, Geng S, Zhang T, Sadiq FA, Sang Y. Bifidobacterium animalis subsp.  lactisBB-12 Has an Effect Against Obesity by Regulating Gut Microbiota in Two Phases in Human Microbiota-Associated Rats.  Front Nutr. 2022 Jan 10;8:811619. doi: 10.3389/fnut.2021.811619. PMID: 35083265; PMCID: PMC8784422.

[xxxii] Jeung WH, Nam W, Kim HJ, Kim JY, Nam B, Jang SS, Lee JL, Sim JH, Park SD. Oral Administration of Lactobacilluscurvatus HY7601, and Lactobacillus plantarum KY1032 with Cinnamomi Ramulus Extract Reduces Diet-Induced Obesity and Modulates Gut Microbiota.  Prev Nutr Food Sci. 2019 Jun;24(2):136-143.  doi: 10.3746/pnf.2019.24.2.136.  Epub 2019 Jun 30.

[xxxiii] Jung SP, Lee KM, Kang JH, Yun SI, Park HO, Moon Y, Kim JY. Effect of Lactobacillus gasseri BNR17 on Overweight and Obese Adults: A Randomized, Double-Blind Clinical Trial. Korean J Fam Med. 2013 Mar;34(2):80-9. doi: 10.4082/kjfm.2013.34.2.80. Epub 2013 Mar 20. PMID: 23560206; PMCID: PMC3611107.

[xxxiv] Richard A. Anderson, Effects of Chromium on Body Composition and Weight Loss, Nutrition Reviews, Volume 56, Issue 9, September 1998, Pages 266–270, https://doi.org/10.1111/j.1753-4887.1998.tb01763.x

[xxxv] Briskey D, Malfa GA, Rao A. Effectiveness of “Moro” Blood Orange Citrus sinensis Osbeck (Rutaceae) Standardized Extract on Weight Loss in Overweight but Otherwise Healthy Men and Women-A Randomized Double-Blind Placebo-Controlled Study. Nutrients. 2022 Jan 18;14(3):427. doi: 10.3390/nu14030427

[xxxvi] Youovop J., Takuissu G., Mbopda C., Nwang F., Ntentié R., Mbong M., Azantsa B., Singh H., Oben  J.The Effects of DyglomeraⓇ(Dichrostachys glomerata extract) on Body Fat Percentage and Body Weight: A Randomized,Double-Blind, Placebo-Controlled Clinical Trial. Functional Foods in Health and Disease2023; 13(6):334-346,DOI:https://www.doi.org/10.31989/ffhd.v13i6.1088

[xxxvii] Rao A, Clayton P, Briskey D. The effect of an orally-dosed Gynostemma pentaphyllum extract (ActivAMP®) on body composition in overweight, adult men and women: A double-blind, randomised, placebo-controlled study. J Hum Nutr Diet. 2022 Jun;35(3):583-589. doi: 10.1111/jhn.12936.

[xxxviii] Ngondi JL, Etoundi BC, Nyangono CB, Mbofung CM, 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 March 2;8:7. doi: 10.1186/1476-511X-8-7

[xxxix] Laue, C., Papazova, E., Pannenbeckers, A., & Schrezenmeir, J. Effect of a Probiotic and a Synbiotic on Body Fat Mass, Body Weight and Traits of Metabolic Syndrome in Individuals with Abdominal Overweight: A Human, Double-Blind, Randomised, Controlled Clinical Study. Nutrients, 15(13), 3039. https://doi.org/10.3390/nu15133039