Obesity Weight Loss Drugs Legal Ephedra

Ephedra pills were extremely popular dietary supplements and over-the-counter weight loss treatments until 2004, when the U.S. Food and Drug Administration (FDA) banned all ephedra products. A traditional Chinese medicine known as ma huang, ephedra is a stimulant and metabolism booster. Both anecdotal stories and some small clinical studies suggest ephedra diet pills may produce at least short-term treatment of obesity.

Ephedra’s future as a treatment for obesity was cut short by serious concerns about the safety of ephedrine, the active ingredient in most ephedra diet pills. Ephedrine can cause a number of serious health problems, including:

  • Death
  • Heart attack
  • Irregular heartbeat
  • Migraine
  • Seizures
  • Stroke.

At present, ephedra diet pills are banned in the United States.

Bitter Orange Diet Pills

The ban on ephedra pills was a blow to the dietary supplement industry, which lost an active ingredient that actually promoted weight loss (albeit at a dangerous cost). Replacements for ephedra products soon appeared on the market, advertised as “legal ephedra” or “ephedra-free.”

As a substitute for ephedra, products often contain bitter orange. The active ingredients in bitter orange, such as synephrine and octopamine, are chemically similar to ephedra compounds. Like ephedra diet pills, bitter orange supplements increase both heart rate and blood pressure.

The use of bitter orange as a treatment of obesity is controversial, as its active ingredients can potentially cause fainting, heart attacks, migraines and strokes.

Serious complications are more common when bitter orange is combined with caffeine, a common dietary supplement ingredient. Among other names, caffeine may be listed as green trea, guarana, kola nut or yerba mate.

Ephedrine-Free Ephedra Pills

The FDA ban on ephedra actually bans ephedrine alkaloids, a compound found in the stems of a species of ephedra known scientifically as Ephedra sinica. Other species of ephedra contain little or no ephedrine.

Some dietary supplements are advertised as ephedrine-free ephedra pills. If a supplement contains extracts of ephedra species that don’t contain ephedrine alkaloids, the supplement is indeed a legal ephedra pill.

Of course, since these new ephedra products don’t contain ephedrine, the extracts of ephedra they do contain likely have no effect on weight loss. Any weight loss seen when taking legal ephedra pills would be due to other ingredients in the supplement, such as bitter orange and caffeine.

When using “legal ephedra” products as a treatment for obesity, bear in mind that ingredients and dosages vary widely, and can interact with medications or aggravate existing medical conditions. Always consult with your doctor before using any dietary supplement. In addition, some sources, especially online stores, continue to sell real ephedra pills in defiance of the FDA ban. These pills can cause serious health complications.


Andrews, K., Holden, J., Dwyer, J., Saldanha, L.