Safety and effectiveness of CAM for the treatment of OBESITY
One of the biggest challenges in the use and control of medicine in the last few decades has been the increasing popularity of Complementary and Alternative Medicine (CAM) in western societies. In the US, the 1990s could be considered the period when CAM started to become more rapidly widespread, and nowadays, over 40% of Americans use complementary or alternative methods to treat their health problems. Biomedicine, and Evidence-based Practice that follows very strict and structured models of research and stages to demonstrate the safety and effectiveness of medications and treatments mark the origin and bases of Conventional medicine. On the other hand, CAM roots enclose a variety of products, therapies, and medical systems, that are not part of Conventional Medicine but can work together or replace it in some cases because they are culturally believed to have a positive impact on people’s health (Fjær et al., 2020).
According to a report from the World Health Organization released on March 4th, 2022, over 1 billion persons surpass the BMI of 25 (overweight) and 30 (obese), with a high prevalence in adults and children, so these diseases are considered a global epidemic that leads to other potentially life-threatening ones. Usually, the Conventional treatment for overweight and obesity is mainly based on a low-calorie diet, lifestyle changes, and increasing physical activities, complemented with a few approved drugs that have been used but have not had the expected impact because of their high costs and potential adverse effects. This therapy usually fails, and more than two-thirds of the patients return to their old habits after the interventions and regain weight, which makes the classic Conventional medicine not effective for the management of this problem. This is one of the many reasons why a lot of people explore CAT to control their problems with overeating and weight management (WHO, 2022).
There is a long list of herbal and dietary supplements, that have been widely believed to be useful in the treatment of obesity, some of them to control appetite, others to increase the body’s metabolism, or to cause satiety. We could mention green tea, psyllium, Garcinia Cambodia, bitter orange, Chromium Picolinate, Conjugated Linoleic Acid, Hoodia Gordonii, Spirulina, Chitosan, etc. Even while different, there is something common to all of them, apart from being natural products, and it is the lack of serious and consistent research that demonstrates any evidence of their effectiveness, and even less, to be safe to be used in over 12 weeks. Some of these supplements show not to be more effective than placebos, and some of them have been proved to be harmful to the body. So, contrary to what is culturally very recommended and believed to be useful about some herbs in the management of weight, there is a serious lack of evidence about their safety and effectiveness (Wharton et al., 2019).
Some other complementary and alternative therapies like acupuncture have been more consistently researched in the management of weight and fat deposits, and even when some studies have shown physiological positive effects from the insertion of needles in some positions in the body, they suffer from complex methodological limitations and weaknesses like the absence of control groups with placebos, irregular or short follow up, arbitrations on the exact point to place the needle and the angle and deepness for it, which make these investigations invalid to create enough evidence to consider this procedure safe and/or effective, and reproducible.
The body contouring techniques include the Liposuction, which is invasive and carries a lot of complications and it makes it not to be safe and is not effective in patients with high BMI or morbid obesity. The well-known non-invasive contouring therapies (High-Intensity Focused Ultrasound; Low-Level Laser Therapy; Cryolipolysis; Radiofrequency) have been gaining popularity in the last decade due to their fast results, rapid recovery after the procedures, and smaller side effects, which has led to consider these methods safe and effective, but because of the short time they have been on the market, there is not enough evidence to support this concept.
If we consider all the lack of evidence on the safety and effectiveness of the CAM, specifically in the management of obesity, and how dissatisfied the population is with the Conventional Medicine for that same goal, the healthcare professionals should be more involved in trying to learn more about all these alternatives and complements, to solve the serious gaps that still exist between the knowledge and communication to counsel the patients about these therapies (Review et al., 2018).
We have discussed in our group what form of healing to use in our practice, if Holistic or Allopathic Medicine, and the consent has been that we would use both. The holistic one cares about the person, physically, biologically, emotionally, and spiritually, and the providers will use the patient’s capacity to heal, and all forms of medicines, Conventional and CAT, to control the disease but mainly from the possible factors that led to it. And this would be very helpful in some cases. The allopathic approach refers to Conventional Medicine, by treating symptoms or a focal pathophysiological problem with pharmacological drugs or physical interventions like surgery, which in the short term could also be very effective in some cases (Marks, 2022).
So, in summary, we consider that the best way to deal with a patient is by using both forms of health care, allopathic and holistic because, as a biopsychosocial being, a pathophysiological problem could affect the individual’s emotions and the relation between the internal and the external environment. The patient would need to be interviewed, about the symptoms, and all possible causes of it too, get a physical exam, labs, images, etc., and will need conventional medicine to treat it, but we must also take care of the reasons for their condition, and the effects that it may provoke over the person’s life. So, the allopathic approach could not be enough, and holistic care would be an excellent alternative to obtain the best outcomes for the well-being of our clients.
References
Fjær, E. L., Landet, E. R., McNamara, C. L., & Eikemo, T. A. (2020). The use of complementary and alternative medicine (CAM) in Europe. BMC Complementary Medicine and Therapies, 20(1). https://doi.org/10.1186/s12906-020-02903-w
Wharton, S., Bonder, R., Jeffery, A., & Christensen, R. A. G. (2019). The safety and effectiveness of commonly-marketed natural supplements for weight loss in populations with obesity: A critical review of the literature from 2006 to 2016. Critical Reviews in Food Science and Nutrition, 60(10), 1614–1630. https://doi.org/10.1080/10408398.2019.1584873
Marks, H. (2022). What Is Holistic Medicine? WebMD; WebMD. https://www.webmd.com/balance/guide/what-is-holistic-medicine
WHO. (2022, March 4). World Obesity Day 2022 – Accelerating action to stop obesity. Www.who.int. https://www.who.int/news/item/04-03-2022-world-obesity-day-2022-accelerating-action-to-stop-obesity
Review, M., Mahmood, A., Al Shajrawi, O., Iab, Y., Al Talib, H., Simbak, N., & Amin Baig, A. (2018). Open Access Journal of Biomedical Engineering and Biosciences Role of Complementary and Alternative Medicine In Treatment and Prevention of Obesity; Molecular Strategies to Recommended Acceptance. https://doi.org/10.32474/OAJBEB.2019.03.000162

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