A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity

Table 2 Animal studies on the anti-obesity effects of herbal medicines

Authors	Target	Herbs (scientific name)	Dose/duration	Groups	Main outcome	Other relevant effects & complications
Wang et al[27] 2000	Rat (obese)	Haidonghua powder: Laminaria japonica Aresch & Benincasa hispida (Thunb.) Cogn. etc	(2.5 g/kg)	-	Sig. decrease in Lee’s index & size of fat cells	Did not influence the function of thyroid gland & metabolism of water & salt
Jeon et al[28] 2003	Mouse	Rhus vemiciflua Stokes	8 wk	C: HFD I: HFD + extract	Sig. suppression of body wt. gain and lower wt. of subcutaneous adipose tissue	Lowered plasma TG
Alarcon-Aguilar et al[29] 2007	Mouse	Hibiscus sabdariffa	120 mg/kg 60 d	C: Healthy & obese (by MSG) + placebo I: Same groups + extract	Sig. decrease in body wt. gain in obese mice & increased liquid intake in both groups	No sig. change in TG & Chol levels. Increase in ALT levels was shown but was not sig.
Urías-Silvas et al[30] 2008	Mouse	Fructans extracted from Agave tequilana (TEQ) and Dasylirion spp (DAS)	10% supplement	C: STD I: STD + Raftilose/DAS/TEQ	Sig. decrease in body wt. gain & food intake. The (TEQ) group had the lowest value	Lower serum glucose & Chol level but Sig. decrease in TG levels was shown in Raftilose group. Higher concentration of GLP-1 & it's precursor & proglucagon mRNA in I groups
Park et al[31] 2007	Rat	Platycodon grandiflorum	150 mg/kg 7 wk	C: NLD/HFD I: Same groups + extract	Sig. decrease in body wt & subcutaneous adipose tissue wt. & adipocytes size in I group	Sig. decrease in plasma TG & Chol concentrations, up-regulation of FABP mRNA expression induced by HFD
Jongwon et al[32] 2005	Rat (obese by HFD)	Allium victorialis var. platyphyllum leaves	100 mg/kg 2 wk	-	Considerable reduction of retroperitoneal, epididymal and total abdominal fat pad wt.	Sig. decrease in hyperlipidemia and increased lipid content in feces
Kobayashi et al[33] 2001	Rat	Evodiamine an alkaloid of a fruit: Evodia rutaecarpa	0/02%, 0/03% of the diet 12 wk	C: Control I: Extract	Sig. decrease in perirenal fat wt. & decrease of epididymal fat mass	Sig. decrease of lipid in liver & serum FFAs. Sig. increase of lipolytic activity in perirenal fat tissue & specific GDP binding in brown adipose tissue mitochondria as the biological index of heat production
Jin et al[34] 1994	Rat	Jiang-zhi jian-fei yao: the refined Rhubarb	Injected intragastrically		No sig. increase in body wt. but reduction of food intake. Decreased size of abdominal adipose cells	Prolongation of stomach evacuation time and acceleration of intestinal movements
Kim et al[35] 2008	Rat	Juniperus chinensis	1% supplement/79 d	C: NLD/HFD I: HFD + extract	Sig. decrease in body wt gain & visceral fat pad wt.	Sig. decrease in blood lipid, leptin & insulin levels. Sig. reversal of the down-regulation of genes implicated in adipogenesis & increased gene expressions & phosphorylations related to FABO
Shih et al[36] 2008	Mouse (obese by HFD)	Momordica charantia (bitter melon)	4 wk	C: Control I: Rosiglitazone/extract	Sig. decrease in epididymal white adipose tissue wt. & visceral fat wt.	Sig. improvement in blood glucose, leptin, and FFA. Influenced PPARα/PPARγ expression
Pang et al[37] 2008	Rat (obese by HFD)	Ilex paraguariensis			Sig. decrease in body wt. of visceral fat-pad wt.	Sig. decrease in blood and hepatic lipid, glucose, insulin and leptin levels. Reversed the down-regulation of genes implicated adipogenesis, thermogenesis & enhanced expression of uncoupling proteins in adipose tissue
Bruno et al[38] 2008	Mouse	Green tea	0%, 1%, 2% (wt.:wt.)/6 wk	C: Obese/lean I: Same groups + extract	Sig. decrease in body wt. of both I groups	In obese I group, sig. decrease in hepatic steatosis was observed dose dependently. Liver enzymes decreased. 30%-41% and 22%-33% lower serum ALT and AST activities were shown, respectively
Lee et al[39] 2008	Mouse	A combination of Morus alba, Melissa officinalis and Artemisia capillaries	12 wk	-	Sig. decrease in body wt. gain & adipose mass	Decreased serum levels of TG, Chol & inhibited hepatic lipid accumulation, and increased hepatic mRNA levels of enzymes responsible for FABO
Choi et al[40] 2008	Mouse (obese by HFD)	Cucurbita moschata	500 mg/kg 8 wk	_	Sig. suppression of body wt. & fat storage increase but amount of food intake was not affected
Huang et al 2008[41]	Rat	Momordira charantia L. (Bitter melon)	5%	C: HFD I1: HFD + plant I2: HFD + thiazolidinedione	Sig. decrease in the number of large adipocytes in both I groups. Sig. decrease in adipose tissue mass in I1 group compared to I2 group	Sig. decrease in enzymes of adipose tissue implicating reduction of insulin resistance in I group as compared to C group
Lemaure et al[42] 2007	Rat (obese)	Cyperus rotundus L. tubers	45, 220 mg/kg 60 d	_	Sig. decrease in wt. gain without affecting food consumption
Lei et al[43] 2007	Mouse	Pomegranate leaf	400/800 mg per kilogram 5 wk	C: HFD/NLD I: Same groups + extract	Sig. decrease in body wt. & energy intake and adipose pad wt. percents in I. group. Sig. decrease in appetite of obese mice on NLD was shown	Sig. decrease in serum TG, Chol, glucose levels & Chol/HDL ratio, inhibition of intestinal fat absorption
Aoki et al[44] 2007	Mouse (obese by HFD)	Licorice flavonoids oil (LFO)	0/5%, 1%, 2% 8 wk	C: Placebo I: Extract	Sig. decrease of abdominal white adipose tissue & body wt. gain with 1% & 2% LFO groups, decrease of adipocyte size	Improvement of fatty degeneration of hepatocytes and changes in genes implicating regulation of lipid metabolism with 2% concentration
Oluyemi et al[45] 2007	Rat	Garcinia cambogia seed (bitter cola)	200, 400 mg/kg 5 wk	C: Placebo I: Extract	Sig. decrease in body wt.	Sig. decrease in TG pool of adipose tissue & liver but sig. increase of HDL & decreased LDL
Han et al[46] 2006	Mouse (obese by HFD)	Kochia scoparia	1%, 3%/3 d	-	Prevented the increases in body & parametrial adipose tissue wt.	Sig. increase the fecal content & fecal TG levels in day 3
Goyal et al[47] 2006	Mouse (obese gold thioglucose)	Zingiber officinale	250 mg/kg 8 wk	C: Placebo I: Extract	Sig. decrease in body wt.	Sig. decrease in serum Chol, TG, glucose, and insulin
Kishino et al[48] 2006	Rat and mouse	Salacia reticulata	0/5% 8 wk in mice 0/2% 35 d in rats	C: HFD I: HFD + plant	Sig. decrease in the body wt. and visceral fat mass increase	Sig. decrease in plasma TG, 4 h after ingestion; Sig. decrease in energy efficiency, plasma leptin and adiponectine levels
Jayaprakasam et al[49] 2006	Mouse	Cornelian cherry (cornus mas) (Purified anthocyanins (A) & ursolic acid (u)	1 g/kg (A), 500 mg/kg (u) 8 wk	C: HFD I: HFD + A/A + u	24% decrease in wt. gain in (A) group	Elevated insulin levels; Sig. decrease of liver TG in A + u group
Moreno et al[50] 2006	Rat	Arachis hypogaea nutshell	1% (wt:wt)/12 wk	C: HFD I: HFD + extract	Sig. decrease in body wt. gain and liver size	Increased fecal lipid excretion. Reduced TG content of liver and serum glucose and insulin
Galisteo et al[51] 2005	Rat (obese)	Plantago Ovata	3/5% 25 wk	C: STD I: STD + extract	Sig. decrease in body wt. gain	Sig. improvement of lipid profile, FFA & insulin & TNF-α & hypoadinectinemia
Zhao et al[52] 2005	Mouse (obese by hyperalimentation)	Phillyrin (Fructose forsythia)			Sig. decrease in wet wt. of fat & fat index & diameter of fat cells & lee index	Decrease in jejunum microvillus area, and serum levels of TG & Chol
Chen et al[53] 2005	Rat	Bitter melon (Momordica charantia)	0/75% or 7/5 g per kilogram 7 wk	C: LFD/HFD I: LFD/HFD + extract	Lower energy efficiency and visceral fat mass after 4 wk in I group	Reduced plasma glucose and hepatic TG but higher serum FFA after 4 wk; Higher plasma catecholamine after 7 wk in I group; Sig. decrease in hepatic TG & steatosis and sig. increase of serum epinephrine & FFA in HFD group of I
Han et al[54] 2005	Rat	Coleus forskohlii	50 g/kg	C: Sham operated/ovariectomized + control diet I: Same groups + extract	Reduced body wt.& food intake & fat accumulation
Han et al[55] 2005	Mouse	Chikusetsu saponins isolated from Panax japonicus rhizomes	1%, 3%/9 wk	C: HFD I: HFD + extract	Prevented body wt. gain & increase of parametrial adipose tissue wt.	Sig. increase of the fecal content & TG level in day 3; reduction of plasma TG 2 h after oral lipid intake & inhibition of pancreatic lipase activity
Han et al[56] 2005	Mouse	Zingiber officinale Roscoe	1%, 3%/8 wk	C: HFD I: HFD + plant	Sig. decrease in body wt. gain at 2-8 wk with 3% & in final parametrial adipose tissue wt. with 1% concentration
Cha et al[57] 2004	Mouse	Acanthopanax senticosus	0/5 g per kilogram 12 wk	C: NLD/HFD I: NLD/HFD + extract	HFD group of I had lower wt. gain but no difference in food consumption was shown	In HFD group of I, lower serum LDL and restoration of liver TG at the same level as fed by LFD was shown; No alteration in carnitine status
Kim et al[58] 2005	Rat	Crude saponin of Korean red ginseng	200 mg/kg 3 wk, ip	C: NLD/HFD I: NLD/HFD + extract	Reduced body wt., food intake & fat content in HFD group of I similar to those fed with NLD	Reduction of hypothalamic NPY expression and serum leptin level in HFD group of I
Yun et al[59] 2004	Mouse	Wild Ginseng	250, 500 mg/kg	C: HFD I: HFD + extract	Sig. inhibition of body wt. gain dose dependently. Decrease of white & brown adipocytes diameters	Sig. inhibition of FBG, TG, and FFAs dose-dependently; insulin resistance improved
Junbao et al[60] 2004	Rat (obese)	Semen cassiae	6%	-	Sig. decrease in body wt. & lee index	Reduction of fasting serum TG, insulin & malondialdehyde
Kim et al[61] 2004	Rat	Adlay seed (CoixLachrymajobi var. mayuen)	50 mg/100 g of body wt.	C1: NLD C2: HFD + saline (sham group) I: HFD + plant	Sig. decrease in body wt. & food intake & epididymal and peritoneal fat & white adipose tissue size as compared to sham group	Increase of brown adipocytes as compared to NLD group but not significant
Kwon et al[62] 2003	Rodent	Dioscorea nipponica Makino	5%/8 wk	C: HFD I: HFD + plant	Sig. decrease in body wt. & adipose gain	Suppression of time dependent increase of serum TG level after lipid intake
Lu et al[63] 1999	Rat (obese by hyperalimentation)	Inspissation tea (Guangdong kudingcha)		C: Control I1: Extract I2: Fenfluramine	Stronger modulation on lymphocytes hypertrophy and quantity was shown in I1 group	Only fenfluramine showed sig. difference in small intestine villus model
Yoshikawa et al[64] 2002	Rat (obese)	Salacia reticulata	125 mg/kg 27 d		Suppression of body wt. and periuterine fat storage increase in female rats but no effect on male rats
Xie et al[65] 2002	Mouse	Ginseng berry	150 mg/kg 12 d, ip	C: Diabetic/lean diabetic + placebo I: Same groups + extract	Sig. decrease in body wt. as compared to day 0 in diabetic group of I. wt. loss in lean mice was shown	Sig. increase in glucose tolerance in diabetic mice but no sig. decrease of FBG in lean mice.
Yamamoto et al[66] 2000	Rat	CT-II, an extract from Nomame Herba	8 wk, 12 wk, 6 mo	C: Lean/obese + HFD I: Same groups + HFD + plant	Sig. inhibition of body wt. gain dose dependently without affecting food intake in lean rats after 12 wk. Sig. decrease in body wt. gain in obese mice after 24 wk	Sig. inhibition of TG elevation
Han et al[67] 1999	Mouse	Oolong tea	10 wk	C: HFD I: HFD + extract	No sig. difference in food intake but prevented obesity & liver induced by a HFD	Enhancement of noradrenalin induced lipolysis & inhibition of pancreatic lipase activity
Pusztai et al[68] 1998	Rat	Kidney bean (Phaseolus vulgaris)	130, 150, 280 g/kg 10-70 d	C: Lean/obese + LFD/HFD I: Same groups + extract	The growth was retarded dose-dependently lower body fat	Sig. decrease of body protein in lean I group. Sig. decrease in plasma insulin levels in obese I group. Sig. pancreatic growth after long term feeding in all I groups
Nagasawa et al[69] 1991	Mouse (obese)	Tree peony root (Paenia suffruticosa)	0/5% 30 wk	C: Control I: Extract	Sig. decrease in food intake and Lee index	Improvement in glucose tolerance. No sig. difference in serum FFA levels
Wang et al[70] 2008	Mouse	Parasitic loranthus from Loranthacea or Viscaceae	20 d	-	Sig. decrease in body wt. & food intake	High inhibitory ability on FAS-Loran thacea was nearly 400 fold stronger than that from the viscaceae
Hu et al[71] 2008	Mouse (female)	Escins extracted from Aesculus turbinata Blume (Hippocastanaceae)	2%/11 wk	I: HFD C: HFD + extract	Suppressed the increase in body & parametrial adipose tissue wt.	Suppressed the increase of liver TG content; increased TG in feces after fat ingestion
Ohkoshi et al[72] 2007	Mouse	Nelumbo nucifera Gaertn leaves (Nymphaceae)	50%	C: STD/HFD I: Same groups + extract	Sig. suppression of body wt. gain	Exhibition of lipolytic activity especially in visceral adipose tissue; β adrenergic receptor pathway was partly involved
Kang et al[73] 2004	Rat	PM-F2-OB composed of Lycii Fructus, Rehmanniae Radix, Coicis Semen, Carthami Flos, Hoelen, Angelicae Radix, Nelumbinis Semen, Radix Dioscorea and Aurantii Fructus	6 wk	C: STD/HFD I: Same groups + plant	No sig. difference in wt. change if STD was used but in HFD group of I resulted in sig. decrease in body wt. gain but showed no sig. difference in amount of food intake	Sig. decrease in serum Chol/LDL and total lipids; reduction of kidney fat wt./FFA/PL & TG to levels equal or below the normal diet
Mary et al[74] 2003	Rabbit	Caps HT2 A herbal formulation	5 mg/kg (iv) 30 d 100/200/300/400/mg per kilogram orally	-	Sig. decrease in body wt.	Sig. increase in HDL after oral administration and decrease in atherogenic index in oral administration; Sig. increase of the release of LPL enzyme and sig. hypolipidemic effect in IV groups
Wu et al[75] 2005	Rat (diabetic by STZ )	Astragalus polysaccharide (APS) a component of Astragalus membranaceus roots	400 mg/kg (APS) 5 wk	-	Sig. decrease in body wt.	Sig. decrease in plasma glucose; improved insulin sensitivity
Xie et al[76] 2005	Mouse (Genetically obese)	Total, Ginsenosides in Chinese ginseng (TG CG), from leaves and the stem of Panax ginseng	100, 200 mg/kg (ip) 12 wk & 150, 300 mg/kg (oral)/12 wk	C: Placebo I: Extract	Sig. decrease in body wt.	Sig. decrease in FBG in 200 mg/kg dose after injection Sig. decrease in FBG in 300 mg/kg dose
Palit et al[77] 1999	Mouse	Galega officinalis	10% (w/w) of the diet 28 d	C: Diabetic/NL I: Same groups + plant	Sig. decrease in body wt. in both I groups, sig. wt. loss in normal mice independent of a reduction in food intake but in diabetic mice wt. loss was with reduced food intake	Striking loss of body fat in both groups; Sig. decrease in serum glucose in both groups but Sig. decrease in serum insulin in diabetic mice
Oi et al[78] 1999	Rat	Garlic	8 g/kg of diet 28 d	C: HFD I: HFD + extract	Sig. decrease in body wt. & perirenal adipose tissue wt. & epididymal fat pad	Sig. decrease in plasma TG levels; sig. decrease in mitochondrial protein and (UCP) in brown adipose tissue, and in urinary noradrenaline and adrenaline excretion
Yoshida et al[79] 1995	Mouse (obese and lean)	Bofu-tsusho-san	1/4%, 4/7% of wt. of food 8 wk	-	Sig. decrease in body wt. & retroperitoneal white adipose tissue wt. and no change in food intake	Sig. increase in GDP binding dose dependently
He et al[80] 2008	Rat (obese by STZ & HFD	Yi-Qi-Yang-Yin-Ye	2, 4, 8 g/kg 4 wk	-	Body wt. decreased	Decrease in TG/Chol/LDL/FFA/FBG/insulin; improvement of glucose tolerance
Jeong et al[81] 2008	Rat (fatty)	Gyeongshang angjeehwan: Liriope platyphylla F.T./Wang & T. Tang (Liliaceae), Platycodongrandiflorum A. DC. (Campanulaceae). Schisandrachinensis K. Koch (Magnoliaceae). Ephedra sinica Stapf (Ephedraceae)	8 wk	C: Placebo I: Compound	Sig. decrease in food intake & body wt. gain & abdominal fat	Sig. decrease in plasma leptin levels; decrease in circulating TG and inhibition of lipid accumulation in liver; increase of mRNA of genes responsible for FABO
Park et al[82] 2005	Rat (obese by diet)	Platycodon grandiflorum	150 mg/kg 7 wk	C: Convert to NLD/HFD I: Same groups + extract	Sig. decrease in wt. of body & adipose tissues in rats converted to NLD as compared to those remained on HFD	Sig. decrease in fat cell number & size in both I groups as compared to their state before intervention; decrease of FABP expression in HFD group of I
Akagiri et al[83] 2008	Mouse (obese by HFD)	Bofutsushosan (BOF)	1%/4 wk	C: Placebo I: Compound	The wt. of WAT and increase in size of adipocytes inhibited	Expression of UCP1 mRNA in WAT was found but not sig.
Kim et al[84] 2005	Mouse (diabetic)	Pine extract (bark and needle)	21 d	C: Control I: Extract	Sig. decrease in body wt.	Effectively suppressed the increase of postprandial blood glucose level by delaying absorption of diet
Attele et al[85] 2002	Mouse (obese diabetic)	Panax ginseng berry	150 mg/kg (ip) 12 d	C: Control I: Extract	Sig. loss of wt. with a sig. reduction in food intake & a very sig. increase in energy expenditure & body temperature	Sig. improvement in glucose tolerance & sig. reduction in serum insulin levels & plasma chol levels

MSG: Monosodium glutamate; FABO: Fatty acid β oxidation; STD: Standard diet; LFD: Low fat diet; NLD: Normal diet; HFD: High fat diet; FABP: Fatty acid binding protein; FFM: Fat free mass; sig.: Significant; AST: Aspartate transaminase; ALT: Alanine transaminase; C: Control; I: Intervention; FAS: Fatty acid synthetase; UCP: Uncoupling protein; GDP: Guanosine 5' diphosphate; FAS: Fatty acid synthetase; TG: Triglyceride; HDL: High density lipoprotein; LDL: Low density lipoprotein; FBG: Fasting blood glucose; ip: Intraperitoneal; iv: Intravenous. Caps HT2 is a herbal formulation containing methanolic extract of selected parts of plants: commiphora mukul; Allium Sativum; Plumbago indica/some carpus anacardium/Hemidesmus indicus/Terminalia arjuna/Tinospora cordifolia/Withania somnifera ocimum sanctum.