JURY IS OUT ON DIET SUPPLEMENTS

Take a pill and lose some weight. Not a new idea but potent in its appeal
no matter how elusive.

So appealing, in fact, that the hubbub about a dietary supplement called
Metabolife 356 has proven difficult to miss. Radio DJs hawk it. Shop owners
from hair stylists to antique dealers display Metabolife signs in their
windows. Kiosk attendants at malls stand ready to fill orders.

Michael Ellis, president of Metabolife International in San Diego, Calif.,
said his company now has a million customers for its herbal supplement,
with no significant, adverse health effects to report. That makes it the
biggest-selling diet supplement ever, he said, and the company has plans to
expand the number of retail outlets next year from 1,000 to 3,500.

The federal Food and Drug Administration has issued warnings about dietary
supplements containing ephedrines as "amphetaminelike compounds" that may
cause serious side effects. Although the agency hasn't proposed banning
supplements containing ephedrine, it is considering label warnings and
dosage limitations, including instructions against taking the supplements
on a long-term basis.

It's not hard to find doctors and nutrition experts worried about the formula.

Nancy Russell, an internal medicine physician in Kansas City North, Mo.,
hears more and more from patients who want to try the supplement.

"I do not advise patients to use Metabolife," Russell said. "I need to lose
a few pounds, and I wouldn't take it."

Her concern about the formula centers on the herb called ma huang. Ma huang
contains ephedrines, Russell said, with potential side effects that include
increased blood pressure, anxiety and insomnia. People with heart
conditions and thyroid disorders should stay away, she said. Those taking
other medications risk interactions.

"I'm sure some people can take it safely," Russell said. "But you just
don't know if you're going to be one of those people who react to it
adversely."

The company says the formula's combination of ephedrines and caffeine act
to suppress the appetite and to increase the body's metabolic rate.

That second claim is especially appealing to many. Everyone knows skinny
people who eat what they want but don't gain weight. They seem to naturally
burn up fuel, effortlessly avoiding saddlebags and love handles. Metabolife
and other dietary supplements claim to have a thermogenic effect, shifting
the body into higher gear.

Jane Murray of the Sastun Center of Integrative Health Care said the
formula's stimulant effect most likely does suppress appetite. But even if
it also increases metabolic rate, the problem arises when you stop taking
it: The weight returns.

What if you don't stop?

"It probably would not be a wise move," said Murray, who has had many
patients quiz her about Metabolife. "There are no long-term data on taking
these things forever."

One option would be to use the pills as a jump-start at weight loss, Murray
said, although she worries about the side effects for some people.

In the meantime, if people don't also determine how much food they can eat
and how much exercise they need to maintain their desired weight, they
won't succeed. Gaining and losing weight over and over isn't healthy,
either.

"They still have to do a lifestyle change," Murray said.

Ellis feels confident that the product is safe for most people. As the
label says, people with high blood pressure, heart or thyroid disease,
diabetes, difficulty in urination due to enlarged prostate or those taking
other prescription drugs should seek advice from a health-care
practitioner.

"The reason it works is because it's active," Ellis said.

Customers shouldn't see the word natural on supplements and conclude that
they are safe for everyone. Lots of substances are natural but are still
harmful if abused, he said.

Dosage is important. You wouldn't take 30 aspirin rather than two or three
because you have a really bad headache, he said.

And the worries about ephedrines? Ellis said the company's medical experts
assured him the amounts are safe. Two tablets of Metabolife have less of
the substance than a child's dosage of cold medicine, he said.

The Herb Research Foundation in Boulder, Colo., an information source about
herbs, doesn't examine specific products. But its general advice about
stimulant herbs or other ingredients is that they shouldn't be used
long-term, said Christine Meadows, executive assistant at the foundation.

John Renner at the Consumer Health Information Research Institute considers
it a mistake to take herbs on trust without long-term studies showing they
are safe. But consumers, it seems, really are looking for that magic pill,
he said.

"Until these things are regulated, we're really buying a pig in a poke," he
said. "People like to gamble."