Lose weight without diet or exercise? I guess that leaves cancer.

–David Letterman.

It is the day after Thanksgiving, and I have probably eaten enough calories to support the average family for at least three days. I am hesitant to comment on what my actual weight may be, but others have not been so reticent about discussing my appearance over at RDCT. At least I am not female; then I would get no end of critiques based on my looks.

Now that I am up a few holiday pounds, it would be nice to lose some weight. Of course I do not want to do it the old fashioned way, with diet and exercise. Diet and exercise take time and are fundamentally painful. I want to eat what I want when I want from the comfort of my Lazy Boy. I want an easy way to lose weight. The interwebs, as is often the case, have been kind enough to provide me with numerous emails suggesting all sorts of simple ways to alter my physique for the better, some of which even include weight loss.

For some reason I have been on a spam list that keeps me well supplied with offers to try acai berry juice to lose weight.

Acai is a palm tree whose fruit, like that of many palms, is a food source for the indigenous peoples in the area where they grow. The akai berry is grape sized and purple and if it is purple it must be good. Of late acai has been touted for a wide number of health benefits, including weight loss, because it is believed to be high in antioxidants.

How do antioxidants help you lose weight?

According to the weight loss center antioxidants can help with weight loss as follows

“The reality is that antioxidants may very well improve weight loss or, at the very least help provide the body with the nutritional support it needs to keep it strong and energized during the fat burning process.

To help you understand how antioxidants can enhance weight loss, you need to take a closer look at the actual process that occurs when we lose fat. While most people tend to look at fat as their enemy when they are overweight, it is imperative that you realize fat is necessary for our health. There are two types of fat:

1. Essential fat – necessary for many body functions including reproduction.
2. Storage fat – Essential for protecting some of the body’s organs.

The fat in our bodies is stored in our adipose tissue. This tissue contains lipids that are needed to transform nutrients into energy. Fat cells have many functions and one of them is to store toxins that are released throughout the digestive process. Thus, when you reduce the fat in your body, the amount of toxins in your body increases and this can result in some negative side effects. For instance, the extra toxins often affect the liver, causing it to work overtime to process and remove them. Moreover, when fat molecules are broken down, a process called oxidation, they release free radicals, which can result in cell, protein and DNA damage.

Oxidation occurs when free radicals (unstable atoms) attack cells to re-stabilize themselves. The re-stabilized atoms release more free radicals and the process continues like a chain reaction throughout the body until the free radicals are stopped. The body will create its own antioxidants to help stop the reaction, but often there is not enough, which is why ingesting foods or supplements rich in antioxidants can be beneficial.

Thus, when you lose weight, you are not only shedding excess fat, you are also losing some of the nutrients in your body that are needed to maintain good health. Also, if you are exercising as part of your healthy weight loss program then your body will be creating even higher levels of toxic by-products. Therefore, antioxidants can help provide your body with the nutritional support it requires during the oxidation process, reducing the stress on your body and keeping energy levels and metabolism as high as possible.”

Huh? So as best as I can tell from this tortuous explanation, antioxidants contribute to weight loss by nutritional support. It appears the the purpose of antioxidants is not so much to help stimulate weight loss but to act like a catalytic converter, taking off the ‘toxins’ generated by fat oxidation. Just where these anti-oxidized toxins then go is never mentioned. This is one of the more coherent explanations I have found. My rule of thumb is that if a product provides support and is not an undergarment, it is crock.

Is there data to support the use of any antioxidants to help with weight loss? Not that I can find. Although there are many interweb claims that antioxidants help with weight loss, Pubmed and Google Scholar are silent on the topic. So despite the common use of supplements as an adjunct to weight loss, there is nothing to support the use of antioxidants, in acai or other foods, in weight loss.

Ironically, there is at least one study to show that antioxidants may help with weight gain in AIDS and cancer, although I doubt the increase in weight was due to any antioxidant properties of the supplements. Antioxidants may also prevent some of the beneficial effects of exercise as well. The take home message, as is often the case in medicine, is that the effects of supplements on physiology are rarely simple or straightforward.

So antioxidants have no role in weight loss outside of an advertising gimmick.

Back to acai. From Google trends, acai juice seems to be a relatively new fad in the US. Searches for the product stated in volume in the middle of July, 2008. While association is not causation, it is worth noting that the big spike in Google searches occurred shortly after Dr. Oz mentioned acai on Oprah

The Oprah mention apparently spawned the acai industry with the inadvertent help of Dr. Oz and Oprah, who are now suing the acai companies for using their likenesses and for implying that Oz and Oprah were supporting acai and using their good name. Do not mess with Oprah and suggest she gives your product a seal of approval.

The other industry spawned at the time was the acai scam, where people will sign up for ‘free’ acai using their credit card for shipping and handling, and then get charged large sums and be unable to cancel the order. Do NOT order acai online. If you are going to purchase worthless products, buy them at your local supplement store.

Like silver or other supplements, there is also a growth industry in the real acai, as opposed to all the posers who are peddling second rate products. One of the more important features of quality acai is the ORAC levels. Really. Orac. Go figure. But I do prefer high levels of Orac. The most amusing part of the acai industry is that the model used in many of the websites for ‘before’ and ‘after’ is a photo-shopped iStockphoto who never used the product. I wonder if the second rate acai products leads to photo-shopped weight loss.

“There are no magical berries from the Brazilian rainforest that cure obesity—only painfully real credit card charges and empty weight loss promises,” said Connecticut Attorney General Richard Blumenthal. “Aggressive Acai berry pitches on the Internet entice countless consumers into free trials promising weight loss, energy and detoxification. These claims are based on folklore, traditional remedies and outright fabrications—unproven by real scientific evidence. In reality, consumers lose more money than weight after free trials transition into inescapable charges. We will investigate these allegedly misleading or deceptive nutrition and health claims and take action under our consumer protection statutes—as we have done with other food products.”

This is the same Blumental who sued the Infectious Disease Society of America for anti-trust for their Lyme treatment guidelines, so I doubt it is a deep understanding of science and medicine that guides his actions.

So is there anything at all to acai as a way to lose weight? Perhaps.

Eating the fruit straight from the tree may give you Chaga’s, a parasite that destroys your heart and esophagus, rendering you unable to eat, so you might lose weight that way. Hardly seems worth it. Analysis of the fruit does show it has vitamin C and a variety of antioxidants, so it is not bad for you. But there are more palatable alternatives:

“ PJ (pomegranate juice) had the greatest antioxidant potency composite index among the beverages tested and was at least 20% greater than any of the other beverages tested. Antioxidant potency, ability to inhibit LDL oxidation, and total polyphenol content were consistent in classifying the antioxidant capacity of the polyphenol-rich beverages in the following order: PJ>red wine>Concord grape juice>blueberry juice>black cherry juice, açaí juice, cranberry juice>orange juice, iced tea beverages, apple juice. Although in vitro antioxidant potency does not prove in vivo biological activity, there is also consistent clinical evidence of antioxidant potency for the most potent beverages including both PJ and red wine.”

Is there anything special from acai? I am uncertain and unenthusiastic. It is safe to say, if you have ever had a Bordeaux, that the Connecticut Attorney General was only partly wrong, that magic berries can be found in France. There is nothing special about acai except the hype.

If you are not interested in spending money on acai juice, I found a more direct way to rid your self of 10 pounds of ugly, unwanted fat. Rather than have the fat go away from metabolism, inject it away. Maybe I can be rid of the turkey and gravy with mesotherapy. What is mesotherapy? It is

“ a minimally invasive technique that consists of the intra- or subcutaneous injection of variable mixtures of natural plant extracts, homeopathic agents, pharmaceuticals, vitamins, and other bioactive substances in microscopic quantities through dermal multipunctures.”

Minimally invasive is correct, as the needles used in mesotherapy are 3 mm long.

Mesotherapy has a curious origin, oddly familiar to those who wander the fringes of medicine.

In 1952 a French physician, Michel Pistor, treated a man with asthma with IV procaine, an anesthetic, and while it did not help the patients asthma, it did improve the patients hearing, DD Palmer be praised. Dr Pistor at that point decided to inject the procaine superficially around the ear, and while it did not restore hearing in other patients, others had improvement in their temporal-mandibular joint pain syndrome, eczema, and tinnitus.

Of course, this therapy was a panacea, not limited to treating hearing loss, but used for treating systemic problems with local superficial injections. Dr Pistor said ‘‘the action on tissue originating from the mesoderm is so extensive that these treatments deserve the global name of mesotherapy’’ and a new branch of medicine, at least in France, was launched.

The list of diseases treated with mesotherapy is extensive:

‘Allergies, arthritis, asthma, carpal, tunnel, syndrome, cellulitis, chronic, fatigue, constipation, degenerative, disc, disease, depression, fibromyalgia, gout, headache, hearing, loss, hemorrhoids, hepatitis, herpetic, neuralgia, immune, system, deficiencies, insomnia, irritable, bowel, syndrome, lower, back, pain, lymphedema, obesity, osteophytes, (‘‘bone, spurs’’), peripheral, vascular, disease, prostatitis, reflex sympathetic, dystrophy, sports injuries, (i.e.,, sprains,, strains, tears,, bursitis,, tendonitis, plantar, fasciitis, calcium, deposits), substance, abuse, temporal-mandibular, pain, syndrome, tinnitus, and vertigo.”

A large numner of diseases require a remarkable number of substances to be injected with mesotherapy, not limited to

“ T3-T4 thyroid, isoproterenol, aminophylline, pentoxifylline, l-carnitine, l-arginine, hyaluronidase, collagenase, yohimbine, lymphomyosot, co-enzyme cofactors, dimethylethanolamine, gerovital, glutathione, tretinoin, alpha lipoic acid, vitamin c, procaine, lidocaine, ginkgo biloba, melilotus, c-adenosine monophosphate, multiple vitamins, phosphatidylcholine, trace mineral elements, and carbon dioxide” and more as well as homeopathic preparations.

Mesotherapists choose their injectables for their alleged effects, for example injecting an NSAID for anti-inflammatory effects or artichoke (really) for circulatory stimulation. Often multiple substances are mixed together, based on the experience of the mesotherapist, rather than data, into a cocktail that is then injected.

There are less than a dozen articles in the European medical literature to support the use of mesotherapy for medical conditions such as pain and musculoskeletal conditions and have the same rigor as acupuncture studies.

In the US mesotherapy is used primarily for cosmetic changes and body sculpting, but also to ‘dissolve fat’ and treat cellulite. Its efficacy is debated as evidenced by one review entitled “Cosmetic mesotherapy: between scientific evidence, science fiction, and lucrative business.”

The plastic surgery literature often states that mesotherapy is not the same as using injections of phosphatidylcholine and deoxycholate to remove superficial fat, for which there is some supporting literature. Histopathology after phosphatidylcholine and deoxycholate injections demonstratess an inflammatory response with fat necrosis, and there may also be some fat necrosis from traditional mesotherapy products as well .

Part of determining if mesotherapy can lyse fat is defining what constitutes mesotherapy, what kind of fat you are trying to eradicate and, with what are you injecting. One patient, with congenital large symmetrical fat collections was treated with good cosmetic effect with injections of phosphatidylcholine, but many would not consider this mesotherapy since the phosphatidylcholine was injected deep into the fat.

Whether similar or other injections are beneficial for cellulite or other superficial fat depositions cannot be determined; the data to date is minimal and suggests it is without efficacy. Unfortunately mesotherapy is worthless for the turkey induced muffin top. It can run thousands of dollars and, to judge from sites not promoting mesotherapy, it is both painful and useless. Many who use ‘CAM’ seem to like to ‘do it yourself’, but I would advise against home mesotherapy with lipase .

Mesotherapy is not FDA approved, but since the products are (except, I suppose, for artichoke) FDA approved medications, they can be used off label by mesotherapists.

While efficacy is uncertain and cost is variable, what is well described are the complications. There are numerous outbreak reports of infections with atypical mycobacteria, cousins of Tb, that cause long term scarring. Not unsurprisingly, some of the outbreaks are due, in part, to the practitioner not using standard sterile technique.

“Fourteen patients reported breaches in safe-injection practices by the practitioner, including 1) failure to practice hand hygiene, 2) failure to prepare the skin with an antiseptic, 3) failure to wipe vials with alcohol before injection, and 4) failure to wear gloves. Of 11 patients who could recall, all reported use of a new needle; however, nine patients reported use of a multidose vial. Patients reported being told their injections contained various substances (e.g., plant extracts from artichoke and thuja, liquid “graphites,” and procaine). With the exception of procaine, none of the substances reported by patients have been approved for subcutaneous injection by the FDA. ”

Mesotherapy is also associated with care reports of other odd reactions including thyrotoxicosis, septic arthritis, and a variety of local skin reactions. I wonder if I were to get a mesotherapy injection with acai juice…

I suppose I am still stuck with diet and exercise.

Go Ducks.



  • Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at