DHEA makes the fat go away

A study shows that the hormone could control the effects of obesity. But it’s early. Don’t be swayed by the promises in ads.

DHEA, a hormone with a checkered past, may have a future as a way to prevent and treat the metabolic problems caused by belly fat.

The initials stand for dehydroepiandrosterone. (Little wonder it’s known by its initials!) It’s one of several hormones made by the adrenal glands, which are perched on the kidneys. The body converts it into estrogen, testosterone, and other less well-known hormones. DHEA also activates receptors that influence how we metabolize and store fat.

Like many other hormones, DHEA has its heyday in the young. Fetal adrenal glands churn out 200 milligrams daily, 10 times the amount produced by adults. After birth, DHEA levels peak between the ages of 20 and 30 and then taper off at a rate of 5% per year. By age 70, most of us have negligible amounts in our systems.

Slipping through a loophole

For years, DHEA was marketed as a weight-loss pill. Then the FDA put its foot down and said it could be sold only as a prescription drug. In the mid-’90s, DHEA slipped through the giant-size regulatory loophole for dietary supplements, and it returned to the market as a dubious (to put it mildly) anti-aging medicine.

It’s an old, if shameful, sales tactic to gather the slenderest pieces of suggestive evidence and ballyhoo them into scientific proof. DHEA and countless other products have been sold that way.

A hormone worth studying

But exaggerated claims don’t mean that there isn’t something to the evidence. DHEA actually has a pretty good track record in animal experiments for reducing fat accumulation in both genetic and diet-induced obesity. So the National Institutes of Health (NIH) funded a randomized, double-blind study of the hormone in slightly overweight adults between the ages of 65 and 78. Half of the 56 participants took 50 milligrams of DHEA daily — a fairly typical dose — while the other half took a placebo.

DHEA didn’t produce dramatic weight loss. People taking the hormone lost, on average, about 2 pounds, while those taking the placebo gained a little more than 1 pound. The results for abdominal fat were more notable. At the end of the six-month study, MRI images showed that the women taking the hormone had shed about 10% of their abdominal fat and the men lost about 7%. That may not seem like much, but the fat that accumulates around our middles is one of the main reasons why being heavy is so unhealthy.

Interestingly, the study also showed that DHEA increases the levels of testosterone in women, but not in men. Levels of estradiol, the most potent, naturally occurring estrogen, went up in both women and men. The hormone also increased the levels of insulin-like growth factor 1 (IGF-1), a protein with a wide range of effects on various tissues.

Why DHEA might work

Your body must “choose” how it’s going to process extra calories and where it’s going to store excess fat. It’s very much a group decision, based on elaborate interactions of enzymes, hormones, and cell receptors.

The Washington University School of Medicine researchers who conducted this study believe DHEA probably reduces abdominal fat by flipping on a particular receptor (the PPAR-alpha receptor). When it’s activated, the receptor triggers a complicated chain of events that improves the way the body metabolizes fat, so less fat is deposited. As a result, there’s less excess fat around to wind up bulging the belly.

The increased estradiol levels might also be important; postmenopausal women who take estrogen usually avoid the postmenopausal tendency to put on abdominal fat. The higher levels of IGF-1 may also play an antifat role.

Certainly anything that reduces abdominal fat merits some attention because abdominal fat is such a metabolic troublemaker. It releases greater quantities of free fatty acids than other sorts of fat tissues. High free fatty acid levels affect the liver, so insulin and blood sugar levels get out of control. Diabetes is the obvious result. But high insulin levels may also explain the connection between abdominal obesity and certain cancers because insulin can act as a cancer-promoting growth factor.

Let’s look before we leap

So what are we to make of this study? The researchers ended on a high note. DHEA, they wrote, may reverse the age-related accumulation of abdominal fat in the elderly. They also dangled out the possibility that the hormone could be used to prevent the development of prediabetic syndromes. If either came true, we’d be celebrating a fairly significant medical advance.

But they also applied the brakes in the conclusion of their study, which was published in the Nov. 10, 2004, Journal of the American Medical Association. Their findings are preliminary, they note, and the study was too small and too brief to determine whether DHEA might pose some dangers.

In the wrong hands, this promising but tentative research will be puffed up into promises of effortless fat reduction and diabetes prevention.

In the right ones, it will spur additional research. DHEA is neither a weight-loss pill nor a hormonal fountain of youth. But some day, it may emerge as a way to help control some of the effects of middle-age weight gain.


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