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The similarity learn more in the structure of pregnane and that of P57 (found in H. gordonii) shows that C. auriculatum could be an alternative to H. gordonii in developing anti-obesity dietary supplementation (51). Wilfoside K1N is the most widely known pregnane glycoside, which bears great structural resemblance to P57 (51). An animal trial, involving rats, has demonstrated that Wilfoside K1N can produce a considerable appetite-inhibiting effect (51). The efficacy and safety of pregnane glycosides need to be further investigated, especially because, unlike H. gordonii, which may soon become an endangered species, C. auriculatum is an abundant plant source (50, 52). 3.1.7. Chitosan Chitosan is a polysaccharide extractable through the partial deacetylation of chitin (53). A non-toxic dietary supplement, Selleckchem Lapatinib Chitosan has been shown to bring about anti-obesity effects (54, 55) and is widely believed to be a safe compound (56). Its anti-obesity effects have been generally attributed to its fat-binding quality, which restricts the absorption of nutritional fat from the gastrointestinal tract (57). In vivo studies on mice indicate that the consumption of chitosan can lead to reduced food intake (58, 59). The effect of chitosan on obesity was evaluated through a review of fifteen randomized trials, with a total of 1219 subjects. Although initial analyses ascribed a considerable weight loss to the use of chitosan preparations (mean loss: 1.7 kg; 95%CI: 1.3-2.1 kg, P S6 Kinase the previous subliminal trials claimed. In fact, the anti-obesity effect of chitosan was deemed minimal at best and therefore clinically irrelevant (60). 3.1.8. Gambisan Gambisan is a newly developed extract formula which was designated as HH911G at Kyung Hee University and Korean Medicine Hospital, Seoul, South Korea (60). In spite of the fact that its mechanism of action is yet to be understood, Gambisan has been clinically used as a popular supplement, with over 2800000 prescribed doses from 2010 to 2013. Indeed, Gambisan may be able to offer an effective method of weight loss, though more in vivo investigations and clinical trials are required before any indisputable conclusions are to be drawn, concerning the safety, effectiveness, and the mechanisms of action of Gambisan (61-63). In conclusion, herbal supplements are widely marketed and commercialized, yet the evidence in support of their effectiveness is either non-existent or point to a negligible effect. This should be viewed in light of their possible side effects and lack of proof of their long-term safety. 3.2. Acupuncture A longstanding oriental practice, acupuncture consists of the insertion of needles into certain points on the skin, called acupoints (64). Over the recent years, this technique has come to be increasingly regarded as an alternative treatment for obesity.