TODAY’S DOSE OF HONESTY

Can a colon cleanse help you lose weight?

Have you ever seen advertisements for “colon cleansing” to help with weight loss? Maybe it was for a colonic, which involves inserting a small tube (a hose, really!) into the rectum and flushing out the lower part of the colon with pressurized water. Does this have any benefit? Are there risks? Does it really work for weight loss? Here's your dose of honesty...

In my medical opinion, NO, it does not have any meaningful benefit; YES, there are definitely risks; and NO, it does not help with sustainable weight loss. 

Let's start with some mini-med school/anatomy 101. The portion of the colon that is "cleaned out" during a colonic is the descending colon—in other words, not a majority of the large intestine. This “service” produces a temporary emptying since the other parts of the colon are constantly pushing their contents (fecal matter, or poop) into the descending colon. Actually, the colon generally does not require “cleansing,” since it is, by its very nature, continually self-cleaning. So, at the very least, these cleanses may interfere with normal colon function: By introducing a large volume of water, a colonic may throw off the fluid balance in this delicate ecosystem.

As for the purported outcomes: While companies, clinics, and wellness centers market procedures and formulations—made with everything from herbal solutions to (yes) coffee grounds—by extolling the many benefits of colon cleansing, none of these are FDA-approved. And there is no scientific evidence that supports the health benefits of colon cleansing. Some studies have shown positive results for people who do colonics, but these have had small study populations or did not undergo proper peer review. Additionally, colonics are performed by people who are by and large NOT medical professionals. And there ARE potential dangers involved here. According to the Mayo Clinic, possible risks include:

• Less serious but still nasty side effects, such as cramping, bloating, diarrhea, upset stomach, and vomiting.

• Bleeding in the digestive tract and other more serious complications for those with colitis, a blocked intestine, or other bowel disorders.

• Losing too much fluid, leading to dehydration.

• A tear in the rectum, also called a perforation, caused by placement of the tube.

• Inflammation and/or infections due to introduction of foreign materials into the large intestine.

• A change in the balance of important minerals in the body called electrolytes, which can be especially dangerous for people with kidney or heart disease or other chronic conditions.

All of this discomfort and risk is unnecessary, since there are safer, cheaper, and easier options for anyone who hopes to achieve the same result. You could use a standard enema (always follow package directions), or put yourself on a clear liquid diet for a day or so. This means only drinking liquids that you can read print through, such as gelatin, clear chicken or vegetable broth, white soda or seltzer, ginger ale, or tea. For most people, staying well-hydrated and eating plenty of fiber-rich foods are enough to keep things moving properly through your digestive tract.

Bottom line: The material in our colon is NOT preventing us from losing weight. There definitely are people who suffer from chronic bowel/GI issues such as slow colonic transit time or constipation, and medically administered and/or monitored cleanses are indicated in these cases. But emptying the colon is not the answer to shedding pounds. The fact that so many people are tempted to undergo this potentially risky “therapy” without proven medical benefit is a powerful indication of how badly many of us want to lose weight. Remember: when something sounds too good to be true, it usually is. 

SYMPTOM SOLUTIONS

Behind the scenes: Dr. Jen’s makeup routine!

One of my Instagram followers asked recently if I use clean beauty products. I don’t, mainly because they’re not long-lasting, you can’t live in a bubble, and also because I use care with other things I put in and on my body. Instead, I look for quality products that look and feel good on my skin. And I am lucky to have a great expert to counsel me on all things beauty and makeup—my stylist at GMA, the fabulous Camille Zola! (@camillian13). I asked Camille to share some of the products she uses on my face, as well as her advice on how to use makeup to create a fresh, youthful look.

Here are Dr. Jen’s top 5 favorite beauty products:

1. Merit Great Skin Instant Glow Serum. When it comes to Jen’s “glowy” complexion, this product is the superhero! It instantly plumps and hydrates the skin, and over time, it protects the skin’s natural moisture barrier. Great with or without makeup. 

2. Charlotte Tilbury Invisible UV Flawless Primer. This has a broad-spectrum SPF 50 with no scent. Jen loves the high SPF and how it smoothes the texture of her skin. You can wear it alone without makeup. 

3. Charlotte Tilbury Wonder Glow Primer. I use this under Jen’s eyes prior to applying her foundation. It creates a soft, reflective glow—which means I can use less concealer. 

4. Makeup by Mario Softsculpt Transforming Skin Enhancer. This is a lightweight bronzing cream. I use it to contour and warm up Jen’s complexion. It’s easy to blend and buildable. 

5. Merit Day Glow Highlighter in Bounce. This is a rose-gold cream highlighter that I use on her cheekbones. It subtly contours her cheeks and gives her face a fresh, healthy, and youthful glow. 

Makeup can perform wonders for the 40-plus face, if you choose quality products and know how to apply them for best results. Here are my top 5 tips for achieving that dewy, natural look!

1. Less is more! Focus on skincare products that are lightweight with SPF. Tinted moisturizers are great for every day. 

 2. Natural lash extensions will open up your eyes, then you can ditch the mascara! If lash extensions aren’t for you, an eyelash curler and a few coats of mascara will really open up the eyes. 

3. Avoid powders. Go for glowy and creamy products. I love a cream blush and highlighter. Your skin will look youthful and hydrated. 

4. A little concealer goes a long way. Try applying your eye concealer in the inner eye area and on the outer corner to lift the eye. Avoid applying directly under the eye. This can look like you are wearing too much makeup and can draw more attention to fine lines. 

5. Hydrate your lips! Have fun and don’t be afraid to wear some color on your lips. I love a gloss in the center of the lip to create volume. 

❤️ Expert tip: Take a selfie in natural lighting. If you see harsh lines of makeup, make sure you are blending well. I love the brushes from Spectrum’s Katie Jane Hughes brush collection.

COMMUNITY

Could you be taking fake Ozempic?

Here’s a timeline: About 20 years ago, scientists and clinicians began to realize that the injectable drug semaglutide—otherwise known by its brand names Ozempic and Wegovy—actually helped people to lose fairly significant amounts of weight. Originally formulated for use in treating diabetes, semaglutide (in a class of drugs called GLP-1s) was now being prescribed off-label by doctors for overweight and obese patients. In 2021, Wegovy was formally approved by the FDA for “chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol).”

With the FDA’s approval came a superstorm of demand for these medications—a demand so great that, suddenly, patients like diabetics who truly needed the drug could not get access to it. This explosion in semaglutide’s popularity quickly led to limited supplies, shortages and, as has happened with breakthrough products in any industry, a new wave of counterfeits. Despite FDA warnings about the prevalence of fake substances, case reports from around the U.S. have revealed administration errors, unintentional overdoses, calls to poison control center hotlines, and visits to hospital emergency rooms in connection with the use of counterfeit products. 

This situation points to the larger issue of weight management in this country, at a time when the scale has become not just a measure of pounds but also one of wealth, health, and self-esteem. And it begs the question: How do you know if what you’re taking is real or fake? And what are the risks? I asked our Core Expert, pharmacist Dr. Christina Madison, to talk about this 21st century phenomenon, and what you need to know to stay safe.

What are the risks people take in using fakes?

• Purchasing any prescription medication from a non-healthcare professional or prescriber can be dangerous.

• If you’re getting the medication from a place other than a licensed pharmacy, you won't be able to verify the contents of the medication, or if it actually contains the active ingredients you’re paying for.

• They may contain some of the product but might also include "fillers" to extend the supply they have in stock.

• This is an injectable medication, so it's also a potential infection risk if it’s not properly prepared and if clean injection supplies are not included with the prescription. 

What are the most prevalent sources of fakes?

• Medi-spas are gaining access to “like” medications, or if they have the true medication, they may only be providing clients with a partial dose. Depending on the level of obesity and the dosage being used, some people may require multiple injections to get an adequate dose. This may not be supervised properly in a medi-spa or wellness center setting. A licensed healthcare professional familiar with weight loss should be overseeing this therapy.

• There are ads circulating online for “semaglutide-like" medications that can be delivered right to your door without having to see a healthcare provider. You just answer a few simple questions to see if you qualify. This is highly unadvisable.

• Some of these online providers, such as compounding pharmacies, are legitimate, but you need to do your homework to determine if there is a licensed healthcare provider evaluating your profile and making sure you are using the medication safely. Both your medical history and medication history must be reviewed to determine if you are at high risk for experiencing severe side effects from the medications or if you are currently taking medications that may interact with GLP-1s.  

So, how can people considering weight loss drugs stay safe? 

• It's best to start with your healthcare professional or primary care provider.

• You can also speak to your local pharmacist, who can help connect you with a healthcare professional who is prescribing GLP-1s for weight loss in combination with a weight management plan that includes diet and exercise.

• You will need more than one medical visit to determine if you are tolerating the medication well.

• You can do this with a telehealth visit, but these checks should not be done exclusively online. Severe side effects include pancreatitis, gallbladder problems, changes in vision, hypoglycemia, and kidney problems, so in-person physical monitoring is key.

Our Core Expert

Christina Madison, Pharm.D., F.A.A.C.P., is a clinical pharmacist specializing in infectious disease and gender-based health. She is the founder of The Public Health Pharmacist, a consulting firm specializing in healthcare communication and media and branding strategy. She is based in Las Vegas. @thepublichealthpharmacist

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ABOUT DR. JEN

In her roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—shares the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has written several books, including the best-selling The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

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