Restrictive surgeries work by shrinking the size of the stomach and slowing down digestion. A normal stomach can hold about 3 pints of food. After surgery, the stomach may at first hold as little as an ounce, although later that could stretch to 2 or 3 ounces. The smaller the stomach, the less you can eat. The less you eat, the more weight you lose.
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Bitter orange is a currently available herbal stimulant used in some weight-loss supplements and is often called an ephedra substitute. The active ingredient in bitter orange has chemical properties and actions that are similar to ephedra and may be associated with similar adverse effects. Because of limited research and the use of bitter orange in multi-ingredient supplements, the safety of the product isn't well-understood.
A somewhat less extreme version is biliopancreatic diversion with a duodenal switch, or “the duodenal switch.” It's still more involved than a gastric bypass, but this procedure removes less of the stomach and bypasses less of the small intestinethan biliopancreatic diversion without the switch. It also makes dumping syndrome, malnutrition, and ulcers less common than with a standard biliopancreatic diversion.
The Keto diet emphasizes weight loss through fat-burning. The goal is to quickly lose weight and ultimately feel fuller with fewer cravings, while boosting your mood, mental focus and energy. According to Keto proponents, by slashing the carbs you consume and instead filling up on fats, you safely enter a state of ketosis. That’s when the body breaks down both dietary and stored body fat into substances called ketones. Your fat-burning system now relies mainly on fat – instead of sugar – for energy. While similar in some ways to familiar low-carb diets, the Keto diet’s extreme carb restrictions – about 20 net carbs a day or less, depending on the version – and the deliberate shift into ketosis are what set this increasingly popular diet apart.
Orlistat can cause bothersome gastrointestinal side effects, such as flatulence and loose stools. It's necessary to follow a low-fat diet when taking this medication. Orlistat is also available in a reduced-strength form without a prescription (Alli). Rare cases of serious liver injury have been reported. However, no cause-and-effect relationship has been established.