Overview
Caralluma fimbriata is a succulent plant native to India, Africa, Saudi Arabia, and Southern Europe. It has a long history of traditional use as a natural appetite suppressant and thirst quencher among indigenous populations. Belonging to the Apocynaceae family, this cactus-like plant thrives in hot and dry regions and has been an integral part of Indian Ayurvedic medicine for centuries. Its purported health benefits focus primarily on weight management to blood sugar control and associated cardiometabolic effects.
But is there any clinical research to support these claims? This updated 2024 Caralluma review will evaluate the existing peer-reviewed scientific evidence on its effects on obesity and cardio metabolic outcomes.
What is Caralluma fimbriata?
Chemical analyses of Caralluma species have identified numerous health-promoting phytonutrients like pregnane glycosides, flavonoid glycoside, flavones, magastigmane glycosides, pregnane steroids, steroidal glycosides, saturated and unsaturated hydrocarbons, aromatic and nonaromatic volatile compounds, and β-sitosterol.
Accordingly, Caralluma has been used as a traditional remedy for the treatment of a multitude of conditions, including rheumatism, diabetes, leprosy, paralysis, and inflammation, and may also have antimalarial, antitrypanosomal, anti-ulcer, antioxidant, antinociceptive, and antiproliferative activities.
In particular, the pregnane glycosides found in caralluma are similar to those identified in African Hoodia Gordonii which is reported to have anti-obesity and appetite-suppressant effects (and used by indigenous hunters to suppress hunger and appetite and improve stamina).
Caralluma fimbriata scientific evidence
Kuriyan et al., 2007
Overview
In a 2007 randomised controlled trial to examine the effect of Caralluma extract on overweight individuals, 50 men and women, aged 25 to 60 years with a BMI greater than 25 kg/m2, were split into two groups: one receiving a daily dose of 1 g of Caralluma extract for 60 days, and the other receiving a placebo. Both groups were given standard advice on diet and exercise. Blood glucose and lipids, anthropometric measurements, dietary intake and assessment of appetite were evaluated after 30 days and 60 days.
Results
After 30 days
While there wasn’t a significant difference in weight loss between the two groups, those taking the Caralluma extract experienced a larger reduction in waist circumference and reported feeling less hungry compared to the placebo group. Though not statistically significant, there was also a trend towards a greater decrease in body weight, body mass index, hip circumference, body fat and energy intake between assessment time points in the experimental group.
Conclusion
These results suggest that Caralluma extract has potential in curbing appetite and reducing waist circumference over a two-month period.
Kamalakkannan et al, 2010
In a 90-day rodent study in the Journal of Nutrition and Metabolism, Kamalakkannan and colleagues evaluated the anti-obesity and anti-atherogenic effects of Caralluma fimbriata (CFE) extract on male Wistar rats randomly divided into three groups: (1) untreated control (C), (2) control for cafeteria diet (CA), and (3) cafeteria diet fed + CFE treated.
Caralluma fimbriata extract was administered at three doses (25, 50, 100 mg/kg of body weight per day). The anti-obesogenic effects of CFE were evaluated by monitoring changes in feed intake, body weight, serum lipid and hormonal (leptin) profiles, fat pads, and liver weight. Anti-atherogenic effects were measured by histology.
Results
CFE induced significant and dose-dependent inhibition of food intake, with dose-related prevention of gains in body weight, liver weight, and fat pad mass. Alterations in serum lipid profiles associated with weight gain were similarly inhibited, as were the typical increases in serum leptin levels.
Conclusion
These findings support CFE’s reported anti-obesity effects. CFE treatment also conferred protection against atherogenesis.
Astell et al, 2013
Overview
In a 12-week randomised, double-blind, placebo-controlled pilot study, 33 adults aged 29-59 years with a body mass index of at least 25 kg/m2 or a waist circumference >94 cm (male), >80 cm (female) were orally administered 1g/day of Caralluma fimbriata or an inert placebo. The primary outcome measure was the decline in waist circumference.
Results
After 12 weeks
- The experimental group had lost 6.5 cm compared to 2.6 cm loss in the placebo group (Difference: -3.847; 95% CI; -7.466 to 0.228).
- There was a reduction of 0.03 in waist-to-hip ratio (WHR) in the Caralluma group compared to a 0.01 decrease in the placebo group (Difference: -0.033; 95% CI; -0.064 to -0.002).
- There was a significant decline in the palatability (visual appeal, smell, taste) of the test meal and sodium intake in the experimental group at week 12 (p < 0.05).
- There was a significant reduction in body weight, BMI, hip circumference, systolic BP, HR, triglyceride levels, total fat and saturated fat intake within both groups following the intervention period (p < 0.05).
Conclusion
These results suggest supplementation with C. fimbriata extract whilst controlling overall dietary intake and physical activity may potentially play a role in curbing central obesity, the key component of metabolic syndrome.
Medialdea, et al, 2015
Overview
In a 2015 study of 44 (25 pre-menopausal; 19 post-menopausal) women aged 35 to 62 with a body mass index of 25 kg/m2 consumed a product containing 3g/day of Caralluma fimbriata for 2 months (60 days). Height, weight, waist and hip circumference, subcutaneous skinfolds, body fat via bioimpedance analysis, blood cholesterol, glucose, and blood pressure were assessed at baseline and endpoint.
Results
After 2 months
- Overall, 52.78% of participants lost weight (average weight loss of 1.86 kg).
- Pre-menopausal women had significantly decreased the thickness of their biceps (3.3mm), subscapular (2.5mm) and suprailiac (3.1mm) skinfolds.
- Post-menopausal women had reduced their biceps (1.2mm), triceps (2.3mm), subscapular (2.0mm) and suprailiac (3.1mm) skinfolds and had increased their trunk muscle mass (0.5 kg).
- In both groups the amount of women classified with abdominal obesity by means of waist-hip ratio decreased.
- There were also reductions in blood pressure, cholesterol, and glucose.
Conclusion
A dietary supplement containing 3g/day of Caralluma fimbriata may aid in the treatment of central obesity and prevention of metabolic syndrome in women. However, as there was no placebo group, larger trials controlling for diet and activity are needed to verify its efficacy.
Arora et al, 2015
Overview
In a 2015 prospective, randomised, placebo-controlled trial, 89 overweight and obese participants were randomised to receive 1g/day of Caralluma fimbriata extract (n = 47) or placebo (n=42) for 12 weeks. Body weight, body mass index, waist circumference, hip circumference, waist hip ratio, appetite, biochemical investigations and other safety parameters were assessed at weeks 4, 8, and 12.
Results
After 12 weeks
Body weight, body mass index, waist circumference, hip circumference and waist hip ratio in overweight and obese individuals were not significantly different between groups after 12 weeks (P ≥ 0.05). There were no differences in appetite between CFE and placebo groups. There were no significant changes in the biochemical and clinical parameters in both the test and placebo group. CFE was well-tolerated and adverse events noted were mild and transient in nature.
Conclusion
There were no significant differences in the clinical and biochemical parameters or appetite in participants receiving 1g/day of Caralluma Fimbriata extract compared to a placebo group. However, CFE was well tolerated.
Cabrera-Rode et al, 2017
Overview
In a 2017 open-label pilot study of 40 overweight and obese participants aged 23 to 60 years with a body mass index of 25-44 kg/m2 took 3g/day of a dietary supplement (Obex®) containing Caralluma fimbriata extract for 3 months. Participants were divided into two groups: 20 participants with impaired fasting glucose [IFG] and 20 with normal glucose levels. Anthropometric measures and blood pressure (BP), fasting plasma glucose, lipid profile, insulin, creatinine, and uric acid were assessed. Insulin resistance (HOMA-IR) and beta-cell function (HOMA-B) were assessed.
Results
After 3 months
- Obex significantly reduced body weight, body mass index, waist circumference, waist/hip ratio, and waist/height ratio in both groups of participants (p <.05) compared to baseline.
- Obex improved HDL-c (high-density lipoprotein cholesterol) (p <.0001) and lowered BP (p <.05) in participants without impaired fasting glucose.
- Participants with IFG showed a reduction in fasting glucose concentrations (p <.0001) and improved insulin sensitivity and HDL-c (p <.05).
Conclusion
Obex contributed to weight reduction, improved glucose tolerance and insulin sensitivity, as well as HDL-c, and appears to be safe in overweight/obese adults with impaired fasting glucose. However, as Obex has a combination of ingredients, it is not known to what extent these results are directly attributable to Caralluma, other ingredients, or a combination of all ingredients.
Rao et al, 2021
In a 2021 double-blind, randomised, placebo controlled trial to examine the effect of a Caralluma Fimbriata extract (CFE) on biomarkers of satiety and body composition in overweight adults, 83 men and women with a mean age of ~40 and a body mass index of ~30 kg/m2 completed 16 weeks of daily supplementation with either CFE or placebo.
Plasma cardiometabolic (lipid profile, glucose, insulin) and satiety (ghrelin, leptin, neuropeptideY) biomarkers, body composition, diet history and gastrointenstinal function were assessed at baseline, weeks 4, 8, 12 and 16.
Results
After 16 weeks:
- Plasma leptin concentration in the CFE group remained stable (0.05 ± 4.69 ng/mL) while it increased in the placebo group (2.27 ± 4.80 ng/mL) (p = 0.04).
- The CFE group also had a significant reduction in calorie intake compared to the placebo group (245 cal vs 15.8 cal respectively p < 0.01).
- Waist circumference was significantly reduced by 2.7 cm with CFE compared to an increase of 0.3 cm in the placebo group (p = 0.02).
- There was a significant increase in body weight in the placebo group versus the CFE group (1.33 kg weight gain vs 0.37 kg weight loss respectively; p = 0.03).
- The placebo group also had a significant increase in fat mass, android fat mass, BMI and leptin compared to the CFE group (p = 0.04, 0.02, < 0.01 respectively).
Conclusion
These results show that CFE was effective at maintaining bodyweight during a non-calorie controlled diet compared to a placebo, but the physiological mechanism responsible for these effects is unclear and may be due to an increase in satiety receptor sensitivity.
Limitations to Caralluma research
The research on Caralluma fimbriata suggests that dosages ranging from 1 to 3 g/day may be safe and efficacious for reducing appetite, lowering body weight and other anthropometric measurements, improving blood biomarkers for diabetes and cardiovascular disease risk.
Limitations to the research include:
- Follow-up period – As most authors acknowledged in there discussions, it would be helpful to see longer-term studies (1 year or longer) to determine if these effects are sustainable. These would also be helpful for ascertaining long-term safety data.
- Control groups – Some studies did not have a placebo control group, so it may be difficult to draw firm conclusions.
- Combined ingredients – Some studies used Obex®, a combination supplement that contains Caralluma. It’s hard to know if the results obtained in these studies were due solely to Caralluma, other ingredients, or a combination of all ingredients working synergistically.
- Assessment methods – Numerous studies assessed body composition and anthropometric measures using technology which may be prone to error. It would be helpful to see studies on Caralluma using more sensitive equipment such as DEXA scanners for body composition.
- Animal studies – While results from animal studies are certainly suggestive and useful for generating hypotheses for what may occur in humans, they should not be taken alone as conclusive evidence.
Caralluma fimbriata safety considerations
Caralluma appears to be safe based on the existing research up to four months of use. We do not have firm long-term data (greater than one year) to make a conclusive statement of safety, or potential interactions between pregnane glycosides (Caralluma fimbriata’s active ingredients) and other supplements or medications. Moreover, we do not know if there is a subset of the population who may be at higher risk from pregnane glycosides.
Take home message
Caralluma fimbriata is an interesting supplement which may have some usefulness in reducing appetite and inhibiting weight gain. There is modest evidence in both humans and rodents which support these findings, however further research is warranted to more thoroughly evaluate Caralluma’s safety and effectiveness on a long-term basis.
Marketing claims that Caralluma fimbriata is a “magic bullet for weight loss” tend to neglect the practical limitations of the existing evidence. What occurs in a carefully controlled clinical environment during a research study may be quite different to free-living adults who are subject to other real world factors which could mitigate the effects of Caralluma (i.e., diet, exercise, background activity).
Ultimately, a healthy lifestyle which includes healthy eating and physical activity is our best weapon for losing fat and keeping it off. Caralluma fimbriata may aid in this process but should not be regarded as magic pill.
References
Kuriyan R, Raj T, Srinivas SK, Vaz M, Rajendran R, Kurpad AV. Effect of Caralluma fimbriata extract on appetite, food intake and anthropometry in adult Indian men and women. Appetite. 2007 May;48(3):338-44. doi: 10.1016/j.appet.2006.09.013. Epub 2006 Nov 13. PMID: 17097761.
Kamalakkannan S, Rajendran R, Venkatesh RV, Clayton P, Akbarsha MA. Antiobesogenic and Antiatherosclerotic Properties of Caralluma fimbriata Extract. J Nutr Metab. 2010;2010:285301. doi: 10.1155/2010/285301. Epub 2010 Dec 28. PMID: 21234320; PMCID: PMC3018644.
Astell KJ, Mathai ML, McAinch AJ, Stathis CG, Su XQ. A pilot study investigating the effect of Caralluma fimbriata extract on the risk factors of metabolic syndrome in overweight and obese subjects: a randomised controlled clinical trial. Complement Ther Med. 2013 Jun;21(3):180-9. doi: 10.1016/j.ctim.2013.01.004. Epub 2013 Feb 23. PMID: 23642949.
Medialdea, L, Bodas, I, Carmenate, M, Del Valle, A, Marrodán, M, Prado, C. Effectiveness of dietary supplementation with Caralluma fimbriata in metabolic syndrome reduction during climacteric period. Nutr. clín. diet. hosp. 2015; 35(1):56-62 DOI: 10.12873/351medialdea
Arora E, Khajuria V, Tandon VR, Sharma A, Mahajan A, Gillani ZH, Choudhary N. To evaluate efficacy and safety of Caralluma fimbriata in overweight and obese patients: A randomized, single blinded, placebo control trial. Perspect Clin Res. 2015 Jan-Mar;6(1):39-44. doi: 10.4103/2229-3485.148812. PMID: 25657901; PMCID: PMC4314845.
Cabrera-Rode E, Rodríguez J, Álvarez A, Echevarría R, Reyes AD, Cubas-Dueñas I, Turcios-Tristá SE, Díaz-Díaz O. Effects of Obex in Overweight and Obese Subjects With or Without Impaired Fasting Glucose: A Pilot Study. J Diet Suppl. 2017 Nov 2;14(6):626-639. doi: 10.1080/19390211.2017.1304482. Epub 2017 Apr 6. PMID: 28384000.
Rao A, Briskey D, Dos Reis C, Mallard AR. The effect of an orally-dosed Caralluma Fimbriata extract on appetite control and body composition in overweight adults. Sci Rep. 2021 Mar 24;11(1):6791. doi: 10.1038/s41598-021-86108-2. PMID: 33762661; PMCID: PMC7991653.
Stacey
Thursday 14th of March 2013
Thank you Bill. I heard about this pill on the View and I've been a little never about it. I have read the studies and appreciate your opinions.
Brett Roth
Sunday 3rd of June 2012
Hi Dr Bill: Very well-written summation, thanks! We're including CFE in a (liquid) chocolate diet stick product we're developing. While CFE doesn't have as much clinical data behind it as some of our other ingredients, it is an intriguing suppressant. Your review was as good a summation as I've come across: wonderfully balanced and informative. I like that CFE has been used by humans for centuries-- extensively-- to no harmful effect. A lot of ingredients can't say that. And, unlike Hoodia, it tastes decent, in case you don't have the protective sheath of a capsule. :-)
joe cannon
Friday 18th of May 2012
Bill, I can honestly say I have never heard of this before. Thanks for shedding light on it because it's probably only a matter of time before it makes its way to the US. Joe
Bill Sukala, PhD
Saturday 19th of May 2012
Hi Joe, You're right. I think it is already there, but it may not be on the mainstream radar yet. It seems every other year there is some sort of root or cactus popping up promising to curb appetite or stimulate metabolism. While this may technically be correct within the context of a scientific article, I think the extent to which it blunts appetite or increases metabolism in the general population may be different. Other lifestyle habits can possibly negate the potential benefits associated with such supplements (i.e., cutting back on cheeseburgers while continuing to smoke). Anyway, I think these types of supplements are interesting to study but consumers need to have the results framed appropriately so they can set realistic expectations. After all, the operative word is supplement, not substitute for a healthy lifestyle! Keep up the great work, Joe!
Cheers Bill