Study: Ashwagandha helps with stress-related weight gain

reference

Choudhary D, Bhattacharyya S, Joshi K. Body weight management in adults under chronic stress by treatment with ashwagandha root extract: a double-blind, randomized, placebo-controlled trial. J Evidence-based complementary alternative med. April 6, 2016. pii: 2156587216641830. [Epub ahead of print]

design

The aim of this 8-week double-blind, randomized, placebo-controlled study was to evaluate the safety and effectiveness of a standardized ashwagandha extract for weight control and improvement of general well-being in adults with chronic stress. At baseline and at the end of 4 weeks and 8 weeks, subjects were assessed for the primary outcome measures listed below.

Participant

Individuals were selected from several outpatient clinics in Pune, India to address stress and obesity. Inclusion criteria were chronic/daily work stress, a Perceived Stress Scale (PSS) of 20 or more, age between 18 and 60 years, and body mass index between 25 and 39.9 kg/m2. Exclusion criteria were eating disorders; Participation in a weight loss program in the past 3 months; and endocrine or genetic condition predisposing to weight gain; a neurological disorder; any unstable medical condition; known allergies/side effects to ashwagandha root extract; pregnancy or breastfeeding; medications that affect weight; Participation in another clinical trial in the last 3 months; history of alcohol abuse or smoking; and unstable hepatic, renal, cardiovascular or respiratory disease.

The majority of people in both groups were employed (72% Ashwagandha; 68% placebo). The others were identified as either students or housewives. All subjects had chronic stress symptoms, and the majority had difficulty concentrating and insomnia. About 44% of the ashwagandha group and 52% of the placebo group had problems with anxiety and restlessness. Other significant symptoms included physical fatigue, mental fatigue and headaches.

A total of 38 men and 14 women were included in the study and randomly assigned to one of the two groups. One from each group was noncompliant with the protocol. Data for the remaining 50 were then evaluated.

intervention

Subjects received either a standardized extract of ashwagandha root extract (300 mg, containing 5% withanolides) or a placebo twice daily for 8 weeks.

Primary outcome measures

The primary outcome measures were the PSS and the Food Cravings Questionnaire-Trait (FCQ-T). Secondary outcome measures included the Oxford Happiness Questionnaire (OHQ), the Three-Factor Eating Questionnaire (TFEQ), serum cortisol levels, initial and final body weights, and BMI. The PSS, a measure of psychological stress, is a 14-point scale that assesses general stress experienced in the previous month. Scores range from 0 to 56, with higher scores representing higher stress. The PSS assesses physical and psychological symptoms of depression, need for health services, social anxiety, and life event scores that are correlated. The FCQ-T is a 39-item self-report questionnaire used to measure food cravings in 9 domains. The QHQ consists of 29 questions measuring happiness, well-being and optimism. Serum cortisol levels are an indicator of stress and are also associated with appetite. In this study, cortisol represents a measure of the anti-stress effects of ashwagandha in individuals experiencing chronic stress. The TFEQ questionnaire is used to determine eating behavior and evaluate cognitive restraint, uncontrolled eating and emotional eating.

Key insights

The mean PSS score decreased in both the treatment and placebo groups, but the treatment group experienced a significantly greater reduction in PSS scores than the placebo group at week 4 and even more at week 8. The mean FCQ “planning score” was lower in both groups, but was significantly lower in the treatment group than in the placebo group at the end of weeks 4 and 8. The FCQ positive reinforcement score at week 8 was significantly lower in the treatment group than that in the placebo group. The mean “negative reinforcement” FCQ scores of the treatment group showed no significant difference compared to placebo at weeks 4 or 8. Finally, the mean FCQ wounds showed a significant reduction from baseline and compared to placebo due to lack of control, emotion, and environmental, although thoughts about food, physiological, and guilt components did not show significant differences compared to placebo showed.

Of the secondary outcomes, serum cortisol and weight loss are the most interesting from a clinician's perspective. Mean serum cortisol levels, which were equal in both groups at baseline, were reduced significantly more in the treatment group at week 4 (16.05%) and week 8 (22.2%). After 8 weeks, the ashwagandha group had a greater reduction in body weight compared to the placebo group (3.03% vs. 1.46%).

comment

Briefly, after 8 weeks, ashwagandha was more effective than placebo in reducing PSS, several aspects of food cravings (but not thoughts about food or guilt), and uncontrolled and emotional eating (but not cognitive restraint). Reductions in body weight, BMI and serum cortisol were also observed in these stressed individuals who took ashwagandha standardized to 5% withanolides and 300 mg twice daily for 8 weeks. Previous research and decades of observations of ashwagandha users and prescribers strongly support its therapeutic influence against stress and anxiety. The results of the current study reinforce these reports and observations and take the evaluation several steps further, with the added feature of weight loss in individuals living with chronic stress. From this study, we can expand our previous knowledge about ashwagandha and confirm its ability to reduce psychological and physiological stress markers, improve well-being, reduce serum cortisol, reduce food cravings, improve eating behavior, and promote weight control in men and women under chronic stress. Longer-term studies would provide further insights.