People swear by apple cider vinegar for weight loss. Does it actually work?

There is no magic bullet for weight loss.

My main job as an emergency physician is to rule out life-threatening causes of what brings people to the ER. But I value those rare opportunities during a quiet shift to talk with patients about proven dietary or exercise regimens they could adopt to improve their overall health.

A lot of my patients don’t have a primary care doctor, can’t get an appointment or lost their job and health insurance during the pandemic; their ER visit is one of the few times they can ask a doctor their burning lifestyle questions.  

Recently, a patient asked me about apple cider vinegar pills. He’d read on the Internet that they help with weight loss. Apple cider vinegar is proven to control blood sugar spikes in some type 2 diabetics and reduce LDL cholesterol. But does the science support it as a weight loss method?

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Apple cider vinegar is made from apples that have been processed, distilled and fermented. Acetic acid is the active ingredient in apple cider vinegar (as in all vinegars) and is likely the driver of any health benefits. But its acidic nature and high potential for damage to tooth enamel and GI tract lining if consumed undiluted in large quantities likely limits both research studies and widespread use. This has not stopped supplement manufacturers from packaging it into pills, perhaps to make it more palatable to consumers.

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Scientific studies on apple cider vinegar’s ability to help with weight loss are limited. In one small study, 39 participants who took 2 tablespoons of apple cider vinegar daily lost 3-4 pounds at the end of 12 months. In a larger study of 175 overweight participants who were given 2 tablespoons of regular vinegar daily, researchers observed a similar weight loss of 2-4 pounds. While significant, such meager results pale in comparison to other proven diets, exercise and weight loss programs.

Anecdotally, some patients report that including a tablespoon of diluted apple cider vinegar in their diet makes them feel fuller faster and reduces snack cravings between dinner and bedtime. A small study claimed that the level of satiety (feeling full) was related to amount of acetic acid consumed. So perhaps apple cider vinegar helps with weight loss through appetite suppression? But until we have more solid research, the jury is out.

Certainly, other vinegars like balsamic and wine vinegars have long been an important part of the Mediterranean diet. In addition to helping diabetics avoid post-meal sugar spikes, one of the best studied benefits of vinegar is its anti-oxidant ability to control or lower LDL cholesterol. If your doctor advises adding vinegar to your diet, try using it safely in a dressing for salads, for example, and be sure to dilute it to 3 parts olive oil to 1 part vinegar.

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A nutritious diet with daily exercise remains the cornerstone of a scientifically proven weight loss program. It’s certainly not as easy as popping a pill, but the rewards start immediately and pay dividends for your health for years.

And if you are looking for an alternative to cardio, consider strength training like weightlifting to help you burn that unwanted fat. Compared to the scant scientific data on apple cider vinegar, consider a recent analysis of 58 studies totaling 3,000 research participants who were followed in strength training programs for an average of five months. Researchers found that on average, participants lost 1.4% of their total body fat, a much more significant and desirable result for those looking to lose weight.

And remember: There is no magic pill for healthy weight loss. Be skeptical of any claim otherwise

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Michael Daignault, MD, is a board-certified ER doctor in Los Angeles. He studied Global Health at Georgetown University and has a Medical Degree from Ben-Gurion University. He completed his residency training in emergency medicine at Lincoln Medical Center in the South Bronx. He is also a former United States Peace Corps Volunteer. Find him on Instagram @dr.daignault