Hoodia gordonii: To eat, or not to eat

Ethnopharmacological relevance: Hoodia gordonii (family Apocynaceae) has become known globally for its claimed effect of appetite suppression. Despite a relatively large body of evidence of the plant׳s chemical make-up, peer-reviewed studies to provide scientific information on physiological effects of Hoodia gordonii are relatively sparse. The role of the pregnane glycoside P57—commonly accepted to be responsible for appetite suppression—has been questioned recently. Furthermore, a variety of physiological side-effects associated with consumption of the plant in extracted form questions its suitability for consumption. Although adverse effects have been described before, the relative abundance of non-peer-reviewed data originating from patent documents and lay publication for advertising, which specifically only focus on beneficial outcomes, skews the view of the risk-benefit-balance. Here we provide a review of peer-reviewed studies on the plant׳s physiological effects. Novel data from an in vivo rodent study further elucidate the benefit-to-risk ratio associated with consumption. Conclusions: we conclude that although Hoodia gordonii seems to have a desired effect on appetite and weight loss, this effect may at least in part be a secondary symptom of the serious adverse effects that are associated with consumption of the high doses required to achieve therapeutic clinical effect. [Display omitted]