When Emma Hackett stepped on the scales during a health check last September, she was dismayed by the number staring back at her.
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she → step → her
Weight gain had crept up on the mother-of-four after menopause, and at 5ft 5in and 14 stone, her BMI was 32.6 – putting her in the obese range.
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BMI → creep → range
'When I had my children, I tried Weight Watchers and a 'keto' low-carb, high-fat plan,' says Emma, 54, an assistant manager from West Sussex.
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Emma → have → Sussex
'But even though I lost weight and was pleased with it, I couldn't keep it off.
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I → lose → it
Once I hit 50, it became very difficult to lose any weight at all.
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it → hit → weight
'None of the things that I used to do worked and my weight was just going up and up.'
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weight → use → that
After seeing the dramatic weight-loss transformations achieved with prescription drugs such as Mounjaro and Wegovy, Emma considered joining the estimated 1.6 million adults in Britain using weight-loss medication.
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Emma → see → medication
But concerns about potential side effects put her off.
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concerns → put → her
Instead, while searching online for other options, she came across Elcella, a £160-a-month dietary supplement developed by scientists at Queen Mary University of London.
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she → search → London
Emma Hackett, 54, from West Sussex, before her 2 stone weight loss (left), and after (right)
Its makers claim that a combination of linseed, coconut and MCT oils stimulates the gut to release GLP-1 and peptide YY – hormones involved in signalling fullness to the brain – helping users eat less.
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users → claim → less
The premise is superficially similar to the mechanism exploited by blockbuster weight-loss drugs, although the products are very different.
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products → exploit → drugs
Mounjaro and Wegovy are prescription medicines that act directly on hormone receptors and have been tested in large clinical trials.
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that → act → trials
Elcella, by contrast, is sold as a food supplement and can be bought without a prescription.
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Elcella → sell → prescription
And there is not yet comparable evidence that taking it produces substantial, sustained weight loss.
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taking → be → loss
That makes Emma's experience intriguing – but also difficult to interpret.
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experience → make → ?
She began taking Elcella in November and says that for the first two months virtually nothing happened.
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nothing → begin → months
'By January, I noticed I had lost a good few pounds,' she says.
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she → notice → pounds
But then suddenly, I noticed I had stopped snacking.
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I → notice → ?
At around the same time, however, Emma made significant changes to both her diet and activity levels.
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Emma → make → diet
Previously, although she ate a largely vegan diet with plenty of fruit and vegetables, she regularly grazed on bags of crisps while watching television.
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she → eat → television
She began walking two miles four or five times a week and strength training twice a week.
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She → begin → miles
She also cut back on ultra-processed foods, replacing them with meals based around foods such as oat bran, pulses and beans.
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She → cut → bran
By April, she had lost another stone.
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she → lose → stone
It is therefore impossible to know how much – if any – of Emma's weight loss was caused by Elcella rather than the substantial lifestyle changes she made after starting it.
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she → know → it
There is another complication: in May, after six months, Emma stopped taking the supplement.
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Emma → be → supplement
She continued losing weight.
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She → continue → weight
By the end of July she was down to 12 stone and today weighs 11st 12lb – more than two stone below the weight recorded at her health check last September.
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she → weigh → check
Elcella capsules contain just three ingredients, linseed oil (also known as flaxseed oil), coconut oil and MCT oil, which is also derived from coconuts
Emma is a keen walker and is pictured on a hike in Derbyshire in April 2024
Emma nevertheless believes taking Elcella helped her break her old eating habits.
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her → contain → habits
'Even after I've stopped taking Elcella, I haven't been snacking as much,' she says.
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she → stop → Elcella
'I've been quite regimented with my mealtimes and in the evening, I'll have a square of dark chocolate rather than sitting with a big packet of crisps.'
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I → have → crisps
Elcella claims that in its clinical studies, people taking the supplement cut their calorie intake by 18 per cent and lost an average of 1st 1lb in 12 weeks, with no side effects reported.
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effects → claim → weeks
The supplement's inventor, Dr Madusha Peiris, of Queen Mary University of London, says: 'The tragedy of obesity is that you lose much of your ability to tell when you're full.
'
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you → say → ability
But we found a combination of nutrients that triggers hormones that control appetite, so you eat less and lose weight.
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you → find → weight
However, these findings do not provide anything like the weight of evidence behind prescription weight-loss drugs.
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findings → provide → drugs
Experts point out that Elcella has not undergone the large-scale, independent, gold-standard clinical trials that would be needed to establish whether the supplement itself causes significant and sustained weight loss.
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supplement → point → loss
That distinction is particularly important in cases such as Emma's, where taking the supplement coincided with substantial changes to diet and exercise.
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taking → take → diet
Previous products marketed as 'natural' weight-loss aids have also frequently failed to live up to their claims when subjected to rigorous testing.
And simply believing that a treatment will suppress appetite may itself influence eating behaviour – making it difficult to disentangle any biological effect of a supplement from changes in habits and expectations.
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it → market → habits
'It's great to hear that someone found one of these natural supplements helped them with weight-loss, but one person's story is not the same as evidence from a medical trial involving thousands of patient,' says Dr Philippa Kaye, a London-based GP.
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Kaye → hear → patient
'It's also important that patients always speak to their GP or pharmacist first before taking a new supplement.
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patients → speak → supplement
For Emma, however, the distinction matters less than the result.
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distinction → matter → result
…and 4 more, not listed.
The Aporia
