Diet pills, also called anti-obesity drugs, aim to allow weigh loss or weigh regulation by controlling the metabolism, suppressing appetite, or absorbing calories. However, most diet pills available are exploiting consumers through deceptive marketing using false claims that the product’s effectiveness and safety are supported by scientific evidence. Although fraudulent marketing is the main issue with over-the-counter diet pills, prescription diet pills usually carry similar risks. Scientific evidence for most products does not clarify their long-term effects, so it is not possible to guarantee safety when it comes to diet pills. Furthermore, research does not provide detailed insight for accountability of chemical compounds in diet pills for weight loss. In most cases, potential development of side-effects using anti-obesity drugs outweighs the potential results.
Most diet pills aim to exploit users psychologically by stimulating their desires using false promises. According to Dr. Aronne, fraudulent marketing in the weight loss industry is the most chaotic field because it lacks proper regulations, financially exploits people, demoralizes consumers, and offers promises without credible evidence that the product works (Weisbaum, 2007). Rimonabant is an example of a drug which blocks cannabinoid receptors in the brain to prevent cravings, so it was considered a universal drug that will stop all forms of addiction, including food, alcohol, and cigarette addictions (Anti-obesity drug, 2007). However, clinical studies showed that consumers lost only 5% of their weight that would come back once they stopped taking the drug (Anti-obesity drug, 2007). Furthermore, the drug was expected to have a positive effect on people with type 2 diabetes, but studies show that it might actually lead to complications and cause cardiovascular issues or strokes (Anti-obesity drug, 2007).
Besides synthetic chemical compounds, herbal remedies that promise fast weight loss also rely on fraudulent marketing by exploiting the desire to lose weight instantly. Ephedra and kava are examples of compounds that have been banned by the Food and Drug Administration (FDA) because they were associated with high blood pressure, arrhythmia, insomnia, anxiety, seizures, liver injuries, and other side-effects (Warner, 2005). Rather than supporting weight loss, herbal diet pills are usually ineffective, but most case studies show they can sometimes lead to irreversible damages (Warner, 2005). Both supplements have been removed from the market after 2002 when the Federal Trade Commission (FTC) implemented regulations that aimed to remove products that relied on deceptive marketing. In collaboration with the FDA, the FTC helps prevent advertising and sales of banned substances that are proven as harmful to health (Beales, 2002).
However, both over-the-counter and prescription drugs are still widely available even after the joint attempt of the FTC and FDA in 2002 to remove harmful substances from the market. One of the most common reasons for that condition on the market is because some substances reveal harmful side-effects only in post market evaluations. For example, the National Health Service (NHS) in the United Kingdom defends rimonabant, which is not approved by the FDA, because some arguments suggest that it is useful and safe when doctors prescribe it and when people do not have a clinical history of depression (Suicide risk fears, 2007). However, even substances, such as orlistat or sibutramine, which have been previously approved by the NHS, are currently questionable. According to the FDA (2010), twelve foreign reports stated that severe liver injury was caused by orlistat-based drugs, and one report within the U. S. stated a case of severe liver damage from an orlistat-based drug. Two patients died from liver failure, and three patients required liver transplantation (FDA, 2010). Drugs using that substance have been approved by the FDA, but the manufacturers are required to update the medication’s safety information (FDA, 2010).
Another reason why harmful diet pills are available is because they avoid listing prohibited ingredients or accurate amounts of weight loss substances. Cohen (2009) reports a case of diet pills imported from Brazil and sold in the United States which supposedly contained vitamin E, centella, senna, and other beneficial nutrients extracted from natural compounds. Although all listed contents were in compliance with dietary substances allowed and regulated by the FDA, a consumer’s urine drug screening showed increased amounts of amphetamine. After that incident, more than 140 dangerous and contaminated products have been indentified, but the FDA is concerned that it only represents a fraction of contaminated products (Cohen, 2009). In July 2009, the FDA reported another 75 weight loss products which contained undeclared medication. Further analysis showed that the products contained three times more sibutramine, a frequent stimulant found in diet pills, than it was recommended for daily allowance (Cohen, 2009).
Despite the obvious risks, exploitation, and public health warnings, weight loss pills are still in high demand. On the other hand, scientific research and case studies fail to develop or support the effectiveness and safety of diet pills. It would be safe to conclude that diet pills are too dangerous, and people should find alternative ways for losing weight. Furthermore, lack of information regarding molecular and physiological causes for obesity could be considered the reason why substances, such as orlistat or sibutramine, eventually cause negative outcomes. However, Bray and Greenway (1999) reject those conclusions as premature because obesity is a chronic disease, so it should be possible to treat it with drugs. Bray and Greenway argue that improving existing substances and treatments in compliance with the mechanism that cause obesity is required to improve treatment outcomes, minimize risks, and ultimately provide a cure for obesity (1999). Unfortunately, their argument is questionable. There are several chronic conditions that require regulation because there is no pharmacological cure for them, so it is not possible to make an accurate prediction that it will be possible to create a definite pharmacological cure for obesity.
Despite the amount of tragic reports on diet pill consumption outcomes, Bray and Greenway (1999) argue that the current level of understanding the regulation of body fat, presented in Figure 1, allows a higher proficiency in constructing effective and safe anti-obesity drugs. Furthermore, it allows healthcare professionals to identify three major factors for treating obesity. According to the feedback mechanism on storing fat, treatment strategies should focus on reducing energy intake, shifting the metabolism, and increasing energy expenditure (Bray & Greenway, 1999). Despite their optimistic perspectives on the future of anti-obesity drug research, both historical and contemporary evidence suggests that every new trend eventually proves to be temporary and dangerous.
While some researchers hope for and anticipate positive breakthroughs in anti-obesity medication, others do not test the effectiveness of diet pills, but they focus on psychological needs and behavioral patterns that could influence an individual’s need for diet pill abuse. Statistics show that 80 percent of the world population relies on herbal medication, but most of them use over-the-counter products without considering their medical condition, their medical history, or professional advice (Dara, Hewett, & Lim, 2008). Dara et al. (2008) provide several cases in which users of a popular herbal weight loss supplement, namely Hydroxycut, have suffered from severe liver damage. Because clinical evidence denies any correlation between a patient’s medical history and the development of hepatoxicity after using Hydroxycut, researchers argue that diet pills are the main cause of liver damage (Dara et al., 2008). Previously popular anti-obesity drugs, such as Leptoprin, Adipokinitex, or Ephedrasil, have all been banned because of their associations with liver injury (Dara et al., 2008). With contemporary and historical examples of negative outcomes in mind, understanding the psychological necessity for diet pill consumption is the primary focus of most researchers.
Diet pills are currently under high regulations because of their lack of credibility and extent of previous fraudulent activity. The current situation indicates that both pharmacological, regulatory, and presentation issues exist. Evidence obviously shows that diet pills are both physiologically and psychologically hazardous to health and well-being. Medication such as Ma Huang, has been considered responsible for cardiovascular disorders and deleterious CNS (Dara et al., 2008). Diet pill abuse suggests traits that are usually considered risk factors for mental disorders, including trait anxiety, anxiety disorders, eating disorders, and substance addiction (Reba-Harrelson et al., 2008). Furthermore, it encourages other forms of addictive and self-harming behavior, such as drug abuse, suicide attempts, and suicide ideation (Neumark-Sztainer, Story, Dixon, & Murray, 1998). The availability of questionable diet pills on the internet is still an issue of false presentations. For example, advertising the human Growth Hormone (hGH) on the internet as an anti-aging panacea and a completely risk-free weight loss substance was a common practice, so the FTC had to respond with fines between $250,000 and $500,000 for deceptive advertising (Perls, Reisman, & Olshansky, 2005).
The amount of issues concerning diet pills indicates that strict regulations are only a partial solution to preventing negative outcomes of diet pill abuse. Physicians are required to engage in extensive patient education about obesity, weight loss, and diet pills. All diet pill users need to be aware of risks when they obtain diet pills from unreliable sources or engage in diet pill consumption without seeking clinical advice. The FTC, FDA, NHS, and healthcare professionals are all aware that magic bullets do not exist to any solution, but patients often hope for a magic bullet with each new diet pill released on the market. Despite the efforts to educate the public that magic bullets do not exist, the popularity of dangerous and questionable over-the-counter diet pills remains high. Rather than forcing more regulations, patient education on evaluating information sources and potential risks associated with diet pills should be the priority for preventing negative outcomes caused by inconsiderate diet pill consumption.
References
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Beales, J. H. (2002, October 8). Prepared statement of the Federal Trade Commission. Retrieved from http://www.ftc.gov/os/2002/10/dietary_testimony.htm
Bray, G. A., & Greenway, F. L. (1999). Current and potential drugs for treatment of obesity. Endocrine Reviews, 20(6), 805-875. doi:10.1210/er.20.6.805
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Suicide risk fears over diet pill. (2007, June 15). BBC News. Retrieved from http://news.bbc.co.uk/2/hi/health/6755665.stm
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Warner, J. (2005). The skinny on diet scams: Experts weigh in on the top 5 diet scams and how to avoid them. WebMD. Retrieved from http://www.webmd.com/diet/features/skinny-on-diet-scams
Weisbaum, H. (2007, January 15). Diet pill fraud: ‘Just the tip of the iceberg.’ MSNBC. Retrieved from http://www.msnbc.msn.com/id/16491430/ns/business-consumer_news/t/diet-pill-fraud-just-tip-iceberg/#.T04hf_XFvIU
