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DANGEROUS DIET AND WEIGHT LOSS PRODUCTS (Part II): As the Number of Weight Loss Aids Increases, so do the Risks to Consumers.

Nov 1, 2003 In last month’s Newsletter, we discussed the dangers associated with two specific products, Meridia brand diet pills and PPA (phenylpropanolamine) as an ingredient in dietary aids. This month’s Newsletter deals with the dangers found in a broad array of diet pills and “gimmicks” including: supplements, herbal teas, fat burners, Asian diet pills, chromium picolinate, chitosan, pyruvate, guarana, laxatives, and diuretics. We have also included an update with respect to Ephedra (see previous Newsletters from August 2002 and October 2003).

Miscellaneous Diet Pills: What you need to know.

Today, there are many prescription and non-prescription (Over-The-Counter [“OTC”]) weight loss drugs available to the public. The problem with most of them, however, according to numerous studies is threefold: (1) they do not appear to promote the significant degree of weight loss required by many individuals; (2) they do not provide a realistic long-term plan to prevent the regaining of weight already lost; and (3) they come with a host of mild to severe side-effects.

In addition, no one should expect any drug alone to act as a total solution to weight-related problems. Healthy and sensible eating habits as well as regular exercise should always accompany any weight loss plan. Anyone with a weight problem who is considering a regimen of either a prescription or OTC diet drug should consult their physician first. This is all the more necessary if the individual involved suffers from one or more complicating factors such as heart disease, diabetes, high blood pressure, or elevated cholesterol. It is also important to consider that a diet drug’s effect will vary from person to person.

Xenical

Xenical, or Orlistat, is an FDA-approved lipase inhibitor (fat blocker) prescribed to patients who are 30% over their recommended weight to assist with weight loss under controlled conditions. When a lipase inhibitor is used, fat from food can only be absorbed into the body after being digested by lipase enzymes. This prevents intestinal absorption of fat by 30 percent. These weight loss drugs do not affect brain chemistry and, therefore, haves minimal systemic side effects. There are, however, several side effects which can be quite uncomfortable and embarrassing. They include abdominal cramps or pain, diarrhea, fatigue, fatty or oily stool, fecal urgency, gas or incontinence, oily discharge, vaginal discomfort and vomiting.

Studies have shown that people who use Xenical can actually lose about 10% of their initial weight within the first year by sticking to the recommended dosage, which is three capsules a day, and a low-fat diet. The FDA recently approved Xenical as well as Meridia for use by children with weight problems. Significantly, the long-term effects of these drugs on children’s growth and development have yet to be determined.


Adipex and Ionamin

Adipex and Ionamin are prescription-only appetite suppressants designed to affect neurotransmitters in the brain by decreasing appetite-related cravings. These drugs are highly addictive and should only be used for short-term weight management by individuals who do not have a history of drug dependency or abuse. Some side effects of Adipex and Ionamin include dry mouth, sleeplessness, irritability, and stomach upset or constipation.

Bontril and Didirex

Bontril and Didirex are appetite suppressants similar to Adipex. Their side effects, however, can be somewhat more severe ranging from blurred vision, dry mouth, sleeplessness, irritability, stomach upset or constipation, to chest pain, pounding heart, gastrointestinal disturbances, breathing difficulties, and changes in libido.

Phentermine

Phentermine weight loss pills are yet another form of appetite suppressants which are available in three different forms: resin capsules, regular capsules, and tablets. When combined with a healthy weight control program which reduces calorie-intake and increases exercise, Phentermine can be quite effective. Unfortunately, side effects can be severe and include blurred vision, breathing difficulties, chest pain, depression, diarrhea, drowsiness, dizziness, fainting, headaches, changes in libido, nausea, and swelling in the lower legs.

Tenuate

Tenuate pills are oral appetite suppressants prescribed for short-term use (a few weeks) only. This is because the drug loses its effectiveness within a few weeks as the body adjusts. When this occurs, users should discontinue the drug rather than increase their dosage. Side effects include blurred vision, dry mouth, sleeplessness, irritability, stomach upset or constipation, chest pain, pounding heart, gastrointestinal disturbances, breathing difficulties and changes in libido.

Reductil

Reductil, or sibutramine, is an anti-obesity drug manufactured by Abbott Laboratories which has already been linked to 34 deaths as well as a number of other illnesses and adverse reactions worldwide. The majority of the reported deaths (28) occurred in the United States as well as two deaths in Italy, two in Britain, one in South Africa, and one in Switzerland. Italy suspended the sales of the drug in March of 2002 after receiving 50 reports of adverse reactions. In the UK, a total of 212 reports of adverse reactions have also been received. French drug regulators reported that they had received 99 reports of side effects, 10 of which were serious. Patients taking Reductil should consult their physicians if they are experiencing any adverse side effects or other unusual health conditions.

Dietary Supplements

Dietary supplements are made of essential nutrients such as vitamins, minerals, and protein. The definition given by the Dietary Supplement Health and Education Act (DSHEA) passed in 1994, however, identifies a dietary supplement as: “Any product intended for ingestion as a supplement to the diet.” Therefore, the term dietary supplement can now be used to also include herbs, botanicals, other plant-derived substances, amino acids, concentrates, metabolites, constituents, and extracts of these substances.

The DSHEA requires manufacturers to include the words “dietary supplement” on product labels. This minimal requirement, without more, does nothing to warn consumers of the potential dangers posed by these dietary supplements. The FDA, however, does not authorize, or even test, dietary supplements. Thus, dietary supplements should never be viewed as a replacement for a well-balanced conventional diet, and their use alone does not ensure a healthy lifestyle.

Supplement manufacturers claim their products are able to melt away fat or raise metabolic rates. Neither of these claims, however, is supported by any clinical evidence. One reason for this is that supplement manufacturers are not required to prove that their products are either safe or effective as weight loss aids.

Herbal Diet Pills

Recently, the FDA has issued warnings and recalls on herbal diet pills because numerous medical experts are concerned that consumers are not only wasting their money, but that they are also taking serious risks with their health.

Ephedra, or Ma Huang, is one of the more dangerous ingredients found in herbal diet pills as it has been known to cause high blood pressure, heart problems, stroke, seizures, and death. Athletes and young people are especially attracted to ephedra and tend to use it in dangerously high dosages. (See our Newsletter for October 2003). The FDA has received reports of 100 deaths related to ephedra usage. In November of this year, New York became the second state (Illinois is the other) to ban the sale of ephedra. Florida has banned the sale of ephedra to minors since May of 2003. The New York law includes a fine of up to $500 for each illegal sale of the supplement. Manufacturers of ephedra are also facing numerous lawsuits and a possible ban by the Food and Drug Administration. In addition, broad bans are under consideration in Massachusetts, Nebraska, New Jersey and Hawaii.

The herb Aristolochia fangchi is another potentially harmful dietary supplement that may cause kidney failure and urinary tract cancer.

One of Metabolife’s herbal diet pills, Metabolife 356, has been basically classified as “speed” since it produces the same effects as an amphetamine. It is also a natural diuretic and laxative. Experts say people are attracted to the product because it is marketed as being “all natural.” Amphetamines speed up a person’s heart rate and increase blood pressure. These side effects pose serious health risks, especially to individuals suffering from obesity.

Hyroxycitric acid, or HCA, is an herbal extract found in at least 14 major weight-loss drugs and is supposed to suppress the appetite. In a study where HCA was given to 66 overweight patients and a placebo given to 69 patients, researchers concluded that HCA failed to produce significant weight loss.

Fat Burners

The term “fat burners” applies to a category of over-the-counter diet pills with amphetamine-like active ingredients intended to raise metabolism in order to help the body burn fat. Despite the popularity of these products, there is absolutely no clinical evidence that fat-burners melt away fat or even produce lasting weight loss.

The active ingredients in fat-burners include ephedra and guarana which contains caffeine. Fat burners often include a high concentration of amphetamine-like ingredients and, as a result, anyone using them risks high blood pressure, stroke, and death.

Asian Diet Pills

Most of the Asian diet pills on the market today are nothing more than a waste of money. Some, however, can be deadly. In the past two years, seven women in Japan, Singapore, and China have died as a result of taking these diet pills. These seven women all took diet pills containing a compound called N-nitroso fenfluramine which doctors believe can cause liver failure. Even after these reports of death, diet pills containing fenfluramine can be found on shelves in those countries.

In 1997 the FDA asked American Home Products, the makers of Pondimin (Fenfluramine) and Redux (Dexfenfluramine), to withdraw its popular anti-obesity drugs from the market. Medical studies have linked Pondimin or Redux to heart valve damage. Additionally, a study published in the New England Journal of Medicine in 1997 suggested that as many as one-third of the people using Fen-Phen for weight reduction had evidence of heart valve disease. In addition to heart valve disease, the use of fenfluramine and dexfenfluramine has been found to increase the risk of developing Primary Pulmonary Hypertension or (PPH). PPH is a rare disease of that causes the progressive narrowing of the blood vessels of the lungs. Studies estimate that treatment with certain appetite suppressant drugs tends to increase the chances of developing PPH by approximately 25 to 30 percent.

Diet Teas

Weight-loss or diet teas contain strong botanical laxatives and diuretics which can cause diarrhea and loss of water from the body which can lead to the depletion of sodium, potassium, and dehydration. But herbal diet teas have not been proven to help you lose weight. To be sure, dehydration should never be confused with weight loss. Moreover, the long-term use of these teas can impair colon function.
The most dangerous aspect of so-called diet teas lies in the fact that they are regarded as food and, therefore, their ingredients are not monitored as closely as drugs. If you must drink diet teas, you should avoid brands that contain senna, aloe, buckthorm, rhubarb root, cascara, and castor oil. Other potentially harmful ingredients in diet teas include Ma huang, locust plant, wymote, ginseng, honeysuckle, and chaparral.

Chromium Picolinate

Chromium, which is found in tiny amounts in many foods, helps the body burn fat, build muscle, and control blood sugar. Chromium picolinate, a synthetic compound, has been touted by its manufacturers as an effective weight loss product. Too much chromium, however, can lead to kidney failure, and there is no evidence that chromium supplements are a necessary part of a healthy daily diet.

Chitosan

Chitosan is a naturally occurring shellfish fiber which binds itself to fat and, therefore, is now being used in diet pills. Tests conducted to determine the effects of Chitosan failed to find evidence that it is an effective weight loss product.

Pyruvate
Pyruvate is another naturally occurring substance found in “fat-burners” and other over-the-counter diet pills. Although some manufacturers claim that pyruvate is a natural alternative to prescription diet drugs, a recent report in the International Journal of Medicine states that there is no evidence to support this claim and, therefore, you should not expect to lose weight by taking this substance.

Taking Laxatives to Lose Weight

Diet pills, weight loss supplements and diet products that contain laxatives can actually make you gain weight and an also be damaging to your health. Laxatives stimulate the digestive system and can cause severe diarrhea. This may prevent the proper absorption of food and lead to dehydration as well as vitamin and mineral deficiencies. Continued use of laxatives can cause bloating, cramping, dehydration, electrolyte disturbances and imbalances, cardiac arrhythmias, an irregular heart beat, heart attacks, renal problems, and death.

Taking Diuretics to Lose Weight

Diuretics stimulate water loss, not fat loss and, therefore, should not be used for the purpose of losing or maintaining weight. Diuretics can be very harmful when taken outside the care of a physician since their prolonged or improper use may cause potassium loss thereby requiring the need for potassium supplements. Potassium depletion, or hypokalemia, can lead to muscle weakness, including weakening of the heart muscle, and mental confusion.

As with laxatives, diuretics simply result in the transitory weight loss associated with water weight. These products deplete many of the body’s vital minerals and may lead to serious dehydration if not monitored properly. In short, they are simply not weight-loss products.

Conclusion:

After all is said and done, weight loss products in general do not produce the results most people hope for. Over-the-counter products are usually a waste of money, and some are very dangerous. Prescription weight loss drugs must be carefully monitored by a doctor and often pose significant health risks of their own. The weight that is lost by using these products is usually regained in a relatively short time.

Thus, it would appear that conventional weight-loss plans that result in gradual but long-term weight loss are still superior to fad diets or drugs. A healthy diet with regular exercise and medical monitoring is the most effective way to lose weight and to keep it off. Moreover, individuals who are severely overweight are placed at even greater risk when they use diet drugs of any kind. If they have additional medical problems such as diabetes, heart disease, high blood pressure, or elevated cholesterol, diet drugs pose an even greater risk of severe adverse reactions. In such situations, new and successful surgical alternatives offer hope for better and long-lasting results and should be considered.

If you or a loved one has suffered an injury as a result of taking an OTC weight-loss product or prescription weight-loss drug, contact Parker & Waichman for a free case evaluation. Even if you only suspect that there might be a problem, a free consultation is available by contacting us by telephone or online at our award winning website.

At this time, we wish all of our subscribers a joyous holiday season and a happy and healthy New Year.
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