Tuesday, October 2, 2012

Cycling back to the diet pill craze

Most of us are aware that people typically look for that “quick fix” to weight loss. What you might not be aware is that we’ve been looking for that fast weight loss regime since the 1890s.

A historical view of the diet pill craze in the latest issue of The American Journal of Public Health describes the birth of the ever-popular diet pill and the continued use of such products that remain dietary staples for most people despite controversial reviews.

In the late 1800s, experiments with various drugs, including strychnine, prompted the creation of a new era of medications – the ubiquitous diet pill. These pills worked to speed up the thyroid, which in turn would increase metabolism for faster weight loss.

Since then, weight loss pills have been a significant profit-making venture for drug companies. In the 1940s, pharmaceutical companies would create the same pill in different colors, marketing them as specially formulated pills for different people’s needs. These practices, while shunned by some physicians, were embraced by others and many doctors went on to specialize in weight reduction for their patients by prescribing such Rainbow Pills. In fact, a Congressional investigation in 1967 found that weight loss clinics earned $250 million in patient fees alone. Furthermore, patients had spent an additional $120 million on these Rainbow Pills.

An interesting expose’ in Life magazine published in 1968 found that these pills were being prescribed for everyone who visited such weight-loss clinics, including people who did not need to lose weight. The Journal reported that a “slim” investigative reporter for Life magazine visited 10 obesity clinics and “despite receiving only perfunctory evaluations and sometimes counseled that she did not need to lose weight, she was prescribed more than 1,500 pills.”
                                        
Not long afterward, more than 60 deaths had been attributed to the use of Rainbow Pills. While the Federal Drug Administration did seize 43 million tablets from a dozen manufacturers, the pills continued to be manufactured and sold under different venues.

Today, pills formerly marketed as “Rainbow Pills” have morphed into the existing diet supplement drugs that are on the shelves at nutrition, grocery, drug and discount stores. And, they are no longer marketed to physicians but directly to the consumer.  According to the Centers for Disease Control and Prevention, about half of all adults in the nation take multivitamins and other dietary supplements. A quick Google search with the words “diet pills” netted 43.6 million results. Dietary supplements are not subject to the same FDA rigorous approval process as prescription drugs, thereby, they create doubts and fears about their effectiveness as well as side-effects.  Consumers of the “new” rainbow pills of today are ingesting a nearly unknown product. What exactly are you putting into your system? Only the supplement industry knows, and many times, they aren’t telling.

In what drugs have been tested, the FDA found that almost all dietary supplements touting weight loss were highly ineffective, including using the popular Hoodia and Green Tea Extract. It also found that Xenical (aka Alli) had a modest weight loss effect but came with significant side effects including serious liver damage. Of interest, it was found that Xenical by itself was effective. The effective form of Xenical is only available through prescription. Of interest, this particular prescription drug is the only FDA-approved weight-loss drug for long-term use for up to two years. Effectiveness beyond two years is unknown at this time.

But, physicians as well as researchers caution the use of any medications to help you lose weight unless your primary care physician has you under strict supervision. The general guidelines suggest that prescription weight loss drugs only be used under two circumstances: 1) people with a body mass index (BMI) of 30 and over with no obesity-related conditions; and 2) people with a BMI of 27 and above with obesity-related conditions such as diabetes or high blood pressure.

Even if you fall into one of these two categories, or simply wish to take off a few pounds, taking diet pills (aka rainbow pills) is not a good answer and never has been. Your best option is a healthy diet and regular activity. There is no quick fix to weight loss. You didn’t put on the weight overnight, so don’t expect to lose it in the same manner. Your first step in weight loss should be a consultation with your primary care physician. Don’t try anything on your own without getting professional advice – especially if you are overweight or obese. It’s not fair to put your entire body at risk when it’s only your body fat you wish to lose.


References

Cohen, P.A., Goday, A., & Swann, J. P. (2012). The return of rainbow diet pills. American Journal of Public Health, 102(9), 1676-1686.

Mayo Clinic. (2012). Over-the-counter weight-loss pills: Do they work? Retrieved from http://www.mayoclinic.com/health/weight-loss/HQ01160.

WebMD. (2012). Prescription weight loss drugs. Retrieved from http://www.webmd.com/diet/guide/weight-loss-prescription-weight-loss-medicine.

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