THE DANGERS OF DIET AIDS
About a month ago, I stepped onto my bathroom scales. When I looked down at the numbers, my fears were confirmed: I had gained 5 pounds. Overcome with a desire to shed this unwanted extra weight, I decided to join millions of Americans just like me, and buy some sort of diet aid to help me along. I had no idea what to look for, what to avoid, and possible side effects, so I began to research the different types of diet aids, both chemical and herbal, and was hit with some very disturbing facts.
It has been estimated that nearly 10 million women in the U.S. buy over-the-counter diet aids.(Cottrell, 99) Diet aids come in the form of pills, tablets, capsules, powders, milkshakes, herbal teas, and candies. They work in one of two ways, either by suppressing the appetite or by producing a feeling of fullness that encourages the eater to limit her food consumption.(Cottrell, 99) This feeling of fullness is often brought about by the ingredient guar gum, which
forms a gel in the stomach. It has not been proven, though, that guar gum has a benefit for weight reduction.(Cottrell, 99)
Amphetamines, which suppress the appetite, are a common ingredient in many over-the-counter diet aids. They are also commonly found in other drugs such as Speed, Crystal, White Crosses, 357 Magnums, Black Beauties, Crank, Ice, and Meth, most of which are illegal.(Cottrell, 99) Amphetamines increase heart and breathing rates and blood pressure, and dilate pupils. Users can also
experience a dry mouth, sweating, headache, blurred vision, dizziness,
sleeplessness, and anxiety.(Cottrell, 100) Extremely high doses can cause usersto flush or become pale; they can cause a rapid or irregular heartbeat, tremors, loss of coordination and even physical collapse.(Cottrell, 101) Toxic psychosis, delusional thinking and even death can also occur. Long-term heavy use of amphetamines can lead to malnutrition, skin disorders, ulcers, and various diseases that come from vitamin deficiencies.(Cottrell, 101) Lack of sleep,
weight loss, and depression also result from regular use. When people stop using amphetamines abruptly, they may experience fatigue, long periods of sleep, irritability, extreme hunger and depression.(Cottrell, 101) The length and severity of the depression seems to be related to how much and how often the amphetamines were used.(Cottrell, 101)
Another common ingredient that is chemically related to the
amphetamine, is Phenylpropanolamine (PPA), the only FDA-approved
over-the-counter weight loss drug.(Cottrell, 100) PPA, the active ingredient in Dexatrim, Acutrim, and most other diet aids, acts on the appetite center in the brain, the hypothalamus, reducing the desire to eat.(Cottrell,100) PPA is also found in over 150 prescription and over-the-counter drugs. The FDA labeled
the 75-mg dose of PPA found in diet aids Safe and effective. (Cottrell, 100) This does not mean that there are no side effects. Phenylpropanolamine related side effects include dizziness, heart palpitations, and rapid pulse, and are increasingly being reported to poison-control centers and emergency rooms at a
slow but steady rate.(Cottrell,100) Peter Vash, M.D., M.P.H. warns that PPA can raise blood pressure and cause cerebral hemorrhaging and strokes — even in some fairly young people. (Cottrell,100-101) Because of these side effects, it is recommended that Phenylpropanolamine-based diet aids be used for no more
than twelve weeks at a time and to never be used if another medication — such as cold medicine — containing PPA is being taken.(Cottrell,101)
Many people are under the misconception that natural diet aids are better to use than chemical. Often their side effects can be just as harmful. Natural diet aids suppress the appetite by filling the user up with a mixture of grain and citrus fiber, making her feel full.(Cottrell, 101) Potentially dangerous herbal diet aids contain ephedra, also known as ma huang.(Fraser, 62) Ma huang, especially in combination with caffeine, can drive up blood pressure or cause seizures or strokes and has been implicated in more than two dozen deaths.(Fraser, 66) The Food and Drug Administration recently
investigated reports of thirty-eight deaths among more than eight hundred cases of side effects associated with using products containing ephedrine alkaloids, one of ma huang s main components.(Fen-phen, 6) It is advisable for pregnant or nursing women to not take ephedra, as well as people who have heart disease,
anxiety disorder, high blood pressure, diabetes, glaucoma, or an overactive thyroid gland. (Williamson, 74) Ephedra can be especially harmful if taken at the same time as momoamine oxidase inhibitor drugs, commonly prescribed for depression.(Williamson, 74)
On most diet aid boxes there are no indications that the aid contains a laxative that can cause diarrhea, cramping, and with long-term use, problems with the colon and even the heart.(Fraser,62) Senna, one such laxative, is often identified as locust plant. (Fraser, 62) Used for long periods of time, senna can
flush important minerals, called electrolytes, out of the body. Among these electrolytes is potassium, which sends electrical signals to the heart and keeps it beating normally. Sometimes the messages to the heart get confused and the heart stops.(Fraser,66) People using senna can also easily become dependent on its laxative effects.(Fraser,66) Fen-Phen, Fenfluramine and Phentermine, is a popular prescription diet aid combination. On their own, these appetite suppressants proved disappointing, but in 1992 University of Rochester researchers reported that taken together the two drugs helped patients lose almost four times as much weight as before.(New, 58) Still, only one in four patients lost weight and fifteen percent had to stop taking the drugs because of side effects such as dry mouth and dizziness.(New, 58) In 1997 Fen-Phen was taken off the market
because of more deadly side effects. Fenfluramine has a connection with primary pulmonary hypertension (PPH), a disease that kills the majority of people who get it.(Kramer, 206) PPH is when the seratonin that the drugs keep flowing through the brain, making the
user feel full, constrict blood vessels in the lungs, causing the heart to beat harder and harder until it s difficult to breathe.(Kramer, 206) PPH is also difficult to diagnose. Often, by the time there are symptoms, the heart and lungs are damaged beyond repair, and a heart-lung transplant is the patient s only hope
Redux is a prescription diet aid also known as Dexfenfluramine. Redux works by increasing the availability of serotonin, a brain chemical that seems, among other things, to curb cravings for sweets. In one study patients who took
dexfenfluramine — and made no special effort to cut calories– lost an average often pounds over three months.(New, 58) Last year Johns Hopkins neurologist George Ricaurte found that high doses of dexfenfluramine caused lasting damage to the rain nerve-cell endings in lab monkeys.(New, 58) Despite these findings, the U.S. FDA says it is not aware of human studies that demonstrate a problem, and people in Europe have taken the drugs for years without any problems.(Kramer, 206) The FDA approved Redux in 1996 with the knowledge that could cause PPA, but it was argued that Redux could prevent twenty obesity-related deaths for every one death caused by PPA, preventing two hundred and eighty deaths per million
users.(Kramer, 208) The chances of dying from a reaction to penicillin or from being struck by lightning are greater odds than those from dying from Redux or fen-phen.(Kramer, 206)
In 1997, the FDA revealed that 82 patients had developed defects in their heart valves while on fen-phen, and that seven patients had come down with the same condition on Redux. Redux was later recalled from the market in June of 1998.(Lemonick, 81)
Even after reading dozens of magazine articles and books about the positive and negative effects of diet aids, I decided to take my chances and buy a month s supply of Metabolife, an over-the-counter appetite suppressant and metabolism stimulator. Though the side effects I read about range from minor ailments to deadly diseases, few are extremely common among users in my age group and health status. Any drug, whether prescription or over-the-counter, has potential to be harmful to the body when abused.
When used with caution and as directed on the packaging, appetite
suppressants can be a helpful supplement to most dieters. But, before using any medication, it is a good idea to make an appointment with a physician for a consultation and physical examination to make sure that the medicine you choose will not have a negative reaction with any existing health problems.
Cottrell, Randall R. Weight Control. Guileford, CT: Dushkin Publishing Group 1992.
Fen-Phen: Risky for Dieters in Any Form. Consumer Reports September1997:6.
Fraser, Laura. The Dangers of Natural Diet Aids. Glamour March 1996: 64-68.
Kramer, Carol. Dying to Lose Weight. Vogue May 1997: 206-229.
Lemonick, Michael D. Dark Side of Diet Pills. Time 22 September 1997: 81.
Williamson, Madeleine J. Herbal Diet Aids: Are They a Safe Alternative? Cosmopolitan August 1998: 74-78.