Over-the-Counter Diet Pills: Worthless
By Zach Desmond
The medical dictionary defines a diet pill as, “An agent that either decreases appetite or increases basal metabolic rate—e.g., amphetamines—by prescription and OTC diet aids—e.g., phenylpropanolamine, ephedrine, and caffeine; in high doses, diet pills may cause marked agitation, hypertension, seizures, or, rarely, death due to cerebral hemorrhage.” Two out of three Americans are now overweight (Body Mass Index over 25) and 30% of Americans are considered obese (Body Mass Index over 30), which puts America at the top of the list of most obese countries (Nation Master). This ever-growing problem has created an entire industry attempting to thwart it and with this comes the individuals’ discretion on what they should believe. Flashy ads feature attractive lean muscular persons claiming they lost an absurd amount of weight relying solely on “wonder drugs” known as diet pills; however, these claims should be disregarded. Since the US government views diet pills as simply a type of supplement (such as vitamin pills), the majority of diet pills are not regulated by the FDA, which means that the creators of them can put almost anything in them; and even so, they have wrongfully become an alternative for the obese individual. The question to be addressed is: are these over-the-counter diet pills worth your time, money, and effort? After researching this issue I argue that these OTC diet pills are not worth one’s time, considering the fiscal and health costs associated with them.
There are two legal classifications of diet pills, over-the-counter and prescription; prescription drugs require a doctor visit and are regulated by the FDA, which means they are more closely watched. Technically, only people with a serious obesity problem are supposed to be given prescription diet pills (BMI over 30), and it is likely that a doctor would simply recommend other options, my father who was an MD surely would have. This being said, over-the-counter diet pills are the focus here, because they are so readily accessible at your nearest grocery store. Most health officials agree that it is best to stick to good old-fashioned diet and exercise for weight loss (Consumer search). According to WedMD, the most common negative side effects of diet pills are: increased heart rate, increased blood pressure, sweating, constipation, insomnia, excessive thirst, lightheadedness, drowsiness, stuffy nose, headache, anxiety, and dry mouth. These may seem mild, but there have been a numerous amount of severe side effects recorded, such as heart disease, heart attack, and brain hemorrhaging. These drugs also have the risk of being addictive (as many people enjoy crave stimulant effect) and a developed tolerance (so that the user must take increased amounts to elicit the same effect, with any possible weight loss leveling at six months) (WebMD). According to consumer search, “OTC diet pills are a waste of money….manufacturers have no credible scientific evidence to back up their claims”. This wasn’t the first time I had heard this sort of statement.
It’s no surprise that obese adults (especially those who are older) tend to have increased health risks such as high blood pressure, heart disease, type II diabetes, overactive thyroid, depression, and migraines. If an obese person with these health issues or who are at risk for them is attempting to become healthier with the aid of diet pills, they have unfortunately been misinformed or are simply indifferent because they want an easy-out or simply want to look better. When obesity is an issue for an individual, health considerations should come first; taking diet pills, regardless of whether they are OTC or prescription type, cannot do this. Diet pills that suppress appetite can have detrimental effects on health and can even lead to heart attacks especially when the user has any of the above health defects because they amp up the sympathetic nervous system, the same system amped up when adrenaline is produced off the charts (fight or flight) (Watson). The last thing a morbidly obese adult with health problems is feeling like they just saw a mountain lion. In fact, 49 deaths were attributed to the diet pill Sibutramine (a appetite suppressant/Meridia brand name) between February 1998 and March 2003 due to associated heart problems (How stuff works). If an obese individual’s goal is to lose weight to better their health, why kill yourself doing it?
Diet pills work in a variety of ways via different chemical and biological pathways, but the two most common and effective methods are by appetite suppression and fat absorption inhibition. Appetite suppressants target the appetite center of brain known as the hypothalamus by increasing the hormones serotonin, catecholamine, and norepinephrine in the body, which makes the pill taker feel full or not hungry and therefore the user does not want to eat (Watson). A common appetite suppressant is Ephedra, which has been banned by the FDA even though it is OTC, because it has been markedly shown to increase risk of heart attack (Watson). Fat absorption inhibitors work by inhabiting the enzyme lipase, which normally digests the fat we eat and stores it in the body for future use; a common OTC fat blocker is Chitosan(Watson). This means that a good percentage of fat in food simply passes through; this can lead to oily passings between stools, inability to control bowel movements and loss of absorption of vitamins. OTC diet pills rarely work on one biochemical pathway- they are often combined with additives (often unannounced). One such “cocktail drug”: Dexatrim, combined caffeine with ephedra to create a physiological phenomenon known as thermogenesis, which increases energy expenditure (Watson).
Diet pills came onto the scene around 30 years ago, when amphetamine diet pills (related to methamphetamine) were being used by women who wanted to lose a few pounds. It soon turned out that not very much weight was lost, people were becoming addicted to them, and any weight lost was put back on shortly (1 is 2 fat/History). The growth of this industry climbed astoundingly, so much so that in 1996, 18 million people in the US were using a “cocktail drug” colloquially coined fen-phen, as it contained the appetite suppressants fenfluramine and phentermine. The FDA soon realized that this combination led to heart problems and in September 1997, “fen-phen” was taken off the market (Watson). In the previous paragraph I mentioned Dextratrim (a combination of caffeine and ephedra) which elevates heart rate, constricts blood vessels, and triggers fight or flight; this combination of ingredients and side effects led to at least 155 deaths before it was taken off the market in 2003(Watson). Diet pill creators weren’t going to let death stop them; they were persistent. In January 2007, the Federal Trade Commission demanded that the makers of Xenadrine EFX, CortiSlims, TrimSpa, and One-A-Day Weight Smart to pay 25 million dollars in fines because these drug makers made claims without scientific backing; these drugs are still on the shelves but with different labels and the same harmful ingredients (Majoras). Most recently, in March 2009, the FDA let it be known that approximately 72 diet pills were filled with undeclared ingredients (Consumer search).
Body mass index (BMI) is calculated from a height to weight ratio, a normal weight person has a BMI of 18.5 to 25, over 25 is overweight, and over 30 is considered obese (Forgoros). I have a BMI of 23.7 at 6 feet, but I went ahead and tried a common diet strategy: take caffeine pills. I went to Rite Aid and bought a bottle of these and went on a two-week regimen of two pills a day. At the beginning of the two weeks I started off with a resting heart rate of 55, a blood pressure of 130/90, and a weight of 175. By the end of the two weeks my resting heart rate was 75 and my blood pressure was 140/95 and I had only lost 1 whole pound. I couldn’t believe the detrimental effect these pills had on my cardiovascular system, along with the ensuing withdrawal I experienced after stopping the regimen; after this self-experiment I am quite certain I will never use diet supplements ever again.
You have probably seen countless advertisements where the actor hocking the diet pill somehow shed an enormous amount of fat simply taking the drug without addition of healthy diet and exercise. I find these ads very interesting because the only fat absorption inhibitor that is approved for use in the US is the drug Xenical, which inhibits ~30% of fat absorption which equates to only 13 pounds lost over one year of use (WebMD). The cheapest Xenical I could find on the Internet was 120 dollars a box containing 30 pills. If an individual takes one of these a day, the user is essentially paying 1440 dollars to lose 13 pounds over the course of year. Popular states that 13% of dieters in America use diet pills, and that 54% of Americans are currently trying to cut their weight down; there are 300 million people in America. If we can depend on these statistics, 21 million people in America are spending money to destroy their health.
With increasing dependency the people have placed on drugs, there comes increasing apathy; this certainly includes using diet pills. Just remember that diet pill companies will have no problem making false claims and using enticing adjectives if it helps sell their products. With side effects ranging from bowel disruption to brain hemorrhaging, the choice should be abundantly clear: I hope that this argument gave enough reason to avoid diet pills for whomever reads this. Why spend so much money on a gamble like diet pills when you could spend nothing on a sure bet with 100 percent return on investment by simply exercising and keeping a diet? Majoras of the Federal Trade Commision says it the best, “You’re not going to find weight loss in a bottle of pills.” If we as a people can rise up against the diet pill industry by posting public service announcements, writing letters, and gather more lawyers and lobbyists towards this issue then maybe we will see a day where people reduce their reliability on quick fixes like diet pills, a cycle I would love to see.