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Genie in a pill bottle?

Dave Gordon - Wednesday, 15 July, 2015

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 A Look at the Uninspiring History of Diet Pills

If you haven’t gone on a diet this year, it’s a safe bet that your neighbor has.

According to US statistics, some 100 million Americans are on some kind of diet. Our society is keenly aware of how our beltlines have increased in the past two generations, and the problem has been growing as steadily as our stomachs.

Many of us likely remember the times when there was the one “fat kid” in class. Now, there can be close to a dozen.

According to the Center for Disease Control and Prevention, more than one-third – or 78.6 million – of US adults are obese, and twice as many are overweight.

The first caveat that comes with diet pills is that they will not make the bulk of the weight disappear.

The expanding American belly has recently led airlines to begin considering which passengers need a second seat, as they cannot fit in one. It has also led many overweight Americans to resort to easy fixes, such as meal replacement bars, crash diets, and supplements.

Additionally, one in five dieters are using diet pills that act either to suppress the appetite by chemically inducing a feeling of satiation, or to absorb fat in the body.

Do these pills really work, and how safe are they?

The first caveat that comes with diet pills is that they will not make the bulk of the weight disappear.

Usually, about 10 percent of the body weight is diminished, if the regimen is followed properly. For most people, that’s sufficient to improve blood pressure and blood sugar levels, but it’s a drop in the bucket for those who need to lose much more than a tenth of their weight to reach a healthy body mass index.

The second caveat is that introducing any chemical into the system could have adverse effects.

Nearly 70 years ago, in 1947, the US Food and Drug Administration approved the first weight loss drug, desoxyephedrine, a methamphetamine that suppresses appetite.

Patients had to choose between weight-related heart problems, and the heart problems caused by the drug’s side effects. Hardly an appealing choice.

In the ensuing decade, amphetamines continued as the most popular weight-loss drug. It suppressed the appetite, but was highly addictive. And today, the market – and consumers – are still searching for the ever-elusive perfect diet pill.

A $2 Billion Mess

Today, nearly three dozen companies have weight-loss drugs in development. Decision Resources, a pharmaceutical research firm, says that the obesity drug market is set to increase tenfold from 2006’s market of $222 million, to nearly $2 billion by 2016.

And yet, despite aisles and shelves of pharmacy pill bottles boasting that their pill can pulverize the pounds, there are currently just six FDA-approved weight loss pills on the market.

The rest? Non-approved supplements that tout they can facilitate weight loss. Many indeed work, but like pills of the past, they all have negative side effects.

According to the Journal of the American Medical Association, these side effects can include heart attacks, insomnia, seizures and high blood pressure.

Various pills have been pulled from the shelves in recent years due to terrible side effects.

In 2004, the FDA banned the herbal supplement ephedra after consumers experienced stroke, high blood pressure and other cardiovascular problems.

Four years earlier, they gave the thumbs down to Qnexa and lorcaserin.


Several kinds of diet pills have been pulled from the shelves because of terrible side effects

The latter was thought to be responsible for causing tumors in lab rats, and depression and memory loss in humans. The highly popular Alli – the first government-approved, over-the-counter weight-loss drug, which first appeared in 2007 and was also sold in prescription formats Orlistat and Xenical – was found to cause uncontrollable bowel movements, which in turn resulted in vitamin deficiency.

In another example of a weight loss pill flop, Sibutramine was approved in 1997 as an appetite suppressant, containing chemical compounds that fooled the brain into thinking the stomach was full.

Three years later, the FDA had the drug’s maker, Abbott Laboratories, pull the product when it was discovered that many consumers suffered from increased heart rates, strokes and high blood pressure.

Many might recall another popular product that flew off the shelves – fen-phen, which was launched in 1992.

Two years was all it took for the FDA to red flag fen-phen along with a sister product, Redux, linking them to heart valve defects, hypertension and lung problems. Lab animals used for testing the product were found to suffer from brain damage.

Still another drug, Rimonabant – sold under the name Acomplia –
was discontinued despite being approved by the European Drug Agency in June 2006.

An ingredient tinkered with parts of the brain so a person couldn’t derive more pleasure out of eating. Unfortunately, messing with the brain’s pleasure-center didn’t turn out so well.

The medical journal Lancet reported that those who took Rimonabant were two-and-a-half times more likely than those who took placebos to stop treatment because they developed depression.

Another side effect was anxiety, which afflicted three times as many people as those who took the placebo.

Among the latest diet drugs to hit the market is Contravene, which is available by prescription only. Roughly one out of four people in clinical tests stopped taking the drug due to its side effects: nausea, constipation and headache.

The drug’s something of a cocktail, combining Naltrexone, which is used to treat alcohol and drug addiction, with the appetite suppressant Wellbutrin.

Qsymia – also recently approved – contains an amphetamine, aimed at accelerating the process of metabolism, coupled with the appetite suppressant topamax. Consumer Reports, the non-partisan, independent research company, says of the drug: “skip it.” Typical side effects listed are dizziness, fatigue, irritability, constipation, memory loss, and dry mouth.

Supplemental Problems

While actual diet pills should be approached with due caution, and on the advice of a physician, what about the so-called supplements – the kind found in pharmacies and health food stores – that promise to facilitate weight loss?

In at least one respect, supplements are less reliable than diet pills. As they are not formally considered “drugs,” producers of supplements aren’t held to the same regulatory standards that apply to pharmaceutical manufacturers. That is, they are not legally tasked with having to demonstrate their products have passed safety tests.

Hydroxycut is but one example.

Anyone can buy it without a prescription, and it is widely available in supermarkets, department stores and pharmacies.

The manufacturing company Iovate boasts the drug’s success in helping people lose weight, but according to WebMD, the company had to recall the product in 2009 when the FDA received complaints from consumers of liver problems, seizures, and a muscle-damaging condition. The company has since changed the ingredients, saying they removed what was believed to be the culprit.

Although anyone can purchase the product, the label warns it should only be used by those over 18 and on advice of a physician.

Meanwhile, a study published in the journal Drug Testing and Analysis gives us more reason for concern, reporting that 12 out of 14 weight loss supplements tested were found to contain the controversial ingredient “AMP Citrate” – also known as DMBA – which is similar to amphetamines.

The problem? The FDA has banned a chemical that shared certain attributes – a stimulant called DMAA, which has been known to cause cardiac and brain problems.

According to researchers, AMP Citrate was only tested on dogs and cats – in the 1940s – and the current batch of chemicals was modified slightly, then injected into the diet drug.

Although research from Georgetown University has shown promise for supplements with garcinia cambogia –  also known as tamarind, a fruit that grows in Southeast Asia and India – other research says: no so fast.

Some supplements manufacturers are using the extract from tamarind shells in their diet pills, claiming that its properties suppress appetites, but thus far there’s only been anecdotal, rather than clinical, evidence to this effect.

And, a 2005 study from Food and Chemical Toxicology warned that high doses of garcinia cambogia caused the testicles of lab mice to stop working.

The Truth Hurts

Is any diet supplement or diet pill actually good for you? Can we trust the FDA to ensure that their rubber-stamp of approval for weight loss products won’t be retracted shortly after it is given?

As we have seen, the history of weight loss products is far from encouraging, and is actually quite frightening.

It must be emphasized, however, that not everyone who takes these products experiences side effects, and they are not necessarily altogether ineffective.

Like any chemical introduced into the body, weight loss products must be used with due diligence, under the careful advice of a knowledgeable physician, and with realistic expectations.

Most of all, though, the medical community is unanimous in its belief that there is no magic pill – or magic anything – for weight loss.

Those seeking to lose weight must, at one point or another, face the reality that when all is said done, there is no substitute for the “old fashioned” technique of leading a healthy lifestyle.

As conventional wisdom tells us: limit consumption of fatty foods, sweets and carbs; eat plenty of salads; drink plenty of non-sugary fluids; limit your intake of caffeine (which can stimulate appetite); don’t eat at night (it stays on you); take a pass on “seconds”; and to round it out, exercise for at least 20 minutes a day.

You’ve probably already heard it from your doctor, but it’s worth repeating: following these guidelines is far more effective for weight loss than any genie in a pill bottle.


All Contents © 2018 Dave Gordon | Lichtman Consulting