In the News

As published in The Hartford Courant, May 14, 2006.

Quick Fix for Weight Loss? Fat Chance

Those Sweet-Sounding Diet Products are Often Deceiving and Sometimes Dangerous

"Amazing 'Lightning in a Bottle' Starts Burning Fat Off Your Body 22 Seconds After Entering Your Bloodstream... Then continues burning more fat, automatically, day after day... even if you're addicted to junk-food, refuse to exercise or have no willpower whatsoever."

This half-page ad for the "Weight Dropper System" ran in The Hartford Courant on May 1, along with the requisite "before" and "after" pictures of "Heather" who went from 192 pounds and a size 18 to a size 2.

It's classic hype for many weight-loss products : amazing transformation, no diet or exercise needed, the testimonial, disparagement of other diet products, money-back guarantee. Hype in a bottle for only $69.95, plus $8.95 shipping.

Americans spend billions each year on pills, drops, patches and creams for weight loss that aren't regulated by the FDA, that may contain dangerous ingredients, that don't work and that can pose serious health risks. Often, consumers don't even know what's in the product, especially if they buy on the Internet.

Doctors and nutrition experts warn if you use them in conjunction with a product-recommended diet, or go on any extreme diet, you may lose a few pounds, but that's due to reduced calories, not magic pills. We almost always gain all the weight back, and usually some extra. This yo-yo dieting keeps us fat and makes us fatter.

So why do we do it?

"The absolute worst thing is being fat," declared one 30-year-old, and she didn't mean health.

"Ninety-nine percent of the population feels inadequate," according to Karen Steinberg, assistant professor of psychiatry at the University of Connecticut Health Center. "Our society is focused on appearance. People who struggle to be thin like the idea of a quick solution to a long-standing problem. These are smart people and, on a cognitive level, they know the products won't work; but they feel hopeless, that they can't do it alone. The advertising is very compelling and exploitive. But it's pseudo science."

But not innocuous.

In January, the federal Food and Drug Administration warned consumers not to buy Emagrece Sim Dietary Supplement, also known as the Brazilian Diet Pill and Herbathin, which was sold on the Internet. The product contained prescription drugs, including chlordiazepoxide HCl (the active ingredient in Librium); fluoxetine HCl (the active ingredient in Prozac) and Fenproporex, a stimulant that is not approved for marketing in the United States and that is converted in the body to amphetamine.

Consumers were lucky. The FDA was able to test the product. "Science News" in 2002 said the "FDA has at times attempted to follow up on health complaints linked to diet products. In a third of the cases, however, it was unable to get lists of all the ingredients in a product. In 77 percent..., even such basic information as a product's labeling was absent. In more than two-thirds of the instances where FDA requested a sample of the supplement described in a report, none was provided... [the] FDA couldn't even identify who made 32 percent of the products cited in adverse reports or find addresses for 70 percent of the manufacturers."

What about our Weight Dropper System advertised in the Courant?

To begin with, consumers should never assume accuracy or truthfulness in an ad just because it's run by a legitimate medium.

However, Bob Briere, the Courant's advertising director, says the paper's advertising staff does screen submissions. "It is always our intent to provide readers and customers [with] advertising content that upholds the standards of truth, fairness and good taste. The publisher reserves the right to reject ads with and without explanation. If we find an advertisement to be questionable, we notify the advertiser," he said.

"However," Briere added, "we cannot review ads for specific product state and federal compliance. We are not experts in what does and does not comply with a host of state and federal regulations. That is the advertisers' responsibility."

I asked pharmacist Lisa Jaser, director of pharmacy services at the University of Connecticut Health Center, to review the product's advertised ingredients (we don't know if all were listed). One is citrus aurantium, which Jaser says is derived from orange zest and "can act as a stimulant, similar to banned ephedrine, which has been linked to devastating effects, including heart attacks and seizures." The other ingredient is garcinia cambogia. Jaser noted that a 1998 trial was published in the Journal of the American Medical Association that reported this ingredient "failed to contribute... to weight loss."

Jaser warns that there is no over-the-counter product with any "proven efficacy" except for orlistat, now called Xenical, which has recently been approved for over-the-counter sale to block fat absorption. She cautions that it has serious side effects and worries whether it also blocks the fat-soluble vitamins that your body needs.

"Often, there is no data or clinical trials to show the products are effective, and poor regulation allows for potentially harmful products," cautions Jaser. "Also, many `natural' products are associated with dangerous side effects. Remember, arsenic is natural. And there is the potential for additional risks associated with drug-drug interactions or drug-disease interactions."

Her concerns are supported by the Federal Trade Commission.

In a 2002 survey, the FTC, which has jurisdiction over labeling, reported that 55 percent of weight-loss ads included claims that were almost certainly false or misleading. (I think it's worse, since many companies dodge the fraud census by avoiding specific, prohibited claims, but their absence doesn't mean the product is benign.)

Here's just a partial list of items and ingredients the FDA warns are dangerous or ineffective: diet patches; "fat blockers," (this was before Xenical) which can trigger severe diarrhea; and "starch blockers," which can cause nausea, vomiting, diarrhea and stomach pains. Also, "magnet" diet pills which allegedly "flush fat out of the body;" glucomannan; guar gum, which can produce obstructions in the intestines, stomach, or esophagus; and Spirulina, a species of blue-green algae.

The list also includes alcohol, caffeine, dextrose, ascorbic acid (vitamin C), caffeine, several forms of sugar, phenacetin (a pain reliever), sodium, yeast and benzocaine and phenylpropanolamine (both banned for this use).

I took this list to a Walgreen's, a Liggett's and a CVS. Unlike so many print, TV or Internet ads, the package claims were vague: "energy boost," "metabolism support," "weight support." "Trimspa" warned of frightening consequences if taken without adequate fIuid. Another product stated that it contained an "extraordinary" amount of caffeine, but failed to say how much. Most alarming, I found patches and starch blockers and a number of the ingredients on the FDA's warning list.

Interesting business model, here. Weight-loss products flourish on failure. "Dieting is a multi-million dollar industry - with actual accomplishments so abysmal that companies would be out of business in any other industry," says state Attorney General Richard Blumenthal.

Body weight is best regulated by a balanced diet and moderate exercise or other measures approved by a medical professional. There's nothing inside those little bottles but heartache.