Another Dangerous Weight-Loss Scam

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Interested in losing weight? Want to do it without: (1) moving, (2) counting calories, (3) restricting food intake, or (4) any change in lifestyle whatsoever, and do it without any detrimental health effects? Well, step right up there are many products designed just to help you accomplish that goal. Then I have some Enron stock to sell you.

Anyone interested in investigating the ability of the human mind to reinvent the wheel should take a good look at the field of weight loss supplements and aids. Again and again, you see the same sorts of creams, powders, pills, and patches, not to mention the magic potions that will "melt away fat" while you sleep. Most of these don't work, and those that do work don't really do so for the gimmicky, stated reason.

Take, for example, a wondrous elixir called Calorad. According to the DJs on my local radio station, this miracle fix allows you to "lose weight while you sleep, with no dieting or exercise." All you have to do is take the appropriate dose before you go to sleep at night. Oh, and did I mention that you have to take it on an empty stomach? That's rightâ you can't eat for at least three hours before drinking the stuff or it won't work, according to the Calorad website. But most of us, if we cut out all snacking for three hours before bedtime, would lose weight even without a magic drink. So is it worth paying for something that fools you into cutting your caloric intake? One bottle (a one-month supply) costs $50.00, but if you hurry , you can get a special three for $120.00, according to the official Calorad website ( http://www.calorad2000.com ). It's your money. You decide.

But there is a darker side to many of these products: the potential for serious health damage. Just last week, a report in the _Annals of Internal Medicine_ (2002;136:590-595) described the cases of seven individuals who visited clinics or hospitals with the symptoms of acute hepatitis (inflammation of the liver). If severe enough, of course, hepatitis can lead to liver failure and death.

These seven people (one man and four women of Japanese descent, two Caucasian males who were body builders, with no obvious ties) had little in common except that they all had been using a dietary weight-loss supplement called LipoKinetix. All developed symptoms within three months of starting to use the supplement, and their symptoms eventually resolved once they stopped using it (in some cases it took four months or more). None of these folks were taking prescription or over-the-counter medications at the same time they used LipoKinetix, so interactions with other drugs were not responsible for the hepatitis. According to the authors of the report, LipoKinetix contains a real witches' brew of herbal and other ingredients.

The pills contained a form of thyroid hormone, norephedrine (also known as phenylpropanolamine), yohimbe, usnic acid (a derivative of a lichen that supposedly increase the rate at which energy is burned), and caffeine. Although most of these products are known to have possible side effects or interactions with other products individually, none would necessarily be expected to cause the liver damage these individuals suffered. Thus, the authors speculate that some unknown interaction between the ingredients of the supplement itself may have been responsible for the symptoms. They analyzed the supplements and did not find contamination by other ingredients that could have caused the illness.

This report is just the latest in a series of warnings about the ingredients in a number of dietary supplements. St. John's Wort, for example, can interfere with the action of immune system suppressing drugs taken by transplant patients, as well as with oral contraceptive pills and drugs used to battle HIV infection. Phenylpropanolamine was recently removed from over-the-counter (OTC) diet aids because of a small increase in the risk of stroke in young women taking it. Ephedrine and similar compounds have been the subject of over 14,000 adverse comments to the FDA yet ephedrine is still found in many dietary supplements.

The problem with these compounds is twofold. First, dietary supplements are virtually unregulated in the United States. While manufacturers of prescription and OTC pharmaceuticals must demonstrate their safety to the federal Food and Drug Administration (FDA), dietary supplement manufacturers do not. Yes, the manufacturers are ostensibly responsible for the safety of their products (not necessarily their efficacy), but they don't have to show their data to the FDA before they market their products.

The second problem is that since there are no organized, peer-reviewed data on safety, the FDA must rely on adverse event reporting to justify removing a product from the market. This type of reporting may seriously underestimate the true frequency of adverse health effects. Further, the system for reporting problems with supplements is voluntary. In contrast, manufacturers of pharmaceutical products are required to tell the FDA about any adverse effect reports they receive.

Although it can be amusing to read about the many fraudulent weight loss products that are foisted on frustrated consumers, there is always the possibility that some of these products pose a serious danger to health. In today's regulatory climate, the weight loss supplements consumer must follow the rule caveat emptor.

Ruth Kava, Ph.D., R.D., is Director of Nutrition for the American Council on Science and Health.