Spring is in the air, which means many of us will be looking to shed those few extra pounds gained during the cold (Or, if you live in Canada, very very cold) winter. Some will turn to diet pills for a little help, but are they helpful or harmful? Are these little pills actually a healthy way to lose weight?

For centuries, physicians have prescribed unusual remedies to lose weight: from desiccated human thyroid to the tapeworm diet (both still in use today!). In Western cultures, many women fancy being slender while men prefer an athletic look. This formed the model for an ‘ideal’ body type in the 20th century. In turn, this idea fuelled the demand for diet pills. In current times, society is slowly changing this rigid body image in favour of body positivity regardless of size. This new logic reminds people that as long as they remain healthy, the weight on a scale doesn’t matter. However, the fetishization of that idealized image of a man/woman runs deep. No matter how many body-positive accounts pop up on Instagram, there are others who still pine after skinny bodies.

So, what are diet pills? They come in the form of a dietary supplement (US FDA) or a natural health product (Health Canada) and prescription or non-prescription (over-the-counter) drugs and, are taken orally to bring about weight loss or to control weight. Mechanisms by which these drugs work include metabolic rate increase (you burn more fat), decrease nutrient (mostly fat) absorption (you take in fewer calories) or suppress appetite.

Dietary supplements/natural health products are regulated under a different set of rules from those used for usual drugs. Manufacturers and distributers are responsible for evaluating product safety and providing accurate labeling of the ingredients present in both Canada and the US. So, the major risk with taking these products is the presence of drugs or any chemical that may have a biological effect but is not listed on the label; worrisome are those which comprise powerful anorectics (appetite suppressants) usually derived from amphetamines and, psychoactive drugs such as benzodiazepines. According to an officer of the FDA, “When the product contains a drug or other ingredient which is not listed as an ingredient we become especially concerned about the safety of the product.” An example is the illegally imported Fenproporex-based diet pills from Brazil. One report showed a 26-year-old woman who was taking them had, “a two-year history of “intermittent chest pains, palpitations, headaches and insomnia.” A toxicology screen of her urine showed the presence of amphetamines and benzodiazepines. Analysis of the pills she used detected Fenproporex (addictive appetite suppressant) and Chlordiazepoxide (sedative, hypnotic and addictive drug used in the treatment of many health conditions including alcohol withdrawal, insomnia, anxiety, seizures, muscle tension and irritable bowel syndrome).

According to one report, “A drug can be defined as a chemical substance of known structure, other than a nutrient or an essential dietary ingredient, which, when administered to a living organism, produces a biological effect,” (However, they are mostly seen as, “any medication that is used for diagnosing, curing, mitigating, preventing or treating disease.”) Prescription diet pills, like any other drug, require a prescription for dispensation and subject to regulatory control as dictated by individual countries. For diet pills requiring no doctor’s prescription (over-the-counter drugs), the US FDA and Health Canada require manufacturers to report results on the safety, quality and efficacy of their drug as well as a list of ingredients. Nonetheless both types of pills can bring about adverse reactions or harmful side effects.

Prescription diet pills are usually given by a doctor in the treatment of obesity. In such cases, the person’s health will be monitored while taking said drugs. It is also recommended that non-prescription drugs be taken with a doctor’s counsel and monitoring. Research shows that with these drugs, in combination with diet and lifestyle adjustments, 3-9 % of body weight (on average) can be lost over long-term treatment in persons with obesity. However, the main concern with taking these drugs are the side effects, some of which are quite severe. So, this begs the question, “Do the side effects outweigh the benefits?” One of the worst cases of a drug with horrible side effects is Fen-Phen: a drug combination of fenfluramine and dexfenfluramine with phentermine. These are anorectic drugs used to treat obesity. Fenfluramine and dexfenfluramine was pulled from the market in 90s because they produced deleterious cardiovascular side effects: pulmonary hypertension and heart valve problems. An article in the Journal of Clinical Endocrinology & Metabolism reported findings of abnormal heart valves in 32% of consumers taking Fen-Phen for up to 2 years. Phentermine is still being sold in diet pills as an appetite suppressant (with side effects!).

I’ve never been an advocate for using a drug to maintain a healthy body weight. I think it’s more about what makes you (personally) feel physically and mentally fit. I’ve had periods in my life where working out like crazy carried me through some pretty stressful situations, and as such, I am a proponent of diet and lifestyle changes to maintain good health. In addition, diabetes and obesity are real problems in society, so keeping that waistline trim (yes it’s a risk factor for diabetes), among other things, and staying fit overall is sometimes necessary to stave off disease. Whatever your reasons for wanting to reduce your body weight, there is no one method that fits every body type, so I think its more about finding what works for you. If your condition is severe overweight/obesity and you are considering taking diet supplements or drugs, it is better to do so in consultation with a physician and you should investigate their side effects. And remember, if it’s a non-prescription pill from a questionable source, you probably have no idea of what you’re about to put inside your body. Information might have been omitted from the labels, and the results it promises could be embellished. That sort of risk is not worth it!

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