If you wanted to lose weight last year, you might have been tempted to try Slimming Beauty Bitter Orange Slimming Capsules, a weight loss dietary supplement sold on the Internet. The label claimed that Slimming Beauty was "100% herbal" and "a natural vitamin and calcium" capsule for use even by children as young as 2. But the label didn't have two important warnings: First, that Slimming Beauty was illegally spiked with dangerous amounts of sibutramine, a powerful prescription-strength stimulant. Second, if you had tried it, you could have had a heart attack.
What's Really in Those Internet Diet Drugs
"Dietary supplements may represent the next big drug safety catastrophe," says Steven Nissen, MD, a cardiologist at the Cleveland Clinic and a Prevention advisory board member. "We don't know exactly what most supplements contain, so we don't know if they're actually safe." More and more, weight loss products—along with supplements that purport to treat sexual dysfunction or enhance athletic performance— are being "adulterated" with potentially dangerous ingredients by their manufacturers.
"Originally, the makers would throw in something like caffeine to give you a kick," says Tod Cooperman, MD, president of ConsumerLab.com. "Now they're adding in compounds you find in prescription drugs without including that information on their labels." Some of these products—which are most often sold on the Internet so the manufacturers can evade regulators—may include versions of Meridia, Viagra, Cialis, or Levitra without consumers' knowledge.
The other thing consumers don't realize is that adulterated products can be far riskier than prescription diet pills. If you'd had a prescription for Meridia, for instance, you would have been under a doctor's care and would have been aware of how much sibutramine you were taking, as well as what side effects you might expect, because they were listed on the label. But in the virtually unregulated world of weight loss supplements, there's no way to know definitively what you're getting, how much—or what it can do to you.
In recent years, the FDA has gone after more than 70 tainted weight loss products, many with names like Slim Burn, 24 Hours Diet, and Natural Model, after finding that they had been adulterated with undeclared stimulants, diuretics, and antidepressants, often in amounts exceeding the maximum recommended dosages at which such drugs can be prescribed. Sometimes the additives aren't legal even with a prescription. For example, one supplement targeted by the FDA contained fenproporex, a stimulant not approved in the United States because it can cause arrhythmia and possibly even sudden death.
In addition, these products often are not effective for the conditions for which they're advertised and may divert patients from legitimate medications, according to Dr. Nissen. If they do seem to be making a difference, that may be cause for concern too. "If a weight loss supplement is working, it could be due to a stimulant whose safety is unproven," says Arthur Agatston, MD, a cardiologist and member of the Prevention advisory board. "Even if you lose weight, you may have unpleasant, even dangerous cardiac side effects."
If, with your doctor's okay, you take a supplement such as fish oil or calcium, look for a seal on the bottle from NSF International, the United States Pharmacopeia, or ConsumerLab.com. Note that these companies are paid by supplement makers to evaluate their products for safety, purity, and ingredient list accuracy. They don't run lengthy patient trials to ensure that the product works—but at least you know it won't be adulterated.
2. Speak out about side effects.
If you've taken a supplement and experienced unexpected symptoms, the FDA urges you to report the problem to its MedWatch Safety Information and Adverse Event Reporting Program at www.fda.gov/medwatch/report.htm or by phone at (800) 332-1088. Even a few such reports can help the FDA determine where to target its efforts to best effect.
3. Say no to diet supplements.
"There's no diet supplement or drug that I know of that's safe and effective long term," says Arthur Agatston, MD. What's more, according to Steven Nissen, MD, even if you do lose weight by using a drug or supplement, research suggests that once you stop taking the product, you will gain back the weight and may be at greater risk of a heart attack or stroke. Both physicians recommend a healthy diet and regular exercise as the only sustainable way to lose weight and stay healthy.