What About Over-the-Counter Weight Loss Pills?
By Linda Hepler, R.N., B.S.N.

Burn fat while you sleep! Drop two dress sizes in ten days! These promises of a quick fix for obesity entice many overweight teens into trying diet pills or other over the counter weight-loss aids. And it is easy to see why this is so. A recent study of 106 severely obese children between the ages of 5 and 18 concluded that these individual’s “health-related quality of life”--which includes physical, emotional and social factors--is as low as that of children who have been diagnosed with cancer.

Over the counter pills

Unfortunately, there is no miracle pill for obesity. In fact, many of the diet pills and weight-loss aids available over the counter are at best ineffective, and at worst, dangerous. Even if the product claims to be “natural,” this doesn’t necessarily mean that it is safe. Because the Food and Drug Administration (FDA) classifies these preparations not as drugs but as “dietary supplements,” they are exempt from the rigorous safety and efficacy testing required of conventional medications.

This means that a diet pill may not do what the label says it will do. Or even if it does, there may be unwanted side effects, such as increased blood pressure or pulse, or loss of body fluid which can lower potassium levels and cause heart and muscle problems. One example is Ephedra, also known as Ma Huang. Ephedra is an herbal ingredient previously found in many weight loss products. In December 2003, only after an alarming number of health problems among those who had taken these products had been reported, including heart attack, stroke, seizures, and even death--the FDA banned this substance from the marketplace.

Prescription diet medications

What about prescription diet pills? Although several weight-loss medications, such as orlistat and subutramine have been found to be safe and effective for adults when combined with diet and exercise (and taken under medical supervision), none of these have been approved by the FDA for use in children younger than 16 years old. There are several reasons for this. First, children’s bodies are smaller, making them more susceptible to drug toxicity than adults are. This makes it difficult to determine a safe dosage of medication. Secondly, some diet pills work by preventing the body from absorbing fat, which also interferes with the absorption of fat-soluble vitamins. These vitamins are important for growth and development during childhood and adolescence. Finally, it is believed that one must continue taking prescription diet medications in order to sustain weight loss. Yet, there have been no studies to determine the long-term effects of using these medications. Until more extensive research has been performed, prescription weight loss medications are not recommended for adolescents and children.

What really works

The simple truth is that weight-loss medications, whether over the counter or prescription, do not promote permanent loss of body fat. It is lifestyle changes, and not pills--that take the weight off and keep it off. Studies have shown that there is no substitute for practicing healthy eating habits and getting appropriate exercise--for life.