More than two thirds of Americans are overweight or obese, according to the National Institutes of Health — and supplement companies are cashing in. About 15 percent of adults in the U.S. have used a dietary weight-loss supplement at some point in their lives, spending roughly $2.1 billion a year on those in pill form.
“The obesity epidemic is not going away, and it’s easy for companies to see how a pill for this will maximize profits,” says Mark Moyad, M.D., director of Preventive and Alternative Medicine at the University of Michigan and author of The Supplement Handbook. “The irony is that we’ve had drugs that work — they could help people lose weight, and sometimes very large amounts of weight — but they also just destroyed the body.”
He points to Meridia — the brand name for a drug called sibutramine — as one recent example. “This is maybe the biggest-selling weight-loss drug of all time, and for a while it seemed like people were losing weight and doing well,” he says. “But then people started dying.” The drug has since been taken off the market.
“We have case reports of young, healthy people with no underlying heart disease who took some of these weight loss supplements, ran a marathon, and dropped dead,” says Pieter Cohen, M.D., an associate professor of medicine at the Harvard-affiliated Cambridge Health Alliance.
One such case report details the story of a runner who died while taking a supplement that contained a banned substance called 1,3-dimethylamylamine (DMAA), which Dr. Cohen’s research has found in multiple weight-loss supplements sold in the U.S.
That’s because the U.S. supplement market is very lightly regulated, and the weight-loss products you can buy online, via infomercial, or in nutrition stores could contain any number of hazardous substances, he explains. Even if the ingredients are approved for consumer use, they may contain chemical variations of banned or dangerous substances and dosages that are well above what has been deemed safe, says Dr. Cohen.
“Unlike taking something like medicine, where every single pill has the same amount, there’s not the same quality of manufacturing when it comes to these supplements,” he says.
Dr. Moyad adds that just because a diet supplement helps you lose a few pounds doesn’t mean it’s safe. “I don’t want to send the message that pills can never help,” he says. “There are things your doctor could prescribe along with diet and exercise that, based on your medical history, could help you lose weight.”
Only having a conversation with your doctor could help you determine whether or not the side effects of prescription-grade weight loss pills would be worse than the side effects of living with obesity. But when it comes to OTC weight-loss supplements, the risks often outweigh the rewards. Death aside, here are six you should take note of.
YOU COULD DAMAGE YOUR HEART
Many weight-loss drugs work by speeding up your body’s metabolism and heart rate in order to increase the amount of energy you burn, Dr. Moyad explains.
Because they’re artificially cranking up your heart rate, these drugs can lead to irregular heartbeat (arrhythmias) and damage or malfunction in the vales of your heart, he says.
“You could also damage the heart muscle itself,” he adds. All of this could tee you up for a heart attack or cardiovascular disease down the road.
YOU INCREASE YOUR RISK OF STROKE
“In general, many of these [substances found in weight-loss supplements] are stimulants, so they work by stimulating the heart to pump faster,” Dr. Cohen says. “The risks of this kind of stimulation are increased blood pressure, which could lead to a stroke or bleeding in the brain.”
These side effects should concern you if you’re taking an OTC supplement. “The safest stimulant I can think of is caffeine,” Dr. Cohen says. “But even with caffeine, taking a tablespoon of pure caffeine is enough to kill most people.”
He reiterates that most weight-loss supplements are virtually unregulated. Even if you haven’t had issues taking a supplement in the past, the next batch could contain too much of one ingredient, potentially causing problems you never experienced before.
YOUR LIVER MAY NOT FUNCTION PROPERLY
Your liver is an important organ: It helps your body process the nutrients in your food, flushes toxic substances from your system, and plays a role in stabilizing your blood sugar — but popping a supplement can put those functions at risk, says Dr. Moyad.
Research backs him up on this. One 2011 study from Mount Sinai Medical Center in New York found “fat burner” dietary supplements — a category that includes some herbal and tree-derived ingredients — could lead to acute liver poisoning and failure.
“Your liver has to deal with the ingredients and chemical byproducts when you take these things, and that can cause a build-up of enzymes that can be toxic,” Dr. Moyad adds. Research has also linked some weight-loss drugs with hepatitis, a form of liver inflammation that can lead to permanent damage or scarring.
YOUR SKIN COULD BECOME RED AND ITCHY
A weight-loss compound called 2,4-Dinitrophenol (DNP) is banned in U.S. and European weight-loss supplements, but this “hazardous chemical” still turns up in weight-loss supplements sold online, according to a 2011 study in the Journal of Medical Toxicology.
Again, it causes damage by over-revving your heart rate and metabolism. However, the study found that the most common side effect of DNP overdose is itchy, inflamed skin due to an allergic reaction. Yellowing of the skin is also possible due to liver damage, the study authors say.
YOUR VISION MIGHT GET MESSED UP
The same study found evidence that DNP can cause cataracts and related vision problems.
Cataracts — cloudy imperfections on your eye’s lens — can develop quickly after the use of DNP due to changes in blood-cell health and production. These can lead to a permanent decrease in vision, as well as issues with light-dark perception, the study authors say.
YOU MIGHT FEEL DIZZY AND HEAR RINGING IN YOUR EARS
Reading the words “green tea extract” on a supplement label may seem reassuring — like the product is “natural” and therefore harmless.
Drinking plain green tea is fine, but Consumer Reports listed green tea extract among its 15 supplement ingredients “to always avoid,” citing research that links the extract to dizziness, ringing in your ears, poor iron absorption, elevated blood pressure, and liver damage.
A just-published consumer fact sheet from the National Institutes of Health also links many of those side effects to green tea extract.
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