Diet Drugs and Supplements
BREANNE BONILLA
CARLIN COOMBS
KIMBERLY WILLOW
JANE JENSEN
History
Late 1800’s and Early 1900’s
 2nd Century AD:

Soranus of Ephesus
prescribes laxiatives and
purgatives for obesity
 Late 1800s:


The first diet pills based
off of thyroid extract were
marketed as "fat reducers“
Discontinued due to
causing side effects such
as hyperthyroidism
 1920’s:


Trend of using laxatives
for weight loss.
Gimmicky weight-loss
products advertised.
Early-Mid 1900’s
 1933:


Dinitrophenol was
introduced.
It claimed that it
prevented food energy
from being turned into fat.
 1938:


Dinitrophenol was
voluntarily withdrawn by
manufacturers.
Enactment of the Food,
Drug, and Cosmetics Act.
 1940’s:

Appetite suppressant
candy called Ayds was
marketed
Mid 1900’s
 Late 1930s - 1950s:
 Doctors began prescribing amphetamines for its side effect of
appetite suppression
 1950’s:
 Tapeworm diet pills hit the news after opera singer Maria
Callas was rumored to have ingested one for weight loss.
 Unverified if there were really tapeworms in the advertised
pills.
 1959:
 Phentermine approved by the FDA
Mid 1900’s
 1960’s:
 "Rainbow pill" regimes were being used. They were a
combination of multiple pills to help weight loss, such as
amphetamines, diuretics, and laxatives.
 1965:
 Appetite suppressant aminorex fumarate was developed as
treatment for obesity.
 Withdrawn from the market two years later due to pulmonary
hypertension side effects.
 1970’s:
 Adderall was used as a diet drug, marketed under the name
Obetrol.
Late 1900’s
 1973:


the Food and Drug
Administration approved
the drug fenfluramine
FDA began the recall of
diet drugs containing
amphetamines.
 1979:

Fenfluramine and
phetermine have been
combined into Fen-Phen
and gained popularity.
1990’s
 1992:
 Fen-phen gained more popularity when a report stated that it
caused a 10% weight loss.
 1994
 Dietary Supplement Health and Education Act is passed,
which adds the "dietary supplement" category.
 Ephedra classified as a herb and use for weight loss increases.
 1995
 Dexfenfluramine (Redux) was developed as an alternative to
fenfluramine with less side-effects.
1990’s
 1997
 Removal of fen-phen is called for by the FDA after reports
linking fen-phen with heart valve problems.
 Redux removed from the market due to similar problems
relating to cardiovascular health.
 1998
 Meridia is put on the market.
2000’s
 2004:
 Ephedra removed from the US market from concerns with
raising blood pressure which could lead to strokes and death.
 2009
 Hydroxycut diet supplements pulled off the market after
reports of liver damage.
 Meridia (sibutramine) is removed from the US market from
concerns that it could raise blood pressure and cause stroke or
heart attack.
2000’s
 2010
 Orlistat (prescription as Xenical, over-the-counter as Alli) is
available.
 Orlistat is taken to reduce the amount of dietary fat that is
absorbed by the digestive tract.
Drug Pharmacodynamics
Prescription Drug Pharmacodynamics
Orlistat (Xenical)
•
•
Basic Function:
• Prevents the absorption
of fats, reducing caloric
intake
• Saturated version of
Lipstatin
• Inhibits pancreatic
lipases which break
down fat molecules
OTC version: Alli
• Half the dose of
prescription Xenical
 Side Effects:
 Oily discharge/fatty stools
 Lower absorption of fat
soluble vitamins
Prescription Drug Pharmacodynamics
Sibutramine (Meridia)
 Basic Function:

Inhibits NT reuptake in brain
Serotonin
 Norepinephrine
 Dopamine


Enhances feeling of satiety
 Increased risk of heart
attack and strokes


Pulled from US market in
October 2010
Still present in many
counterfeit products
Phentermine
 Basic Function:
 Causes release of
norepinephrine in
hypothalamus
 Reduces feeling of hunger
 Similar structure to
amphetamines
 Part of Fen-Phen
combination drug
Prescription Drug Pharmacodynamics
Metformin (Glucophage)
 Diabetes drug
 For people overweight
and suffering from
diabetes to aid in
weight loss
 Basic function:



Lowers glucose levels
Increase insulin sensitivity
Appetite suppressant
Common Side Effects for Prescription Drugs
 Side Effects:
 Nausea (minor or severe)
 Constipation/Diarrhea
 Dry mouth
 Headaches
 Insomnia
 Increased blood pressure and heart rate (minor or severe)
 Nervousness, confusion, and irritability
Prescription Drug Results
 Very minimal results without diet and exercise
 Most show loss of about 8-12 lbs/year
 Lifestyle changes needed for more serious results
 All have serious side effects  should only be used in
more serious cases (risk vs. reward?)
 Many people abuse (OD, use of non-diet prescription
drugs)
OTC Supplement Pharmacodynamics
Ephedra/Ephedrine
 Ephedra: plant with 2
active constituents:


Ephedrine
Pseudoephedrine
 Ephedrine is normally
paired with caffeine in
OTC diet supplements
 Basic function of
Ephedrine:


Appetite suppressant
Acts on adrenergic
receptors
 Side Effects:
 High blood pressure
 Heart attacks, strokes (can
be fatal)
 Tremors/seizures
 Insomnia
 Banned by FDA
 Drugs now contain “legal
ephedra”
 Epehdra without
ephedrine
OTC Supplement Pharmacodynamics
Ephedra Replacements
 Bitter orange



Essential oil from an type
of orange
Similar health concerns as
ephedrine
Lack of evidence about
effectiveness
 Hoodia gordonii



South African spiny
succulent plant
Increases hypothalamic
ATP
No published scientific
evidence demonstrating
use as appetite
suppressant
Celebrity Endorsements
Celebrity Sponsors
 Marketed products claim weight loss through
celebrity endorsements
 Much of the popularity of diet drugs is due to clever
marketing and ad campaigns… such as TrimSpa
Anna Nicole Smith
 “LIKE MY BODY”
 Lost 69 lbs.
 In 2005, TrimSpa was sued for Anna's erratic
behavior at a concert- associated with slurred speech
and behavior
 http://www.youtube.com/watch?v=A4GsS5ua4MEh
t
TrimSpa Baby!
 Potential TrimSpa Side Effects and Concerns






Original TrimSpa formula contained the stimulant herb ephedra
Expensive (>$48/month)
No longer individually lists the ingredients
Side effects may include anxiety and insomnia (rec. amount of 4
pills/day = two 8-ounce coffee)
May trigger migraines (tyramine)
Shouldn’t be taken with Monoamine Oxidase Inhibitor(MAOI)
antidepressant drugs
 What’s good about TrimSpa?

Contains glucomannan, a water-soluble dietary fiber derived from
konjac root
Keeping Up With the Kardashians
 “How HOT Can You Be?”
 Kim claims to have lost 15 lbs, Khloe 25 lbs(some of
which she gained back)
 Advertises “to help burn calories, support energy
levels, and supercharge workouts”
(getquicktrim.com)
 Pressures women receive:


Temptation of getting that bikini body
Kim and Khloe Kardashian use sex to sell their QuickTrim diet
pills
 http://www.youtube.com/watch?v=Q69Igo7xcGA
QuickTrim
 “This product isn’t intended to be a complete
replacement for having a reasonably healthy diet and
lifestyle” (kardashiansquicktrim.com)
 Dangers of Kardashian-Endorsed QuickTrim
 4 QuickTrim products




Sculpting gel for cellulite
14-day "burn and cleanse“
48-hour cleanse
8-hour weight loss formula that burns calories 300% x faster
 All of which are advertising fast weight loss. Most experts
recommend effective weight loss to be gradual and just 2
lbs/week for safe and long-term weight loss, even with
the help of diet drugs.
QuickTrim Weight Loss Supplement
 Burn & Cleanse 14-Day
Diet System- burns calories
by day and cleanses by
night



Daytime pills are mostly
caffeine: contains
thermogenic complex, black
pepper, white willow bark
Nighttime supplements are
laxatives: contains stimulant
laxatives (senna, cascara,
rhubarb) and bulk laxatives
(fig extracts, oat fiber)
May get diarrhea, loss of
nutrients, dehydration
 Iso-Flush- taken along with
Burn & Cleanse



Herbal diuretics to shed
water from body: contains
horsetail extract, juniper
berry
If taken for long periods can
be toxic.
Can reduce kidney function
& may suffer from severe
dehydration.
Lose it on the QT!
 Fast Cleanse- “48-hour
Super Diet Detox” to drop a
dress size


Fiber-rich drink 4x/day b/w
meals
Primarily a digestionresistant polysaccharides
 Extreme Burn- supposed to
be used long term after
finishing 14-day plan


Contains a lot of caffeine and
herbs to boost potency
Powerful stimulants,
laxatives, and diuretics.
 At best, these diet pills will
produce short-term weight
loss because they stimulate
or speed up metabolism
and act as diuretics
 Since under "supplements"
instead of “medications”,
they are NOT required to
undergo rigorous FDA
testing to ensure they are
safe and do what their
manufacturers claim they
do
Problems with Diet Drugs
Diet Pill Makers Misleading Consumers
 Federal Trade Commission says some diet companies
make false advertising claims ranging from rapid weight
loss to reducing risk of cancer, Alzheimer’s, osteoporosis
 FTC challenges marketing of claims -> required to back
up claims with the science
 Fines levied against 4 over-the-counter non-prescription
diet pills:



Xenadrine, One a Day Weight Smart, CortiSlim, TrimSpa
A combined $25 million
Receive money back when consumers have been deceived
 Ex: Bayer Corp. paid $3.2 million civil penalty to settle
claims and agreed to stop ads that say “multivitamins can
increase metabolism”
Trying to lose weight? Don’t turn to pills!
 FTC claims there are NO scientific evidence that diet
pills cause weight loss
 Testimonials from individuals are not a substitute for
science
 FTC also said that customers using the products and
providing testimonials were paid as much as
$20,000 for their “endorsements.”
 The media and women’s magazine have been “urged”
to refuse or remove these type of ads from their
magazines, or investigate the claims being made.

But doesn’t because they want the revenues!
Counterfeit Diet Pills
 Booming trade in
counterfeit slimming pills
 Medicines and Healthcare
Regulatory Agency(MHRA)
sited 2 prescription-only
anti-obesity pills: Xenical,
Reductil

Very commonly
counterfeited in UK
 Through illegal pharmacies
and illegal websites where
demand is high and
maximum profits are made
 Fake prescription obesity
pills contain little active
ingredient, some may cause
harm
 Made in substandard
conditions, contain
impurities
 No true regulation (no
prescription necessary)
Problems
 There is NO medical or other supervision of any kind
 May be easily abused.
 Ex: In fact, teenage girls are some of the heaviest
users of retail diet pills, because they’re easily
accessible.
Advertisements for Male
Audiences
“A SKINNY MAN
HASN’T A CHANCE ”
POP SOME PILLS AND
WATCH THE FAT MELT
AWAY -- THAT’S NOT FAR
FROM THE TRUTH
Apolo Ohno and 8 Zone
 Apolo Ohno


Founder/owner of 8 Zone
Pills for each 8-hour
segment of day
Apolo Ohno and 8 Zone
 Step 1: Aggressive (Red
Zone)



For the most active part of
your day (during work)
For healthy, sustained
energy
And for thermogenic fatburning
 Step 2: Subtle (White
Zone)



To keep you going after work
For wholesome nutritional
replenishment
To promote anti-aging and
combat oxidative stress
 Step 3: Downtime (Blue
Zone)



For full rest and recovery
For great sleep
For muscle recuperation
Apolo Ohno and 8 Zone
Some of the Disclaimers
 22.4 - We do not guarantee
that You will have any
specific or particular result
or benefit from the Product,
or that your experience will
match those of others who use
the Product(s). Individual results
will vary from person to person.
Apolo Ohno is a
professionally trained
athlete and 8zone makes no
guarantee or warranty that
taking 8zone alone will
produce the same results as
a professionally trained
athlete like Apolo Ohno.
 22.5 - Any and all
testimonials and/or
statements from users of
the Product(s) are those of
the respective user. 8zone
does not endorse any such
statement and/or warrant
that any such statement is
true or accurate. 8zone
likewise does not
investigate the
accuracy of any
testimonial.
Xenadrine
 Since Ronnie has started, his GTL routine is
now XGTL-Xenadrine. Gym. Tan. Laundry.
Xenadrine
 Xenadrine ULTRA, “these ingredients have not been






evaluated by the FDA. These products are not intended
to diagnose, cure or prevent any disease”
Sold at GNC where various diet supplements are sold.
1990’s, Xenadrine EFX contained ephedrine and
synephrine (similar to amphetamines)
Now, Xenadrine ULTRA contains yerba mate, guarana,
1,3,7-trimethylxanthine
Contain 200 milligrams of caffeine
Excite body functions, result in short-term weight loss
Vitamins in Xenadrine don’t impact weight loss
Xenadrine
 From Ronnie’s Facebook
page (linked from Xenadrine
website):

“You heard? I got a new
workout partner: Xenadrine.
Gives me the energy I need.
Love that I'm endorsing
something that really works!”
 A response to Ronnie’s Post:

CSP- I truly use Xenadrine cuz
of ONLY one reason and that
reason Ronnie.thank You
Ronnie for be their Spokes
Man cuz of You and Xenadrine
I`am finally lossing the weight
I want.so thank You Ronnie
and Xenadrine
 We are sure that Ronnie is
happy CSP is “lossing” the
weight with Xenadrine.
Xenadrine
 Studies published on




website all have reduced
calorie diet…
Mentions that Xenadrine is
best combined with diet
and exercise!
Promotes the unachievable
body
Promotes weight
management with minimal
effort
Study showed placebos
more effective than
Xenadrine
Children and Teens
Advertisements
 Obesity drug ads
misleading teens
“Xenical”


Ads aired during popular
show, Australian Idol.
Controversial
 The Australian National
Drugs and Poisons
Schedule Committee
banned OTC
commercials as they
were targeted to average
weight people
Effects in Society
 Questioned UCSF study
that 80% of fourth-grade
girls were dieting
 At a school in Illinois
(1986) 75% of 9 year old
girls said they weighed
too much and afraid boys
wouldn’t like them if they
got fat
 Results have not changed
much
TV Shows and Media Icons
 90210 stars although
labeled by magazines ‘too
skinny’ still very popular
show
 Dr Aric Sigman’s article
in The Biologist


The media is a causal risk
factor for body
dissatisfaction
Studied female reactions
to TV shows with thin
characters around the
world
Cost/Common Statistics
 US weight loss market
 1992 $30 billion
 Now estimated $40-60 billion
 Prescription and over-the-counter diet drugs altogether took in
$381.5 million in 2009, according to data from IMS Health.
Diet Pill for Dogs…
 Substitute for exercise
and food reduction
 Slentrol is the first FDAapproved diet pill for
dogs
Final Thoughts
 Rule: Do NO harm
 Question: Do benefits




outweigh the risks?
No Quick fix
Not for people who want
to lose 5-10 lbs
For morbidly obese
Must include lifestyle
change; diet and
exercise!!!!!!
Works Cited - History





"Diet Pills - Overview." Encyclopedia of Drugs and Addictive Substances. Ed. Barbara C.
Bigelow. Gale Cengage, 2006. eNotes.com. 2006. 9 Mar, 2011 <http://www.enotes.com/drugssubstances-encyclopedia/diet-pills/overview>
Whittemore, Frank. (January 18, 2010). The History of Diet Pills. In Livestrong.com. Retrieved
March 2011, from http://www.livestrong.com/article/74336-history-diet-pills/.
Grabianowski, Ed. "Have people ever really eaten tapeworms for weight loss?" 16 December
2008. HowStuffWorks.com. <http://health.howstuffworks.com/wellness/diet-fitness/weightloss/tapeworm-weight-loss.htm> 09 March 2011.



Jones, A. R. (2002). FDA vs. Ephedra: Dietary Supplement Regulation Under DSHEA, pp. 2.

Citation. (2011, March). In Wikipedia, The Free Encyclopedia. Retrieved from
http://en.wikipedia.org/wiki/Anti-obesity_medication
Works Cited - Pharmacodynamics
Zhi, J., Melia, A. T., Eggers , H., & Joly, R. (1995). Review of limited systemic absorption of orlistat, a lipase inhibitor, in
healthy human volunteers. Journal of Clinical Pharmacology, Retrieved from http://jcp.sagepub.com/content/35/11/1103.long
Morris, J. (2006). Little research behind claims that hoodia is safe, effective for losing weight. The Seattle Times,
Retrieved from http://seattletimes.nwsource.com/html/health/2002850423_healthhoodia08.html
Haller, C. A., & Benowitz, N. L. (2000). Adverse cardiovascular and central nervous system events associated with
dietary supplements containing ephedra alkaloids. The New England Journal of Medicine, 343. Retrieved from
http://www.nejm.org/doi/full/10.1056/NEJM200012213432502#t=articleTop
Gurley, B. J., Wang, P., & Gardner, S. F. (2000). Ephedrine-type alkaloid content of nutritional supplements containing
ephedra sinica (ma-huang) as determined by high performance liquid chromatography. Journal of Pharmaceutical Sciences, 87(12),
Retrieved from http://onlinelibrary.wiley.com/doi/10.1021/js9801844/pdf
The pharmacokinetics of phentermine and chlorphentermine in chronically treated rats. (1973). Journal of
Pharmaceutical Pharmacology, 25(3), Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/4146324
Guerciolini, R. (1997). Mode of action of orlistat. Int J Obes Relat Metab Disord. , 21(3), Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/9225172
Bray, G. A. (1999). Sibutramine produces dose-related weight loss. Pennington Biomedical Research Center, 7(2),
Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10102256
James, Philip. (2000). Effect of sibutramine on weight maintenance after weight loss: a randomised trial. The Lancet,
356(9248), Retrieved from http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6T1B-4221FXX-96&_cdi=4886&_user=4429&_pii=S0140673600034917&_origin=gateway&_coverDate=12%2F30%2F2000&_sk=996430751&view=
c&wchp=dGLzVzz-zSkWA&md5=c8f66276ed614b035e95c691f53b50b8&ie=/sdarticle.pdf
Duenwald, M. (2005). Bitter orange under scrutiny as new ephedra. The New York Times, Retrieved from
http://www.nytimes.com/2005/10/11/health/policy/11cons.html?_r=1
Shekelle, P. G., & Hardy, M. L. (2003). Efficacy and safety of ephedra and ephedrine for weight loss and athletic
performance. JAMA, 289(12), Retrieved from http://jama.ama-assn.org/content/289/12/1537.full.pdf+html
Gokcel, A., & Gumurdulu, Y. (2002). Evaluation of the safety and efficacy of sibutramine, orlistat and metformin in the
treatment of obesity. Diabetes, Obesity and Metabolism, 4(1), Retrieved from http://onlinelibrary.wiley.com/doi/10.1046/j.14631326.2002.00181.x/pdf
Lee, A., & Morley, J. E. (1998). Metformin decreases food consumption and induces weight loss in subjects with obesity
with type ii non-insulin-dependent diabetes. Obesity Research, 6(1), Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9526970
Works Cited – Celebrity Endorsements and
Problems with Diet Drugs










Ashton, J. (2010, September 16). CBS News Health Watch. New Diet Drugs Await Approval.
Retrieved from http://www.cbsnews.com/video/watch/?id=6871953n
Blatner , D., & Bauer, J. (2007, October 5). Weight Loss Drugs: How Much Do Diet Pills Help? .
American Dietetic Association, Retrieved from
http://www.medicinenet.com/script/main/art.asp?articlekey=56559&page=2
Blatner , D., & Bauer, J. (2007, October 5). Weight Loss Drugs: How Much Do Diet Pills Help? .
American Dietetic Association, Retrieved from
http://www.medicinenet.com/script/main/art.asp?articlekey=56559&page=2
Bowdler, N. (2010, July 7). BBC News Health. The booming market in counterfeit slimming
pills. Retrieved from http://www.bbc.co.uk/news/10258849
Diet and Nutrition. (2007, January 4). Diet pill makers fined millions for false claims .
Retrieved from http://www.msnbc.msn.com/id/16467558/ns/health-diet_and_nutrition/
Diet Pills Report & Review [The Use of Retail (non-prescription) Diet Pills & Appetite
Suppressants]. (2010). Retrieved from http://www.bestdietforme.com/dietpills.htm
Kardashians QuickTrim Resource [Online forum post]. (2010). Retrieved from
kardashiansquicktrim.com
Kotz, D. (2010, January 19). The Dangers of Kardashian-Endorsed QuickTrim. U.S. News &
World Report of Health on Women, Retrieved from http://health.usnews.com/healthnews/blogs/on-women/2010/01/19/the-dangers-of-kardashian-endorsed-quicktrim
QuickTrim. (n.d.). Retrieved March 6, 2011, from getquicktrim.com
Wong, C. (2007, September 19). Does Trimspa Work? Trimspa Review. Retrieved March 6,
2011, from http://altmedicine.about.com/od/popularhealthdiets/a/Trimspa_Review_2.htm
Works Cited – Ads for Male Audiences and
Children and Teens
Zaslow, Jeffrey. (2009). Girls and Dieting, Then and Now. Wall Street Journal online.
http://online.wsj.com/article/SB10001424052970204731804574386822245731710.html
Beauty and Body Image in the Media (n.d.) Media Awareness Network, CA.
http://www.media-awareness.ca/english/issues/stereotyping/women_and_girls/women_beauty.cfm?RenderForPrint=1
Erfurt, Barbara. (2010). How Does Xenadrine work? Livestrong.com
http://www.livestrong.com/article/74416-xenadrine-work/#ixzz1G30vDgcD
A Skinny Man hasn't a chance. Picture from
http://farm4.static.flickr.com/3167/3009875959_b3273af86f_o.jpg
Ronnie Magro facebook
http://www.facebook.com/pages/Ronnie-Magro/114953338537646
Wall Street Journal. Picture from
http://www.wasauna.com/wallstreet.html
90210 Stars: Too thin for TV? (2008)
http://justjared.buzznet.com/2008/09/17/90210-stars-too-thin/
Marris, Sid. (2007). Ban on Weight Loss Drug Ads. The Australian online.
http://www.theaustralian.com.au/news/nation/ban-on-weight-loss-drug-ads/story-e6frg6nf-1111114303350
Xenadrine information:
http://www.xenadrine.com/
8 Zone information:
http://8zone.com/about.php
Extreme Weight Loss Techniques. Askmen.com
http://www.askmen.com/sports/health_150/154b_mens_health.html