A Short History of Diet Pills and Weight Loss Drugs Part Two

By Hubert Vigilla

Published on February 18, 2008

(This is the final article in a two-part series tracing the rise of diet pills and weight loss drugs and their influence on American society.  The first article followed the early rise of the diet pill.)

A Time Magazine cover story from November 2, 1981 noted that, on any given day, an estimated 70 million Americans would engage in some form of exercise. At the time, that was nearly half of the adult population.

The change in just two decades is astonishing.

A 2002 study by the National Center for Health Statistics found that seven out of 10 American adults did not exercise regularly. In addition, a February 5, 2007 BusinessWeek article estimated that McDonald's alone serves 27 million people on any given day. These numbers shed light on the some of the causes of the obesity epidemic and may also reveal why diet drugs have come to even greater prominence over time.

Yet it's not just the obesity epidemic that has been a boon diet drug companies. Even people looking to lose a few excess pounds have been turning to diet pills. A 2001 survey conducted by the University of Michigan estimated that 24 percent of teenage girls turn to diet pills to help them lose weight. A more scientific five-year study conducted by the University of Minnesota was published in 2006. The study found that 20 percent of girls had used diet pills to lose weight by ages 19 to 20. It also noted that the diet pills did not work and that girls who had used diet pills were more likely to be overweight by the end of the study.

Dangerous Diet Pills

In recent years, a number of high-profile cases and news stories have centered on diet pills and weight loss drugs, citing dangerous side effects despite Food and Drug Administration (FDA) approval. Several side effects associated with these dangerous diet pills included cardiovascular disease, high blood pressure, chest pains, fainting spells, dizziness, fatigue, shortness of breath, and kidney stones.

Fen-phen was one of these dangerous diet drugs. A combination of fenfluramine and phentermine, the FDA received numerous reports that fen-phen contributed to pulmonary hypertension and the development of heart valve disease. In September 1997, the FDA called on manufacturers to voluntarily remove fen-phen from the market. Dexfenfluramine, marketed under the name Redux®, was also removed from the market in September 1997 for similar reasons pertaining to cardiovascular health.

One of the biggest of these diet pill cases involved Metabolife®, a Utah-based company that manufactured herbal dietary supplements. One of the company's best-selling products was the ephedra-based Metabolife 356®. It was later found that ephedra caused a number of adverse health conditions, the most serious of which included irregular heartbeat, hyperthermia, heart attacks, strokes, and seizures. An estimated 155 deaths were linked to ephedra, including the death of Baltimore Orioles pitcher Steve Bechler. Initial concerns about the dangers of ephedra were voiced to the FDA in 1997, though ephedra was not banned outright until 2004.

Off-Label Drug Use for Weight Loss

But dangerous diet pills and dietary supplements aren't the only worry. More recent concerns center on people using pills not expressly designed to aid in weight loss. According to a Wall Street Journal article from August 22, 2006, many people are taking medications for epilepsy, depression, diabetes, and sleep disorders to lose weight despite not suffering from any of those conditions.

The story notes that during the 1970s, Adderall®-a stimulant currently prescribed to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy-was once used as a diet drug, though marketed under a different name. As of that writing, Adderall® was said to be the weight-loss pill of choice for celebrities, college students, and soccer moms, and that many of them were taking Adderall® without a prescription.

These off-label uses of certain medications have led to undesirable side effects, including anxiety, insomnia, hair loss, memory loss, abdominal pain, and even cognitive processing problems. Further risks come from taking more than the recommended doses of these medications and taking these medications without doctor supervision. Insurance does not cover these drugs for off-label uses, leading to high costs. These costs are particularly high if a patient receives a combination of off-label drugs to lose weight. Perhaps the greatest worry comes from the drugs themselves and the long-term side effects that these medications may have.

Better Living Through Chemistry?

While it seems only natural that in the quest for healthy physiques we should turn to diet pills for quick results, one has to wonder whether such decisions are sensible. Surely exercise and dietary changes are healthier and more effective in the long run and more satisfying than the instant gratification of popping a pill.

Then again, there is something about pill popping that still seems to fascinate us. Vitamin pills promised a healthier tomorrow, and it was believed that pills would one day solve everything from headaches to food shortages. Even DC Comics had a pill-popping superhero named Hourman. Arriving on the scene in 1940 wearing black and yellow and bits of red for pizzazz, scientist Rex Tyler could pop a special pill-a miracle vitamin of his own invention called Miraclo-and experience exactly 60 minutes of super strength, super speed, super durability, and super stamina.

These pills entice us with promises of slim waistlines, increased metabolism, suppressed appetites, and pep, pep, pep. But what of it? The vast pharmacopoeia available throughout time has shown that diets pills have often been more harmful than beneficial.

With the potential complications posed by some of the pills and supplements on the market, one has to wonder about our friend the atom and exactly what role chemistry will play in a better tomorrow.

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