August 23, 2017

Dietary supplements: Not safe for teens (or anyone, really)

Every few weeks, I get asked, "What pill can I take to help me lose weight?"

Sometimes it's asked by an overweight teen (or parent), sometimes from someone who is at a healthy weight but wants to be a "little bit smaller."

Many of my eating disorder patients admit to using diet pills. According to the Youth Risk Behavior Survey from the Center for Disease Control, 5 percent of teens have used diet pills/powders/liquid in the past month without a doctor's approval in order to lose weight or prevent weight gain.

Just as often, I am asked about the proper supplement to take to help build more muscle. An astounding 35 percent of teen males have used protein powders or shakes to enhance muscles (6 percent have used anabolic steroids).

I was just made aware of a bill in Massachusetts proposing to make diet pills and supplements illegal for minors to purchase.  Why all the fuss? The market for dietary supplements is a $32 billion a year industry. For such a large industry (and something that people are ingesting), you'd think that there would be some oversight, like there is for other foods or medications. Not the case.

The Food and Drug Administration (FDA) does not regulate diet pills or supplements, so you never really know for sure what you're ingesting (this is my same statement for trusting drug dealers). Supplements are not required to undergo safety testing — under the Dietary Supplement Health and Education Act of 1994, anything labeled as a dietary supplement is assumed to be safe until proven otherwise. The FDA is charged with the task of identifying and removing dangerous supplements only after they have caused harm.

And wow, have they caused some harm. Dietary supplements sold for weight loss and muscle building have been associated with serious health risks and side effects, including organ failure, testicular cancer, heart attack, stroke and even death. Some supplements are mixed with illegal substances such as steroids, prescription pharmaceuticals and heavy metals. In fact, tainted dietary supplements have accounted for slightly more than half of all drug-related recalls since 2004.

Even ones with legal substances are worth scrutinizing — one of the more popular ingredients in diet pills is caffeine (and we all know potential harmful effects of high levels of caffeine, right? Read this blog post to refresh your memory). One of the most popular ingredients in muscle-building substances is creatine monohydrate, a product not recommended for teens by American Academy of Orthopaedic Surgeons due to lack of research into long-term health effects. Creatine is known to cause water retention, muscle cramps, diarrhea and even seizures. According to the Monitoring the Future study, 18.5 percent of male high school seniors have used creatine. Other supplements have been shown to be analogues of highly addictive drugs, like methamphetamine. Yeah, that's a habit I want to pick up to get more defined biceps (shudder).

Another fun fact: Supplement manufacturers can make claims without solid scientific evidence behind them. In fact, the evidence of effectiveness for most supplements is nonexistent. In other words, money down the drain.

In summary, there is no magic bullet to weight loss or muscle building. And since no supplements have been shown to be effective and may lead to severe health consequences, maybe Massachusetts is on to something.

What are your thoughts on the dietary supplement industry?