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Updated 22 October 2013

Dangerous diet pills: how to protect yourself

The SA weight-loss industry remains unregulated, resulting in over-the-counter products that contain "hidden" or "undisclosed" ingredients that could be very harmful to your health, DietDoc warns.

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Not a week goes by that I do not receive questions relating to over-the-counter (OTC) slimming pills and products.

Recently a concerned member of the public asked me if I had heard of the Lida Daidaihua slimming product that promises to “burn yellow fat” and was being advertised as a so-called “wonder pill”.

The person in question added that she had been able to buy these pills without any checks and balances being applied and that she had developed a number of negative side-effects including hypertension, irritability, angina pains, constipation and heartburn while taking the capsules.

Finally she wanted to know if these products are subjected to any controls in South Africa to ensure that they are sold responsibly and that the public is protected against exploitation.

The answers to these questions are:
 
According to the Lida Daidaihua sales website their slimming product relies on "bitter orange" (also know as citrus aurantium) or "synephrine" which is increasingly being used in place of ephedra in slimming pills.

Synephrine is addictive and acts as a stimulant which can stimulate fat metabolism and suppress the appetite, but is unfortunately also capable of causing a long list of negative side-effects.

Side-effects reported for synephrine include:
  • Increase in blood pressure causing hypertension*
  • Palpitations and cardiac arrhythmias (possible causes of the angina pain reported by the above mentioned member of the public)
  • Flushing and sweating
  • Restlessness and problems with sleeping
  • Hostility or irritability*
  • Problems with breathing
  • Headaches and dizziness
  • Tremors
  • Very low blood sugar levels and hypoglycaemia
(*Reported by the above mentioned member of the public)
(Hansen et al, 2012; Karimi, 2013)

 
"Yellow fat" is just another name for "white" fat which is the type of fat human beings and other mammals deposit in their bodies if they ingest more energy than they can use up on a daily basis by physical activity and for their basic metabolic rate (Nordqvist, 2012).

Regarding safety checks of the hundreds and hundreds of OTC slimming products that are sold in South Africa and other parts of the world, these seem to be non-existent.

No official checks

Anyone can order herbal mixtures from countries in the East or source indigenous herbs that may or may not help with weight loss and package them under an exotic name and sell them to desperate people wanting to lose weight and no official checks will be carried out to determine if the ingredients are safe or if they are actually the ones that were ordered.

The Simply Slim scandal in 2011, was a good example of this kind of scam. When the SABS and other laboratories such as the Pharmaworx Laboratory in Midrand tested Simply Slim, one of the most popular OTC slimming pills available early in 2010, they found that this purportedly "safe and natural herbal" mixture actually contained extremely high levels of a chemical called sibutramine.

A few months earlier sibutramine had led to the banning of a number of registered pharmaceutical slimming pills because of its side-effects including cardiovascular symptoms such as arrhythmias and angina pain. After the revelations that the mixture of herbs in Simply Slim ostensibly sourced from China contained sibutramine, the product in its original form was removed from the market.

Falling through the cracks

I am always amazed that OTC slimming, sports and other products seem to "fall through the cracks" of legislation intended to protect the public not only in South Africa, but also in countries like the USA.

However, the Food and Drug Administration (FDA) of America does have a praiseworthy service on their website where they list OTC products that contain "hidden" or "potentially dangerous" ingredients and warn the American public not to use the specific products.

For example, in 2012, a product which was evidently sold in America for slimming purposes called "Japan Rapid Weight Loss Diet Pills Green" was tested by the FDA and found to contain an undisclosed ingredient called phenolphthalein a chemical that is suspected of causing cancer which is banned in the USA. Phenolphthalein is also regarded as genotoxic which means that it can cause DNA mutations.

According to the FDA website: "Consumers should stop using these products immediately and throw them away. Consumers who have experienced any negative side effects should consult a healthcare professional as soon as possible."

In addition, the FDA website also encourages healthcare professionals and the general public to report adverse events or side-effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Programme. The website lists instructions on how such products can be reported to them for testing.

We need a MedWatch programme

It would be most helpful if a similar programme could be made available in South Africa so that "tainted" OTC products that contain "hidden" or "undisclosed" ingredients such as the phenolphthalein in the Japanese diet pill mentioned above or the sibutramine that was found in diet pills in South Africa could be identified and tested and any negative or dangerous findings could then be made public.
 
Such a MedWatch programme obviously costs money, which in the present bleak economy is far beyond our reach in South Africa. However, it is something that legislators should keep in mind for the future because the weight-loss market in South Africa is being exploited by unscrupulous individuals out to make a quick buck at the expense of vulnerable people who would do anything to lose weight.

In the meantime these slimming product scams continue unabated and the public are duped, their health is endangered and the manufacturers of such diet pills laugh all the way to the bank.
 
(References: FDA, 2012. http://www.fda.gov/Drugs/ResourcesForYou/Consumers/ BuyingUsingMedicinesSafely/); Hansen DK et al, 2012. Physiological effects following administration of Citrus aurantium for 28 days in rats. Toxicol Appl. Pharmacol, 261(3):236-47; Karimi S, 2013. Common side-effects of synephrine based diet pills. http://www.sabah- karim.hubpages.com/; Lida Daidaihua Slimming Capsules: http://www.lidadaidaihoumall.com; Nordqvist C, 2012. Brown fat - keeps you warm and keeps you slim. Medical News Today. MediLexicon, Intl. 25 Jan 2012. http://www.medicalnewstoday.com/articles/240759.php)

 

Dr Ingrid van Heerden is a registered dietician and holds a doctoral degree in Nutrition and Biochemistry. She believes that "we are what we eat" and offers free nutrition and weight loss advice via her DietDoc service on Health24.com. Read more of her articles.

 
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