Diet Pill Use Could Be a Step Away From Eating Disorder
Teenage girls who use over-the-counter diet pills and laxatives to lose weight run a very high risk of developing eating disorders, researchers say.
In a new U.S. study, girls who used diet pills had a 258% greater risk of being diagnosed with an eating disorder like anorexia or bulimia within five years. If they used laxatives, the risk was 177% greater, compared with those who didn't use those products.
"These findings, especially when also considering that diet pills and laxatives can lead to a number of dangerous side effects, including liver and kidney damage, really emphasize the need for policies to restrict access to these products, especially for youth," said lead researcher Vivienne Hazzard. She did the work while a postdoctoral fellow at the Sanford Center for Biobehavioral Research in Fargo, N.D.
In the United States, California, Massachusetts and New York are considering banning the sale of over-the-counter diet pills to minors, she said.
"Based on the results of our study and a lot of other evidence indicating the dangers of diet pills, passing these bills should be a no-brainer," Hazzard said.
Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York City, is concerned that banning the sale of these drugs to minors might result in kids turning to more drastic measures.
"The issue is that there is potentially abnormal stress or anxiety about weight and body shape," he said. "That is expressed by taking substances that they have been told may offer short-term weight loss."
If access to these drugs is restricted, the stress would remain, he said. "I'm not sure that would not be expressed in more harmful items and more dangerous drugs. The taking of a substance is the symptom, not the underlying issue," Roslin said. "Beware of unintended consequences."
Hazzard said that parents should be on the alert: If your teens are using diet pills or laxatives as a weight-loss aid, consider this a warning sign of a potential eating disorder.
"If they learn that their child is using diet pills or laxatives to control their weight, parents should have a conversation with their child about the dangers of these products, and also, more broadly, about their child's body image and relationship with food," Hazzard said.
"Parents should also take their child to be evaluated by a pediatrician and consider having their child speak with a mental health professional," she added.
For the study, Hazzard's team collected data on more than 1,000 girls. The girls were followed from their teens for more than 10 years. During that time, they were asked about their health and behavior, including the use of diet pills and laxatives and if they had an eating disorder.
The study doesn't establish a cause-and-effect relationship, merely an association. Also, it only looked at girls, so future research is needed to see if the association holds among boys, Hazzard said.
"We need to protect our youth from using diet pills and laxatives to control their weight, because using these products could lead to eating disorders, which are serious diseases with high mortality rates," she said.
One expert believes that society's obsession with appearance puts undue pressure on girls to conform to an ideal.
"Early intervention with this at-risk population, who are susceptible to the social pressure for thinness and unrealistic weight-loss claims of these products, is important," said Samantha Heller, a senior clinical nutritionist at NYU Langone Health in New York City.
Family, friends and others who witness young women engaging in the abuse of diet pills and laxatives should take steps to address it, she said. "We need to continue to emphasize the notions of being healthy, not skinny, and of self-acceptance and self-respect with populations of all ages."
Laxatives and over-the-counter diet pills aren't recommended for weight loss, and can cause serious health problems, Heller said.
"Laxatives play an important role for people with a medical need to use them. However, laxative abuse is a serious problem. And the majority, if not all, of over-the-counter diet pills and products advertised for rapid weight loss have not been evaluated for safety and efficacy, and really should not be taken by anyone," she said.
The report was published May 5 in the International Journal of Eating Disorders.
For more on eating disorders, head to the U.S. National Institute on Mental Health.
SOURCES: Vivienne Hazzard, PhD, MPH, RD, postdoctoral fellow, Sanford Center for Biobehavioral Research, Fargo, N.D.; Samantha Heller MSRD, senior clinical nutritionist, NYU Langone Health, New York City; Mitchell Roslin, MD, chief, obesity surgery, Lenox Hill Hospital, New York City; International Journal of Eating Disorders, May 5, 2021