California and New York aim to ban the sale of diet pills to minors

California and New York are moving ahead of the FDA in limiting the sale of non-prescription diet pills to minors as pediatricians and public health advocates try to protect kids from extreme weight-loss tricks online.

Govt. A bill before Gavin Newsom would prevent anyone under the age of 18 from buying over-the-counter weight loss supplements without a prescription — either online or in stores — in California. A similar bill passed by New York lawmakers is on Gov. Cathy Hochul’s desk. None of the Democrats indicated how he would act.

If both bills are signed into law, proponents hope the momentum will restrict the sale of diet pills to children in more states. Massachusetts, New Jersey and Missouri have introduced similar bills and plan to continue their push next year.

About 30 million People in the United States will have an eating disorder in their lifetime; According to Johns Hopkins All Children’s Hospital, 95% of them are between the ages of 12 and 25. The hospital adds that eating disorders pose the same risk of death as any mental health disorder. And it’s easier than ever to get pills sold online or at drugstores for minors. All dietary supplements, including those for weight loss, will account for about 35% of the $63 billion over-the-counter health products industry in 2021, according to market research firm Vision Research Reports.

Dietary supplements, which include a wide range of vitamins, herbs and minerals, are classified as food by the FDA and do not undergo the same scientific and safety testing as prescription drugs and over-the-counter drugs.

Public health advocates want to keep weight loss products – including ads that promise to “lose 5 pounds in a week”! And pill names like Slim Sense — steer clear of young people, especially girls, since some studies have linked some products to eating disorders. A study in the American Journal of Public Health, which followed more than 10,000 women ages 14-36 for 15 years, found that “those who used diet pills were 5 times more likely to receive a health care diagnosis of an eating disorder. providers between 1 and 3 years compared to those who did not.”

Many pills have been found to be tainted with banned and dangerous ingredients that can cause cancer, heart attacks, strokes and other ailments. For example, the FDA advises the public to avoid Dr. Reed’s Slim Sense because it contains lorcaserin, which can cause psychotic disturbances and impair attention or memory. The FDA ordered it discontinued and the company could not be reached for comment.

“Unscrupulous manufacturers are willing to risk consumer health — and they’re making their products with illegal pharmaceuticals, banned drugs, steroids, over-the-counter stimulants, even experimental stimulants,” said Brian Austin, founding director of the Strategic Training Initiative for Prevention. Eating disorders, or striped, that support restriction. “Consumers have no idea that’s what these types of products contain.”

STRIPED is a public health initiative based at the Harvard TH Chan School of Public Health and Boston Children’s Hospital.

An industry trade group, the Natural Products Association, disputes that diet pills cause eating disorders due to a lack of consumer complaints to the FDA of adverse events from their members’ products. “According to FDA data, there is no relationship between the two,” said Kyle Turk, the association’s director of government affairs.

The association demands that its members adhere to safe manufacturing processes, random product testing and appropriate marketing guidelines. Representatives also worry that if minors can’t buy supplements over the counter, they could buy them from “crooks” on the black market and undermine the integrity of the industry. Under the bill, minors purchasing weight-loss products must show identification with a prescription.

Not all business groups oppose the ban. The American Herbal Products Association, a trade group representing dietary supplement manufacturers and retailers, dropped its opposition to the California bill when it was amended to remove categories of ingredients found in non-dietary supplements and vitamins, according to Robert Marriott, director of regulatory affairs. .

Children’s advocates have found a worrying trend among young people who imagine their ideal body type based on what they see on social media. According to a study conducted by Fairplay, a nonprofit that seeks to stop harmful marketing practices targeting children, children as young as 9 were found to follow three or more eating disorder accounts on Instagram, while the median age was 19. The authors call this a “pro-eating disorder bubble.”

Meta, which owns Instagram and Facebook, said the report lacked seriousness, such as recognizing people’s need to share life’s difficult moments. The organization argues that blanket censorship is not the answer. “Experts and safety organizations told us it’s important to strike a balance and allow people to share their personal stories while removing any content that encourages or promotes eating disorders,” Lisa Crenshaw, a Meta spokeswoman, said in an email.

Dr. Jason Nagata, a pediatrician who cares for children and young adults with life-threatening eating disorders, believes that easy access to diet pills contributes to the condition of his patients at UCSF Benioff Children’s Hospital in San Francisco. This was the case with one of his patients, an 11-year-old starving girl.

“He basically went into a starvation state because he wasn’t getting enough nutrition,” said Nagata, who testified in support of the California bill. “She was taking these pills and using other extreme behaviors to lose weight.”

Nagata said the number of patients she sees with eating disorders has tripled since the epidemic began. They are desperate for diet pills, with some modest results. “We have patients who were so dependent on these products that they would be hospitalized and they’re still ordering these products on Amazon,” he said.

Public health advocates have turned to state legislatures in response to the federal government’s limited authority to regulate diet pills. Under a 1994 federal law known as the Dietary Supplement Health and Education Act, the FDA “can’t take action until there’s a clear problem of consumer harm,” Austin said.

No match for the supplement industry’s heavy lobbying on Capitol Hill, public health advocates have shifted to a state-by-state approach.

However, there is a push for the FDA to improve oversight of what goes into diet pills. US Sen. Dick Durbin of Illinois introduced a bill in April that would require dietary supplement makers to register their products — including ingredients — with the regulator.

Supporters say the change is needed because manufacturers are known to include dangerous ingredients. A review of a health fraud database by C. Michael White of the University of Connecticut’s School of Pharmacy found that 35% of tainted health products came from weight loss supplements.

Some ingredients are banned, including sibutramine, a stimulant. “It was a very commonly used weight loss supplement that was taken off the U.S. market because of its elevated risk of things like heart attacks, strokes and arrhythmias,” White said.

Another ingredient was phenolphthalein, which was used in laxatives until it was identified as a suspected carcinogen in 1999 and banned. “To think,” he said, “that product will still be in the U.S. market is just absurd.”

This story was produced by KHN, which publishes California Healthline, the editorially independent service of the California Health Care Foundation.

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