Diet pills are incredibly dangerous for teens. California needs to regulate them like cigarettes – San Francisco Chronicle

Weight loss

Eating disorders among young people nationwide have increased dramatically during the isolation of pandemic.
As a pediatrician who treats teens with eating disorders and a public health professor who studies how best to prevent them, we often encounter a similar arc in the young girls we see battling an eating disorder: The onset of middle school brings with it pressure to be thin. These girls then start trying to lose weight any way they can, resorting to numerous unhealthy behaviors, including restricting food intake and vomiting. If not caught quickly enough, many will have to be hospitalized for severe weight loss and dangerously low electrolytes. Some will eventually have to be moved to residential treatment centers to seek further support.
While such therapy and interventions are successful in helping young girls get back to health, there are measures we can take to help prevent them from reaching such a dangerous state in the first place.
Eating disorders in preteens and teens have surged nationwide. In the first 10 months of the pandemic, the National Eating Disorders Association reported receiving 78% more calls to its helpline. The number of teens hospitalized for eating disorders at UCSF doubled from the start of the pandemic to December 2020, and these elevated numbers have persisted through 2021.
So what can be done? One step would be to make it difficult for teens to get their hands on one of the tools they use to drop pounds: weight-loss supplements and over-the-counter diet pills.
Eleven percent of teenagers report having used a weight-loss supplement, according to the Centers for Disease Control and Prevention. This is concerning, as a recent study found that youth who use over-the-counter diet pills are four times more likely to be diagnosed with an eating disorder compared to nonusers. For these reasons, the American Academy of Pediatrics strongly cautions against teens using these products for any reason.
Unfortunately though, these harmful products are easy to access and readily available. We have all seen them in our local pharmacies, grocery stores, health food stores and online. What many people do not know, however, is that weight-loss supplements are not screened by the Food and Drug Administration for safety or effectiveness before they enter the market. Furthermore, a federal law passed in 1994 — with generous support from supplements industry lobbyists — expressly forbids the FDA from requiring rigorous prescreening of these products, so there is no meaningful federal oversight.
Yet, numerous rigorous scientific studies have shown that these types of supplements pose serious health risks to consumers. A recent study using data from the FDA’s adverse events reporting system found that youth using weight-loss supplements were three times more likely than those using ordinary vitamins to experience severe medical harm, including hospitalization, disability and even death. Studies have linked weight-loss supplements to organ failure, heart attacks, stroke and death. The CDC estimates that supplement use leads to 23,000 emergency room visits every year, with a quarter due to the weight-loss category alone.
Why are these products so dangerous? Lab studies conducted by the FDA and by independent scientists have found that weight-loss supplements are often laced with banned substances, prescription drugs, excessive stimulants and other toxic ingredients.
For our country’s teens, the situation is dire, but California is in the position to turn that around.
State lawmakers have introduced AB1341, which if passed, will prevent the sale of dangerous weight-loss supplements and over-the-counter diet pills to minors, just as we have done with other harmful products such as cigarettes.
When AB1341 was introduced last year, it sailed through multiple committee votes with overwhelming approval, but then faltered at the 11th hour of the legislative session, when lawmakers postponed action until January 2022. And while this bill sat on the sidelines, the weight-loss supplement industry intensified marketing post-lockdown. It’s easy to understand why.
The U.S. weight-loss supplements market was valued at $2.56 billion in 2019 and is projected to reach $3.95 billion by 2027. Hitting growth targets at that rate will require adding legions of new users every year, which makes teenagers a crucial part of the consumer base. Companies know that if they can get teens hooked, they will have a guaranteed market for years to come. That’s why the industry has been flooding state capitols with lobbyists to protect its interests.
With the start of the new year, now is the time for state lawmakers to take action and protect California youth from these harmful products. Age restrictions are an evidence-based policy strategy that has been shown to reduce the use of harmful products by youth when appropriately enforced — as with tobacco and alcohol. The bill also appropriately requires these dangerous weight-loss supplements to be kept behind the counter with notices posted on known health risks. These measures will go a long way in helping our youth stay healthy.
Momentum for action is building across the nation, with New York and Massachusetts considering similar bills this year, but California could be first in the nation to sign the bill into law.
AB1341 gives California lawmakers the opportunity to help curb the explosion of eating disorders among teens and lead the nation in the fight to protect the health of our youth.
Jason Nagata is a pediatrician and assistant professor at UCSF. Dr. S. Bryn Austin is a professor at the Harvard T.H. Chan School of Public Health.
Correction: An earlier version of this article misstated the size of the U.S. market for weight-loss supplements.

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