The quest for a slimmer physique has fueled the diet pill industry for decades, with the 1980s marking a particularly intense period. However, beneath the alluring promises of quick weight loss lay a disturbing truth: many of these pills contained dangerous ingredients with potentially fatal side effects. This article delves into the history of 80s diet pills, examining their ingredients, the risks they posed, and the lessons learned from this tumultuous era.
The Allure of Quick Fixes: A Historical Context
The desire to be thin is not a new phenomenon. As early as the late 19th and early 20th centuries, a cultural shift in body image, driven by the advertising industry and Hollywood, created a demand for prescription weight loss medications. The flapper, with her fashionable, mysterious, and thin persona, became the ideal. Even the sales of penny scales grew.
Physicians had been exploring weight reduction remedies for centuries; in 1862, Parisian dermatologist Louis-Victor Duchesne-Duparc noted that bladderwrack, or sea kelp, caused his psoriatic patients to lose weight. James T. Whittaker, a professor at the Medical College of Ohio, experimented with arsenic to treat obesity. Thyroid emerged as the most significant obesity drug in medical practice. In 1894, British physician Nathaniel Edward Yorke-Davies documented weight loss in obese patients given desiccated thyroid. This led to a new understanding of obesity: exogenous, caused by overeating, and endogenous, characterized by diminished thyroid or other internal gland secretion.
"Black Beauties": The Amphetamine Era
In the 1970s, "Black Beauties," a street name for a combination amphetamine capsule/tablet containing 10mg of amphetamine and 10mg of dextroamphetamine, gained popularity. Amphetamines, stimulants known to decrease fatigue and increase wakefulness, were sometimes given to soldiers.
"Black Beauties" became a recreational drug in the 1960s and 70s, considered a cheap and legal alternative to cocaine. These pills provided energy, curbed appetite, and induced euphoria. However, their use began to decline after they became illegal without a prescription in 1965, and further with the passage of the Controlled Substances Act in 1970.
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Black Beauties contained a racemic mixture of dextroamphetamine and levoamphetamine, similar to Adderall, which is still used to treat conditions like ADHD. Amphetamine and dextroamphetamine are Schedule II controlled substances with a high potential for abuse. Adderall contains an even mixture of dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate, and amphetamine aspartate monohydrate. It takes just over 2 days for a dose of Adderall to be out of your system, but allow for 7 days if taken frequently and at high doses. The primary difference between Adderall and Vyvanse lies in their composition: Adderall contains a mixture of four different amphetamine salts, while Vyvanse contains only one type of amphetamine salt called lisdexamfetamine. Lisdexamfetamine (Vyvanse) is a prodrug that converts into dexamphetamine once absorbed by the body. People taking Adderall for ADHD typically notice improved focus and attention and reduced impulsivity.
Rainbow Pills: A Cocktail of Danger
The FDA has warned consumers about weight loss supplements adulterated with multiple pharmaceutical agents. These supplements, known as "rainbow pills" for their bright and varied colors, combined potent anorectics like amphetamine derivatives with benzodiazepines, beta-blockers, and other medications to suppress the anorectics’ adverse effects.
Rainbow pills date back to the 1940s. Pharmaceutical firms aggressively promoted them to physicians and patients, but by the 1960s, they had caused dozens of deaths, leading the FDA to remove them from the US market. However, they later gained popularity in Spain and Brazil in the 1980s and 1990s and have now returned to the United States as weight loss dietary supplements.
Rainbow pills typically contained d-amphetamine, chlorthalidone, and thyroid hormone as weight loss agents, with digitalis, barbiturates, potassium, glandular extracts, and belladonna added to counter side effects. The pills were sold directly to physicians, who then sold them to patients, often in large quantities, bypassing pharmacies.
These companies also assisted physicians in setting up obesity practices and "educating" potential clients about the pills. All-expense-paid pharmaceutical symposia taught physicians that endocrinologic imbalances, not eating or exercising, led to obesity. By 1967, 5000 MDs and DOs devoted a majority of their practices to weight loss, with 2000 practices focused exclusively on weight reduction.
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As the practice increased, so did concerns about attendant health risks. Adverse events, including deaths, were reported to the FDA as early as the 1940s. In 1968, a Life magazine exposé and tightening control of amphetamine led to the decline of rainbow pills in the 1970s.
Obetrol and Adderall: A Troubled Legacy
Obetrol, a drug combining several amphetamine salts, was initially indicated for exogenous obesity. It was sold by Obetrol Pharmaceuticals and approved by the FDA in 1960. Between 1965 and 1973, Obetrol was marketed in 10 mg (blue) and 20 mg (orange) strengths.
In the 1990s, Rexar reformulated Obetrol to exclude methamphetamine salts and continued to sell it under the same brand name. This new unapproved formulation was later rebranded and sold as Adderall by Richwood after it acquired Rexar, resulting in an FDA warning in 1994. When Richwood acquired Rexar, the drug's name was changed from Obetrol to Adderall, and the drug was marketed for use in the treatment of Attention Deficit Disorder (in both children and adults). The ready availability of methamphetamine-based medications in the 1960s led to their use and abuse as recreational drugs.
Fen-Phen: The Cocktail of the 90s
In the early 1990s, the "Fen-Phen" cocktail, a combination of fenfluramine and phentermine, became popular. Fenfluramine works by releasing extra serotonin, creating a feeling of satiety. Phentermine is a stimulant that counterbalances Pondimin's negative effects.
In 1992, doctors began prescribing the fenflurmine-phentermine cocktail, or "Fen Phen," as an "off-label" combination. The FDA approved dexfenfluramine in April 1996, despite concerns about its safety. The drug was easy to obtain by prescription and accessible in weight-loss clinics and over the Internet.
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However, neither Pondimin nor Redux was very effective. In August 1997, an article in The New England Journal of Medicine revealed that women taking fenfluramine-phentermine had developed pulmonary hypertension and heart-valve abnormalities. As a result, Pondimin and Redux were withdrawn from the market on Sept. 15, 1997.
Ayds Diet Candy: An Unfortunate Name
Ayds Diet Candy, introduced in the late 1960s, was an appetite suppressant available in chocolate, chocolate-mint, butterscotch, and caramel flavors. Its active ingredient was phenylpropanolamine (PPA), a stimulant believed to reduce food cravings.
However, the candy's name became a liability as the AIDS epidemic emerged in the 1980s. The association with AIDS led to a decline in sales, and revelations about PPA's potential health risks further eroded consumer confidence. The Carlay Company withdrew the product from the market in 1985.
Ephedrine: A Banned Stimulant
The FDA prohibited the sale of dietary supplements containing ephedrine alkaloids in April 2004 due to significant cardiovascular risk. Ephedrine, used for over 5000 years by Chinese herbalists, was introduced into Western medical practice in the 1930s for asthma treatment.
Despite the ban, the American preoccupation with body image suggests that ephedrine consumption will likely continue through unregulated access via Internet distributors.
DNP: A Lethal Chemical
DNP (2,4-dinitrophenol) is an illegal substance sold as a fertiliser, wood preservative or dye. It gained notoriety as a weight loss pill, but is extremely dangerous.
DNP works by uncoupling oxidative phosphorylation in mitochondria, releasing energy as heat and preventing the production of adenosine triphosphate (ATP). This leads to weight loss, but also overheating and a lack of ATP, which can be fatal.
Despite heavy publicity about the toxicity of DNP, cases of poisoning have increased. The difference between the dose required for weight loss and that associated with fatality is relatively small, making it unsuitable for human use. Symptoms of acute DNP poisoning include fever, dehydration, nausea, vomiting, restlessness, flushed skin, and a rapid heartbeat, which can quickly progress to coma and death.
Lessons Learned: The Need for Regulation and Awareness
The history of 80s diet pills serves as a cautionary tale about the dangers of unregulated ingredients and the allure of quick fixes. The stories of "Black Beauties," rainbow pills, Fen-Phen, Ayds Diet Candy, ephedrine, and DNP highlight the importance of:
- Regulation: Strict regulations are necessary to ensure that weight loss products are safe and effective.
- Awareness: Public awareness campaigns are crucial to educate consumers about the risks associated with diet pills and promote healthy lifestyle choices.
- Responsible Marketing: Marketing practices should be ethical and avoid sensationalized claims that prey on vulnerable individuals.
- Medical Supervision: Weight loss medications should only be used under the supervision of a healthcare professional.
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