The pursuit of quick and easy weight loss solutions has led to a surge in the popularity of dietary supplements, including weight loss drops often marketed as "skinny drops" or "metabolism drops." These products often promise rapid results, but a closer look at their ingredients and the regulatory landscape reveals significant concerns about their effectiveness and safety.
The Allure and Risks of Weight Loss Supplements
The dietary supplement market is a booming industry, with a wide array of products claiming to aid weight loss, boost metabolism, and suppress appetite. These supplements, ranging from colorful patches and fruit punch-flavored gummies to prebiotic powders and under-the-tongue tinctures, are readily available over the counter, making them an attractive option for individuals seeking a convenient path to weight loss.
However, the ease of access and enticing promises often mask the potential risks associated with these products. The Food and Drug Administration (FDA) does not regulate dietary supplements for safety or effectiveness before they hit the market. This lack of oversight means that many supplements contain unproven ingredients, and some may even be adulterated with hidden drugs and chemicals.
Hidden Dangers: Adulteration with Banned Substances
One of the most alarming aspects of the weight loss supplement industry is the prevalence of adulteration. Numerous products marketed as "all-natural" have been found to contain undeclared active pharmaceutical ingredients, some of which are banned substances.
For example, FDA laboratory analysis confirmed that Slim Fit X contained sibutramine and desmethylsibutramine. Sibutramine is a controlled substance that was removed from the market in October 2010 for safety reasons. Desmethylsibutramine is a substance structurally similar to sibutramine. The product poses a threat to consumers because sibutramine is known to substantially increase blood pressure and/or pulse rate in some patients and may present a significant risk for patients with a history of coronary artery disease, congestive heart failure, arrhythmias, or stroke.
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This is not an isolated incident. The FDA maintains a running list of public notifications regarding dietary supplements found to contain hidden drug ingredients. This list includes a wide range of products marketed for weight loss, sexual enhancement, and body building.
The Problem with "GLP-1 Supplements"
The recent popularity of GLP-1 receptor agonists like Wegovy (semaglutide) and Zepbound (tirzepatide) for weight loss has led to the emergence of so-called "GLP-1 supplements." These products are marketed as a way to "complement" or "supercharge" the body's levels of the gut hormone GLP-1, mimicking the effects of prescription weight loss drugs.
However, experts warn that these supplements are likely ineffective and potentially misleading. According to Jamie Alan, an associate professor of pharmacology and toxicology at Michigan State University’s College of Human Medicine, “If you can buy it without a prescription, it’s not an actual GLP-1 drug. It is something else that’s marketed to support your endogenous GLP-1 production. These things are just older weight loss [supplements] that are rebranded, and there’s really no scientific evidence for these.”
Many of these "GLP-1 supplements" contain ingredients like ashwagandha, green tea extract, berberine, chromium, and saffron extract, which have limited scientific evidence supporting their effects on weight loss. Some brands even include disclaimers stating that their products do not contain synthetic GLP-1 or act as GLP-1 agonists.
Metabolism Drops: A Closer Look
"Metabolism drops," also known as "skinny drops," are another popular type of weight loss supplement, particularly among teenagers. These products often contain a blend of ingredients such as raspberry ketones, caffeine, taurine, green tea leaf, and dandelion root.
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However, experts caution that there is no scientific evidence to support the claim that these ingredients can "hack" metabolism or lead to significant weight loss. David Ludwig, a nutrition researcher at the Harvard T.H. Chan School of Public Health, states that there's "no evidence that any of these over the counter metabolism boosters are effective.”
Sharon Akabas, a professor of nutrition at Columbia University, agrees, calling the drops a "false promise." She explains that supplement companies typically only test that what’s on the label is in the pill, not whether it’s safe or effective.
Questionable Ingredients and Potential Side Effects
The ingredients in metabolism drops raise further concerns. Caffeine, while it may temporarily speed up metabolic rate, has no long-term effect on weight loss and can exacerbate anxiety, particularly in vulnerable individuals like adolescents. Raspberry ketones have shown some evidence of increasing metabolic rate, but only in extremely high doses that would be impractical and potentially harmful to consume. Green tea extract and taurine have not been found to produce meaningful weight loss.
Furthermore, ingesting these ingredients can lead to a range of side effects, from digestive issues and sleep disruption to more severe consequences like heart attacks and liver damage.
The Myth of "Boosting" Metabolism
The concept of "boosting" or "hacking" metabolism is a common theme in the marketing of weight loss supplements. However, experts emphasize that human metabolism is a complex and dynamic process that cannot be easily manipulated.
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Metabolism refers to the chain of chemical reactions that occur as the body converts food and drinks into energy. It is influenced by factors such as body size and composition, sex, and age. The only proven ways to boost metabolism are through exercise, physical activity, and strength training.
The Role of Compounded Drugs
The rise of compounded versions of GLP-1 drugs like semaglutide and tirzepatide has further complicated the weight loss landscape. Compounding pharmacies are authorized to create medications that are "essentially copies" of commercially available drugs during drug shortages.
However, the FDA has declared the shortages of tirzepatide and semaglutide over, meaning that compounding pharmacies must now pull their products. This leaves a void in the market that GLP-1 supplement sellers are eager to fill, potentially misleading consumers into believing that unproven supplements can deliver the same results as FDA-approved medications.
Experts warn that compounded versions of weight loss drugs are not the same as their brand-name counterparts. They may not contain the same ingredients, and they have not been subjected to the same rigorous testing.
The Importance of Regulation and Informed Choices
The lack of regulation in the dietary supplement industry poses a significant risk to consumers. The FDA does not approve weight loss supplements before they are sold, and many products on store shelves contain potentially harmful ingredients.
The Federal Trade Commission (FTC) warns consumers to be wary of weight loss supplements that make false promises, such as guaranteeing rapid weight loss without diet or exercise or claiming that a product will work for everyone. It's also important to watch out for fake "success" stories and altered before-and-after images.
A Comprehensive Study on Slimming Nutraceuticals
A study designed a comprehensive assessment system to evaluate the safety, authenticity according to label claim, and pharmaceutical quality of slimming nutraceuticals. Six different popular products were evaluated (Zotreem Plus®, Zotreem Extra®, Malaysian Super Slim®, AB Slim®, Chinese Super Slim®, and Metabolites®). The pharmaceutical evaluation included analyzing the samples via high-performance liquid chromatography to determine any possible adulterants. Additionally, the products' physical properties were assessed via pharmacopeial tests. Finally, a microbial evaluation and a cross-sectional observational retrospective prevalence study were conducted to assess the products' safety and efficacy.
The tested products were found to be adulterated with unreported active pharmaceutical ingredients such as sibutramine, sildenafil, phenolphthalein, and orlistat. Furthermore, they contained heterogeneous amounts of adulterants and exhibited an unsatisfactory pharmaceutical and microbial quality. These products threaten the health of consumers. The study highlights the potential risks of illegal weight loss products. Not only were possible adulterants quantified, but also the pharmaceutical quality of the formulations, their inter- and intra-batch variability, and their safety were assessed.
Nutraceuticals and Obesity: A Growing Concern
A nutraceutical is a health-promoting product which enhances physical and mental activities of the body. Moreover, it is advertised to reduce the risk factors for different diseases. A nutraceutical formulation is simply a hybrid between food and drug. Around 50% of the population in USA consumes nutraceuticals and herbal and dietary supplements. This illustrates the wide spread of nutraceuticals sold globally with the claim of being natural herbal products .
Obesity is the accumulation of fat in adipose tissues in an abnormal or excessive manner leading to health impairment . As reported in WHO global estimates for 2018, more than 1.9 billion adults (39%) were considered overweight at the age of 18 years or older in 2017 . It is predicted that the percentage will increase to 60% by 2020 . Obesity can be a leading cause of many serious health problems, such as high blood pressure, cancer, type 2 diabetes, heart diseases, stroke, erectile dysfunction, nonalcoholic fatty liver disease, and other health complications .
While a healthy diet plan and regular physical activity would help in losing weight and maintaining weight loss in the long term, weight loss medications are attractive, easy options for losing weight. Historically, the first slimming elixirs described by Soranus of Ephesus, a Greek physician in the 2nd century AD , were laxatives and purgatives; furthermore, the British physician Nathaniel Edward Yorke-Davies reported on subjects who lost weight by consuming desiccated thyroids in 1894 .
Unfortunately, most people are attracted to the use of herbal weight loss products because of the misconception that these products are safe. However, nutraceuticals may contain FDA-banned ingredients such as sibutramine and phenolphthalein . Chemical adulterants in weight loss nutraceuticals have many side effects, which may lead to heart failure, cancer, and other life-threatening conditions . Moreover, they may contain stimulants such as caffeine and sibutramine that are addictive and may cause many side effects including insomnia, depression, suicidal thoughts, and heart attacks, which could be fatal . Therefore, these products are contraindicated in people with panic attacks, hypertension, anxiety, and heart problems .
Alarmingly, these diet pills could be misused by consuming more than the recommended dose to speed up the process of weight loss, which may lead to addiction or overdose toxicity .
Analyzing Slimming Products: A Case Study
A study was conducted to assess the safety, efficacy, authenticity according to label claim, and pharmaceutical quality of herbal slimming products. Herbal slimming nutraceuticals in the market are claimed to be 100% herbal and to aid in weight loss without any side effects. Pharmaceutical evaluation of the various nutraceuticals included analyzing the samples via high-performance liquid chromatography (HPLC) to determine any possible adulterants in the evaluated products. Additionally, the products' physical properties were assessed via pharmacopeial tests, including weight variation and disintegration tests, to evaluate the pharmaceutical quality and inter- and intra-batch heterogeneity within and across different batches of these nutraceuticals. Additionally, a microbial evaluation was conducted to assess the safety of these products. Finally, to assess the safety, efficacy, and pattern of use of the products, a cross-sectional observational retrospective prevalence study was carried out.
Methodology
Zotreem Plus®, Zotreem Extra®, Malaysian Super Slim®, AB Slim®, Chinese Super Slim®, and Metabolites® were purchased from different pharmacies in Alexandria, Egypt, between October 2015 and February 2017 in triplicate packages from different batches. An AgilentTM HPLC device was used with a reversed-phase C8 column as a stationary phase. The mobile phase was a gradient system composed of 20 mM aqueous ammonium formate (A) and acetonitrile (B). A photodiode array detector was used at λmax of 285 nm for phenolphthalein, 213 nm for orlistat, and 224 nm for thyroxine and sibutramine detection.
Microbiological assessments, including the total aerobic microbial count (TAMC) and total yeast microbial count (TYMC), were conducted as described by the United States Pharmacopeial Convention. Salmonella was detected using Rappaport Vassiliadis Salmonella Enrichment broth and subsequent growth on xylose lysine deoxycholate agar plates. The membrane filtration technique was adopted to carry out the sterility test on Metabolites® injection, according to the guidelines of USP 40-NF 35 .
A clinical survey had been designed in Arabic to evaluate the use, safety, and efficacy of nutraceuticals among users. The survey was delivered to 4,638 subjects on visits to different diet clinics, with 11.06% (n = 513) successfully completing the survey.
Results
The analyzed products showed nonuniformity in the capsules' content, color, and physicochemical properties. The chromatographic analyses revealed that the mean values of sibutramine, phenolphthalein, and sildenafil content in the different batches of AB Slim® units ranged from 1.54 to 3.25 mg, 32.09 to 40.13 mg, and 196.11 to 292.08 mg, respectively. Furthermore, Zotreem Plus® and Zotreem Extra® were adulterated with phenolphthalein, sibutramine, and sildenafil. Chinese Super Slim® and Malaysian Super Slim® were adulterated with sibutramine and sildenafil. The mean values of sibutramine and orlistat content in the different batches of Metabolites® ranged from 0.23 to 0.26 mg and 0.10 to 0.45 mg, respectively.
All products, except AB Slim®, showed statistically significant differences in weight variability and heterogeneity in capsule content across the different batches analyzed. The TAMC and TYMC of 3 different batches of each brand were all > 104 colony-forming units (CFU)/mL on tryptic soy agar plates and > 103 CFU/mL on Sabouraud dextrose plates, respectively, exceeding the accepted USP limit. E. coli and Salmonella were detected in several of the analyzed products.
Conclusion
The study concluded that the tested slimming nutraceuticals were adulterated with unreported active pharmaceutical ingredients, contained heterogeneous amounts of adulterants, and exhibited an unsatisfactory pharmaceutical and microbial quality, posing a threat to the health of consumers.
Public Notifications from the FDA
The FDA has issued numerous public notifications regarding weight loss products found to contain hidden drug ingredients. These notifications serve as a warning to consumers about the potential dangers of these products. Some examples include:
- FATZorb
- Toki Slimming Candy
- LipoFit Turbo
- THERMO SHOCK
- ITCHA XS
- Body Shape Weight Loss System
- Govvi WOW!
- Phentamene XT
- NORF 20
- Alfia Weight Loss Capsules
- Lipopastilla + Gold Max
- Dr. Reade Slim Sense
- Hydro Pinapple [sic] Burn
- Cholestene
- Genesis Ultra Slim Gold
- 365 SKINNY High Intensity
- Miss Slim
- Tummy Tuck Max
- Vy & Tea
- Super Slim
- Lishou Slimming Coffee
- Li Da Daidaihua Plus
- Imperla Elita Vitaccino
- Fruta Planta
- Fruta Bio
- Burn 7
- Livtone
- Detox Plus
- CholesLo
- Skinny Pill
- Lanugar
- JaDera PLUS
- Sheaya Lender
- Love in S
- Reduktis Max
- Lipro Dietary Capsule
- Adelgasin Plus
- Super Slimming Herb
- Lishou Fuling Jiaonang
- Detoxi Slim
- Absolute Nine Slim
- GoLean Detox
- Ultra Fit
- Slimmer Extreme Thermogenic Formula
- Slim Bio Capsules
- Slimina
- Pink Granada
- Green Lean Body Capsule
- Shengan Natural Model
- Like Slim Coffee
- In Shape
- Baschi Quick Slimming Capsule
- BodySlim Herbal
- Easy 2 Slim
- Slimming Capsule
- Nuvitra
- Asunsa
- Lyn DTOX FS3
- Adipotrim XT
- Body Shape Weight Loss System
- Row of Antibody Pil
- Adriana Balance S
- AB Slim
- PAYA Dietary Supplement Product
- Asia Slim Capsules
- Adipessum Miracle Slimming Capsules
- Fruta Planta Life (Garcinia Cambogia Premium)
- A1 Slim
- Physic Candy - Define
- Physic Candy - Curve
- Slimming Plus Advanced
- Platinum Weight Loss Solution - Fat Loss Metabolizer
- Platinum Max Strength Blue Pill Version
- Lean Extreme Max
- X-treme Beauty Slim
- Queen Slimming Soft Gel
- ABX Weight Loss
- Supreme Slim 5.7
- Ultimate Body Tox
- Zi Su Body Fat Health II (Zi Su Shou Shen Ying Yang Su II)
- Skinny Bee Diet
- Results
- Accelerator Boost
- Natural Eruption
- Citrus' Fit
- Adelganzantes R-II
- Zi Xiu Tang Beauty Face and Figure Capsule
- Ultimate Lean
- Slim Fit X
- Maxx Easy
- Mang Luk Power Slim
- Mang Luk Power Slim Detox
- Xcelerated Weight Loss Ultra Max
- Xcelerated Weight Loss Turbo Charge
- Xcelerated Weight Loss Charged Up
- Dream Body Advanced Acai Weight Loss
- Dream Body Extreme Gold
- Dream Body Original Formula
- Extra Slim Plus Acai Berry Weight Loss Formula
- Exhilarate
- Step 2
- Black Label X
- Black Gold X Advanced
- 3rd Degree
- Propell Platinum
- ENVY BP
- ZlimXter Capsules
- Xerophagy Capsules
- Eradicate Capsules
- Dynamizm Capsules
- La'Trim Plus
- Evolve Bee Pollen
- Jenesis
- Oasis Bee Pollen
- Prime Bee Pollen
- Thirty Plus
- Lipo Escultura
- Zero Fat
- SPCARET Princess Diet
- Slyn Both
- Perfect Slim Fast Track Slim
- Super Herbs
- Xtreme Fat Burner Capsules
- Tip-Top Shape
- Lishou Slimming Coffee
- Basha Nut 100% Fruit Soft Gel Capsules
- Ultimate Herbal Slimcap
- NATUREAL
- Meizi Super Power Fruits Herbal Slimming Formula
- Achieving Zero
- Zero Xtreme Capsules
- Akttive Capsules
- Slim Forte Slimming Capsule
- Li Da Dai Dai Hua Slimming Capsule
- Fatloss Slimming Beauty
- Superior
- Green Algae Combination by Crane Beauty
- Xcel Advanced
- Xcel
- Ultimate Boost
- L-Carnitine Sob Strengthening Version Slimming Miracle Capsule
- Black Mamba Hyperrush
- Natural Max Slimming
- Diablos Eca Fire Caps
- Eliminating Weight
- Oxy ELITE Pro Super Thermogenic
- Nine Slim
- Seven Slim
- Botanical Slimming (Red)
- Lean Body Extreme
- Yanhee Slim
- Slim-K
- Slim-Vie
- Super Extreme Accelerator
- Japan Hokkaido Slimming Weight Loss Pills
- Mix Fruit Slimming
- Lingzhi Cleansed Slim Tea
- 24 Ince
- Lipo 8 Burn Slim Capsules
- Sliming (sic) Diet By Pretty White
- Trim-Fast Slimming Softgel
- Sport Burner
- Toxin Discharged Tea
- Sliming Diet
- La Jiao Shou Shen
- B-Perfect
- Asset Bold
- Asset Bee Pollen
- Natural Body Solution
- Slim Trim U
- Lite Fit USA
- Infinity
- New You
- Vitaccino Coffee
- Citrus Fit Gold
- Tonic Life BP
- Thinogenics
- Dream Body Slimming Capsule
- Meizitang Citrus
- Asset Extreme Plus
- 7 Days Herbal Slim
- Dr. Ming's Chinese Capsule
- SlimEasy Herbs Capsule
- Sliming (sic) Diet Berry Plus
- Asset Extreme
- "SlimExtra Herbal Capsules"
This extensive list underscores the widespread problem of adulteration in the weight loss supplement industry and the importance of exercising caution when considering these products.
Gummies and Other Novel Formulations
Weight loss gummies have emerged as a popular and palatable alternative to traditional pills and capsules. These gummies often contain ingredients like apple cider vinegar (ACV), green tea extract, and other compounds purported to aid weight loss.
However, the effectiveness of weight loss gummies is still a subject of debate. While some studies suggest that ACV may increase fat metabolism and promote fullness, the evidence is limited, and more research is needed. Other ingredients commonly found in weight loss gummies, such as green tea extract and raspberry ketones, have also yielded mixed results in scientific studies.
Furthermore, it's important to be aware of the potential side effects of weight loss gummies, which can vary depending on the ingredients they contain. Some reviewers have reported experiencing headaches, jitteriness, and digestive issues after taking weight loss gummies.
Slenderiiz: Another Supplement Under Scrutiny
Slenderiiz, a supplement sometimes referred to as “Skinny Drops” has raised concerns from multiple sources. This product, comprising drops and dietary guidance, asserts it aids weight control using a blend of homeopathic components and rigorous calorie monitoring. Nonetheless, there are several warning signs linked to this and other products marketed as weight loss supplements.
Garcinia cambogia, a tropical fruit Indigenous to South Asia, has a rind rich in hydroxy citric acid (HCA), which is known for its appetite-reducing properties. A study in the Journal of Obesity revealed that individuals who consumed garcinia shed approximately two pounds more than those who did not. L-Carnitine, an amino acid, facilitates the transfer of fatty acids into cells for energy production. While dietary intake typically meets our needs, high doses of 2000 mg or more may slightly impact weight loss. Alpha Tocopheryl acetate, also known as Vitamin E, is a derivative of Vitamin E and is used in skin creams and lotions.
So, in the end, the ingredient list is sketchy and unproven for weight loss, as many are homeopathic substances that lack scientific backing for their efficacy in weight loss. Locating a list of ingredients requires significant effort, which should not be the scenario for products making unsubstantiated grand claims. The Federal Trade Commission (FTC) advises caution with weight loss products that make sweeping claims without solid scientific evidence.
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