The quest for effective and safe weight loss solutions has led many to explore the use of transform pills. With more than two-thirds of Americans classified as overweight or obese, supplement companies have capitalized on this growing demand. However, the safety, ingredients, and side effects of these pills vary significantly, making it crucial to understand the potential risks and benefits. This article delves into the components, adverse effects, and overall safety of weight loss pills, offering insights for informed decision-making.
The Appeal and Proliferation of Weight Loss Pills
The rise in obesity rates has created a lucrative market for weight loss supplements. As Dr. Mark Moyad from the University of Michigan notes, the obesity epidemic is a significant driver for companies seeking to maximize profits through weight loss pills. The supplement market operates with minimal regulation, allowing for the proliferation of products with potentially hazardous substances. Even when ingredients are approved for consumer use, chemical variations of banned or dangerous substances and dosages exceeding safe limits may be present.
The Allure of a Quick Fix and the Dangers of Unregulated Supplements
The desire for rapid weight loss often leads individuals to seek quick solutions like over-the-counter (OTC) weight loss pills. However, most of these products are not approved by the FDA, and their effects and ingredients may be unknown or unsafe. It's crucial to recognize that using weight management medication solely to improve appearance is not advisable, and most weight loss pills are not intended for long-term use.
Potential Health Risks Associated with Weight Loss Pills
While some prescription-grade weight loss pills may offer benefits under medical supervision, the risks associated with OTC weight loss supplements often outweigh the rewards. These risks can range from cardiovascular issues to liver damage and stroke.
Cardiovascular Damage
Many weight loss drugs accelerate the body’s metabolism and heart rate to increase energy expenditure. But these substances found in weight-loss supplements are stimulants, so they work by stimulating the heart to pump faster. “You could also damage the heart muscle itself,” he adds.
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Increased Risk of Stroke
Stimulants in weight loss supplements can overstimulate the heart, increasing the risk of stroke. As Dr. Cohen explains, many substances found in weight-loss supplements are stimulants that work by stimulating the heart to pump faster. It is important to note that "The safest stimulant I can think of is caffeine,” Dr. Cohen says. He reiterates that most weight-loss supplements are virtually unregulated.
Liver Damage
The liver plays a crucial role in processing nutrients and flushing out toxins. However, taking supplements can put these functions at risk. As Dr. Moyad points out, the liver must process the ingredients and chemical byproducts in these supplements, which can lead to a build-up of toxic enzymes.
Other Dangerous Side Effects
DNP overdose can cause itchy, inflamed skin due to an allergic reaction. Cataracts can also develop quickly after the use of DNP due to changes in blood-cell health and production.
FDA-Approved Weight Management Medications
The Food and Drug Administration has approved seven weight management medications. They include:
Phentermine: A noradrenergic that causes a reduction of appetite.
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Diethylpropion: A noradrenergic that curbs your desire to eat.
Phendimetrazine: A noradrenergic that suppresses appetite.
Benzphetamine: Also a noradrenergic that reduces appetite.
Note: The aforementioned medications should not be used if you have a heart disease, uncontrolled high blood pressure, hyperthyroidism, or glaucoma.
Orlistat: It inhibits the absorption of body fat from the food you eat; this medication is safe for children ages 12 and older.
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Phentermine plus topiramate: It causes appetite suppression.
Naltrexone-bupropion: It makes you feel less angry and it brings satiety sooner.
Potential Side Effects of FDA-Approved Medications
Side effects for these medications depend on many different circumstances. For instance, Orlistat’s side effects include diarrhea, gas, increased defecation, defecation incontinence, oily stools, and stomach pain. Obesity medication may elevate pulse and blood pressure, so they are not recommended for patients who have had a heart attack or a stroke or that suffer a cardiovascular condition. Obesity medication should also be avoided if the patient suffers from anxiety or depression, or if she or he has a previous history of anorexia or bulimia, or if is dependent of pain medications, drugs or alcohol. Some weight loss pills can exacerbate these conditions. Most of these side effects are mild. Serious side effects for these medications are very rare. However, in the cases of non-regulated and non-prescription weight loss pills, the side effects can be very dangerous and non-reversible.
Specific Weight Loss Medications and Their Side Effects
Several weight loss medications have been identified with their respective side effects. It’s essential to consider these when choosing a weight loss treatment plan.
Phentermine and Phentermine-Topiramate
Phentermine, used since 1959, decreases hunger by working at the brain level. Side effects include headache, overstimulation, high blood pressure, insomnia, rapid or irregular heart rate, and tremor. Interactions may occur during or within 14 days following the use of monoamine oxidase (MAO) inhibitors, sympathomimetics, alcohol, adrenergic neuron-blocking drugs, and possibly some anesthetic agents. Phentermine combined with topiramate cannot be taken during pregnancy. Side effects of taking phentermine-topiramate include abnormal sensations, dizziness, altered taste, insomnia, constipation, and dry mouth. Contraindications include uncontrolled hypertension and coronary artery disease, hyperthyroidism, glaucoma, and sensitivity to stimulants.
Naltrexone-Bupropion
Naltrexone-bupropion helps with fullness and cravings. A person should not take this medication if they have a seizure disorder or take opioids for chronic pain. The most common side effects include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea.
Liraglutide and Semaglutide
Liraglutide and semaglutide are injectable medications, although oral forms of both are approved to treat type 2 diabetes. Liraglutide is injected daily and semaglutide weekly. Gastrointestinal issues are the most common complaint among people who are just starting semaglutide. For this reason, many patients start at a lower dose and work up to their eventual dose. Headlines have warned of increased suicidal ideation associated with semaglutide. The JAMA study mentioned above compared GLP-1 agonists against naltrexone-bupropion. Researchers concluded that the use of the GLP-1 agonists was associated with an increased risk of pancreatitis, bowel obstruction, and gastroparesis.
Orlistat
Orlistat is a lipase inhibitor that works by blocking the enzyme that breaks down fats consumed through food, thereby inhibiting the absorption of dietary fats. The undigested fat is then passed through the body. The most common side effects include oily poop, gas, increased pooping frequency, and decreased control of pooping. Eating a meal that has a lot of fat may increase your risk for side effects. Orlistat can decrease the absorption of certain vitamins.
Tirzepatide
Tirzepatide was initially approved to treat type 2 diabetes. In 2023, it was approved for weight loss. As a GLP-1 and GIP receptor agonist, it increases feelings of fullness and helps people maintain a more restrictive diet. Common side effects include constipation, upset stomach, bloating, and diarrhea. Potential serious side effects also include stomach problems, kidney problems or failure, gallbladder problems, pancreatitis, or hypoglycemia, among others.
The Role of GLP-1 Agonists in Weight Loss
GLP-1 agonists mimic a hormone called glucagon-like peptide-1 (GLP-1), which curbs hunger. GLP-1 also slows down the movement of food from the stomach to the small intestine - hence a feeling of fullness - and increases insulin production, lowering blood sugar. Over time, obese patients lose roughly 12% of their body weight on Wegovy (semaglutide) and about 18% on Zepbound (tirzepatide, which targets GLP-1 and another gut hormone, GIP.).
Potential Side Effects of GLP-1 Drugs
The potential side effects of GLP-1 drugs are no fun: nausea, vomiting, fatigue, diarrhea, constipation. Most patients nudge up to the recommended dose, slowly adjusting to the drugs to minimize discomfort. For others, GLP-1 agonists can slow digestion to a problematic degree. Patients have sued the drugmakers after developing dangerous conditions, such as stomach paralysis and bowel obstructions.
Risks Associated with Compounded Versions of Weight Loss Drugs
Compounded drugs should only be used in patients whose medical needs cannot be met by an FDA-approved drug. Patients should obtain a prescription from their doctor and fill the prescription at a state-licensed pharmacy. However, compounded drugs are not FDA approved. This means the agency does not review compounded drugs for safety, effectiveness or quality before they are marketed.
Concerns with Compounded Semaglutide and Tirzepatide
FDA received multiple reports of adverse events, some requiring hospitalization, that may be related to dosing errors associated with compounded injectable semaglutide products. These dosing errors resulted from patients measuring and self-administering incorrect doses of the drug, and in some cases, health care professionals miscalculating doses of the drug. Additionally, the agency has received adverse event reports that may be related to patients prescribed compounded semaglutide or tirzepatide products in doses beyond what is in the FDA-approved drug label. This could mean using more product in a single dose, taking doses more frequently or increasing the amount more quickly (titration schedule). Some of the adverse events are serious and some patients reported seeking medical attention for their symptoms, including nausea, vomiting, diarrhea, abdominal pain and constipation.
Illegal Online Sales and Counterfeit Drugs
FDA monitors the internet for fraudulent or unapproved drugs and has issued warning letters to stop the distribution of illegally marketed semaglutide and tirzepatide. These illegally marketed drugs: may be counterfeit, could contain the wrong ingredients or harmful ingredients, could contain too little, too much or no active ingredient at all.
The Importance of a Holistic Approach to Weight Loss
To be clear, eating a lot less does drop the numbers on the scale. But exercise is still important - for your heart, bones, brain, and more. And the nutritional quality of your food matters, not just the quantity.
Nutritional Guidance for Patients Taking GLP-1s
Patients taking GLP-1s should prioritize fruits and vegetables; whole grains; lean protein; and the healthy fats found in olive oil, nuts, and seeds.
Psychological and Social Considerations
Society’s perception of physical beauty - male and female - is still so one-note. “Body positive” campaigners are working to change this, but there is still a long way to go. Nagata suggests that patients taking GLP-1s check in regularly with a physician or nutritionist who can monitor their progress and flag unhealthy behaviors. Part of what they look for is too-rapid weight loss - which, in addition to straining vital body functions, can accelerate muscle loss.
Real Stories and Cautionary Tales
Elaine Gormley was desperate when she turned to slimming pills. Having ordered the pills from Amazon, she started having unpleasant side effects almost immediately. “Within minutes I was beginning to get really, really hot sweats,” she says. “I wasn’t even moving, and the sweat was lashing off me. But at the same time I felt really cold, and my heart was beginning to beat so hard. By the time I got to work, my hands were shaking.” She had lost 8lb. “I thought, ‘This is the miracle that I have been waiting for.’ But then on the fourth day, I took the tablet and my chest started to really ache. I thought I was going to have a heart attack. I had no choice but to stick my fingers down my throat to force myself to be sick - to get the tablet out.”