1. Diet Drugs and Supplements
BREANNE BONILLA
CARLIN COOMBS
KIMBERLY WILLOW
JANE JENSEN

2. History

3. Late 1800’s and Early 1900’s 2nd Century AD: Late 1800s: 1920’s:
Soranus of Ephesus prescribes laxiatives and purgatives for obesity
Late 1800s:
The first diet pills based off of thyroid extract were marketed as "fat reducers“
Discontinued due to causing side effects such as hyperthyroidism
1920’s:
Trend of using laxatives for weight loss.
Gimmicky weight-loss products advertised.

4. Early-Mid 1900’s 1933: 1938: 1940’s: Dinitrophenol was introduced.
It claimed that it prevented food energy from being turned into fat.
1938:
Dinitrophenol was voluntarily withdrawn by manufacturers.
Enactment of the Food, Drug, and Cosmetics Act.
1940’s:
Appetite suppressant candy called Ayds was marketed

5. Mid 1900’s
Late 1930s s:
Doctors began prescribing amphetamines for its side effect of appetite suppression
1950’s:
Tapeworm diet pills hit the news after opera singer Maria Callas was rumored to have ingested one for weight loss.
Unverified if there were really tapeworms in the advertised pills.
1959:
Phentermine approved by the FDA

6. Mid 1900’s
1960’s:
"Rainbow pill" regimes were being used. They were a combination of multiple pills to help weight loss, such as amphetamines, diuretics, and laxatives.
1965:
Appetite suppressant aminorex fumarate was developed as treatment for obesity.
Withdrawn from the market two years later due to pulmonary hypertension side effects.
1970’s:
Adderall was used as a diet drug, marketed under the name Obetrol.

7. Late 1900’s
1973:
the Food and Drug Administration approved the drug fenfluramine
FDA began the recall of diet drugs containing amphetamines.
1979:
Fenfluramine and phetermine have been combined into Fen-Phen and gained popularity.

8. 1990’s
1992:
Fen-phen gained more popularity when a report stated that it caused a 10% weight loss.
1994
Dietary Supplement Health and Education Act is passed, which adds the "dietary supplement" category.
Ephedra classified as a herb and use for weight loss increases.
1995
Dexfenfluramine (Redux) was developed as an alternative to fenfluramine with less side-effects.

9. 1990’s
1997
Removal of fen-phen is called for by the FDA after reports linking fen-phen with heart valve problems.
Redux removed from the market due to similar problems relating to cardiovascular health.
1998
Meridia is put on the market.

10. 2000’s
2004:
Ephedra removed from the US market from concerns with raising blood pressure which could lead to strokes and death.
2009
Hydroxycut diet supplements pulled off the market after reports of liver damage.
Meridia (sibutramine) is removed from the US market from concerns that it could raise blood pressure and cause stroke or heart attack.

11. 2000’s
2010
Orlistat (prescription as Xenical, over-the-counter as Alli) is available.
Orlistat is taken to reduce the amount of dietary fat that is absorbed by the digestive tract.

12. Drug Pharmacodynamics

13. Prescription Drug Pharmacodynamics
Orlistat (Xenical)
Basic Function:
Prevents the absorption of fats, reducing caloric intake
Saturated version of Lipstatin
Inhibits pancreatic lipases which break down fat molecules
OTC version: Alli
Half the dose of prescription Xenical
Side Effects:
Oily discharge/fatty stools
Lower absorption of fat soluble vitamins

14. Prescription Drug Pharmacodynamics
Sibutramine (Meridia)
Phentermine
Basic Function:
Inhibits NT reuptake in brain
Serotonin
Norepinephrine
Dopamine
Enhances feeling of satiety
Increased risk of heart attack and strokes
Pulled from US market in October 2010
Still present in many counterfeit products
Basic Function:
Causes release of norepinephrine in hypothalamus
Reduces feeling of hunger
Similar structure to amphetamines
Part of Fen-Phen combination drug

15. Prescription Drug Pharmacodynamics
Metformin (Glucophage)
Diabetes drug
For people overweight and suffering from diabetes to aid in weight loss
Basic function:
Lowers glucose levels
Increase insulin sensitivity
Appetite suppressant

16. Common Side Effects for Prescription Drugs
Nausea (minor or severe)
Constipation/Diarrhea
Dry mouth
Headaches
Insomnia
Increased blood pressure and heart rate (minor or severe)
Nervousness, confusion, and irritability

17. Prescription Drug Results
Very minimal results without diet and exercise
Most show loss of about 8-12 lbs/year
Lifestyle changes needed for more serious results
All have serious side effects  should only be used in more serious cases (risk vs. reward?)
Many people abuse (OD, use of non-diet prescription drugs)

18. OTC Supplement Pharmacodynamics Ephedra/Ephedrine
Ephedra: plant with 2 active constituents:
Ephedrine
Pseudoephedrine
Ephedrine is normally paired with caffeine in OTC diet supplements
Basic function of Ephedrine:
Appetite suppressant
Acts on adrenergic receptors
Side Effects:
High blood pressure
Heart attacks, strokes (can be fatal)
Tremors/seizures
Insomnia
Banned by FDA
Drugs now contain “legal ephedra”
Epehdra without ephedrine

19. OTC Supplement Pharmacodynamics Ephedra Replacements
Bitter orange
Essential oil from an type of orange
Similar health concerns as ephedrine
Lack of evidence about effectiveness
Hoodia gordonii
South African spiny succulent plant
Increases hypothalamic ATP
No published scientific evidence demonstrating use as appetite suppressant

20. Celebrity Endorsements

21. Celebrity Sponsors
Marketed products claim weight loss through celebrity endorsements
Much of the popularity of diet drugs is due to clever marketing and ad campaigns… such as TrimSpa

22. Anna Nicole Smith “LIKE MY BODY” Lost 69 lbs.
In 2005, TrimSpa was sued for Anna's erratic behavior at a concert- associated with slurred speech and behavior

23. TrimSpa Baby! Potential TrimSpa Side Effects and Concerns
Original TrimSpa formula contained the stimulant herb ephedra
Expensive (>$48/month)
No longer individually lists the ingredients
Side effects may include anxiety and insomnia (rec. amount of 4 pills/day = two 8-ounce coffee)
May trigger migraines (tyramine)
Shouldn’t be taken with Monoamine Oxidase Inhibitor(MAOI) antidepressant drugs
What’s good about TrimSpa?
Contains glucomannan, a water-soluble dietary fiber derived from konjac root

24. Keeping Up With the Kardashians
“How HOT Can You Be?”
Kim claims to have lost 15 lbs, Khloe 25 lbs(some of which she gained back)
Advertises “to help burn calories, support energy levels, and supercharge workouts” (getquicktrim.com)
Pressures women receive:
Temptation of getting that bikini body
Kim and Khloe Kardashian use sex to sell their QuickTrim diet pills  

25. QuickTrim
“This product isn’t intended to be a complete replacement for having a reasonably healthy diet and lifestyle” (kardashiansquicktrim.com)
Dangers of Kardashian-Endorsed QuickTrim
4 QuickTrim products
Sculpting gel for cellulite
14-day "burn and cleanse“
48-hour cleanse
8-hour weight loss formula that burns calories 300% x faster
All of which are advertising fast weight loss. Most experts recommend effective weight loss to be gradual and just 2 lbs/week for safe and long-term weight loss, even with the help of diet drugs.

26. QuickTrim Weight Loss Supplement
Burn & Cleanse 14-Day Diet System- burns calories by day and cleanses by night
Daytime pills are mostly caffeine: contains thermogenic complex, black pepper, white willow bark
Nighttime supplements are laxatives: contains stimulant laxatives (senna, cascara, rhubarb) and bulk laxatives (fig extracts, oat fiber)
May get diarrhea, loss of nutrients, dehydration
Iso-Flush- taken along with Burn & Cleanse
Herbal diuretics to shed water from body: contains horsetail extract, juniper berry
If taken for long periods can be toxic.
Can reduce kidney function & may suffer from severe dehydration.

27. Lose it on the QT!
Fast Cleanse- “48-hour Super Diet Detox” to drop a dress size
Fiber-rich drink 4x/day b/w meals
Primarily a digestion-resistant polysaccharides
Extreme Burn- supposed to be used long term after finishing 14-day plan
Contains a lot of caffeine and herbs to boost potency
Powerful stimulants, laxatives, and diuretics.
At best, these diet pills will produce short-term weight loss because they stimulate or speed up metabolism and act as diuretics
Since under "supplements" instead of “medications”, they are NOT required to undergo rigorous FDA testing to ensure they are safe and do what their manufacturers claim they do

28. Problems with Diet Drugs

29. Diet Pill Makers Misleading Consumers
Federal Trade Commission says some diet companies make false advertising claims ranging from rapid weight loss to reducing risk of cancer, Alzheimer’s, osteoporosis
FTC challenges marketing of claims -> required to back up claims with the science
Fines levied against 4 over-the-counter non-prescription diet pills:
Xenadrine, One a Day Weight Smart, CortiSlim, TrimSpa
A combined $25 million
Receive money back when consumers have been deceived
Ex: Bayer Corp. paid $3.2 million civil penalty to settle claims and agreed to stop ads that say “multivitamins can increase metabolism”

30. Trying to lose weight? Don’t turn to pills!
FTC claims there are NO scientific evidence that diet pills cause weight loss
Testimonials from individuals are not a substitute for science
FTC also said that customers using the products and providing testimonials were paid as much as $20,000 for their “endorsements.”
The media and women’s magazine have been “urged” to refuse or remove these type of ads from their magazines, or investigate the claims being made.
But doesn’t because they want the revenues!

31. Counterfeit Diet Pills
Booming trade in counterfeit slimming pills
Medicines and Healthcare Regulatory Agency(MHRA) sited 2 prescription-only anti-obesity pills: Xenical, Reductil
Very commonly counterfeited in UK
Through illegal pharmacies and illegal websites where demand is high and maximum profits are made
Fake prescription obesity pills contain little active ingredient, some may cause harm
Made in substandard conditions, contain impurities
No true regulation (no prescription necessary)

32. Problems There is NO medical or other supervision of any kind
May be easily abused.
Ex: In fact, teenage girls are some of the heaviest users of retail diet pills, because they’re easily accessible.

33. Advertisements for Male Audiences
“A SKINNY MAN HASN’T A CHANCE”
POP SOME PILLS AND WATCH THE FAT MELT AWAY -- THAT’S NOT FAR FROM THE TRUTH

34. Apolo Ohno and 8 Zone Apolo Ohno Founder/owner of 8 Zone
Pills for each 8-hour segment of day

35. Apolo Ohno and 8 Zone Step 1: Aggressive (Red Zone)
For the most active part of your day (during work)
For healthy, sustained energy
And for thermogenic fat-burning
Step 2: Subtle (White Zone)
To keep you going after work
For wholesome nutritional replenishment
To promote anti-aging and combat oxidative stress
Step 3: Downtime (Blue Zone)
For full rest and recovery
For great sleep
For muscle recuperation

36. Some of the Disclaimers
Apolo Ohno and 8 Zone
Some of the Disclaimers
We do not guarantee that You will have any specific or particular result or benefit from the Product, or that your experience will match those of others who use the Product(s). Individual results will vary from person to person. Apolo Ohno is a professionally trained athlete and 8zone makes no guarantee or warranty that taking 8zone alone will produce the same results as a professionally trained athlete like Apolo Ohno.
Any and all testimonials and/or statements from users of the Product(s) are those of the respective user. 8zone does not endorse any such statement and/or warrant that any such statement is true or accurate. 8zone likewise does not investigate the accuracy of any testimonial.

37. Xenadrine
Since Ronnie has started, his GTL routine is now XGTL-Xenadrine. Gym. Tan. Laundry.

38. Xenadrine
Xenadrine ULTRA, “these ingredients have not been evaluated by the FDA.  These products are not intended to diagnose, cure or prevent any disease”
Sold at GNC where various diet supplements are sold.
1990’s, Xenadrine EFX contained ephedrine and synephrine (similar to amphetamines)
Now, Xenadrine ULTRA contains yerba mate, guarana, 1,3,7-trimethylxanthine
Contain 200 milligrams of caffeine
Excite body functions, result in short-term weight loss
Vitamins in Xenadrine don’t impact weight loss

39. Xenadrine From Ronnie’s Facebook page (linked from Xenadrine website):
“You heard? I got a new workout partner: Xenadrine. Gives me the energy I need. Love that I'm endorsing something that really works!”
A response to Ronnie’s Post:
CSP- I truly use Xenadrine cuz of ONLY one reason and that reason Ronnie.thank You Ronnie for be their Spokes Man cuz of You and Xenadrine I`am finally lossing the weight I want.so thank You Ronnie and Xenadrine
We are sure that Ronnie is happy CSP is “lossing” the weight with Xenadrine.

40. Xenadrine Studies published on website all have reduced calorie diet…
Mentions that Xenadrine is best combined with diet and exercise!
Promotes the unachievable body
Promotes weight management with minimal effort
Study showed placebos more effective than Xenadrine

41. Children and Teens

42. Advertisements Obesity drug ads misleading teens “Xenical”
Ads aired during popular show, Australian Idol.
Controversial
The Australian National Drugs and Poisons Schedule Committee banned OTC commercials as they were targeted to average weight people

43. Effects in Society
Questioned UCSF study that 80% of fourth-grade girls were dieting
At a school in Illinois (1986) 75% of 9 year old girls said they weighed too much and afraid boys wouldn’t like them if they got fat
Results have not changed much

44. TV Shows and Media Icons
90210 stars although labeled by magazines ‘too skinny’ still very popular show
Dr Aric Sigman’s article in The Biologist
The media is a causal risk factor for body dissatisfaction
Studied female reactions to TV shows with thin characters around the world

45. Cost/Common Statistics
US weight loss market
1992 $30 billion
Now estimated $40-60 billion
Prescription and over-the-counter diet drugs altogether took in $381.5 million in 2009, according to data from IMS Health.

46. Diet Pill for Dogs… Substitute for exercise and food reduction
Slentrol is the first FDA-approved diet pill for dogs

47. Final Thoughts Rule: Do NO harm
Question: Do benefits outweigh the risks?
No Quick fix
Not for people who want to lose 5-10 lbs
For morbidly obese
Must include lifestyle change; diet and exercise!!!!!!

48. Works Cited - History
"Diet Pills - Overview." Encyclopedia of Drugs and Addictive Substances. Ed. Barbara C. Bigelow. Gale Cengage, eNotes.com Mar, 2011 <
Whittemore, Frank. (January 18, 2010). The History of Diet Pills. In Livestrong.com. Retrieved March 2011, from
Grabianowski, Ed.  "Have people ever really eaten tapeworms for weight loss?"  16 December 2008.  HowStuffWorks.com. <  09 March 2011.
Jones, A. R. (2002). FDA vs. Ephedra: Dietary Supplement Regulation Under DSHEA, pp. 2.
Citation. (2011, March). In Wikipedia, The Free Encyclopedia. Retrieved from

49. Works Cited - Pharmacodynamics
Zhi, J., Melia, A. T., Eggers , H., & Joly, R. (1995). Review of limited systemic absorption of orlistat, a lipase inhibitor, in healthy human volunteers. Journal of Clinical Pharmacology, Retrieved from Morris, J. (2006). Little research behind claims that hoodia is safe, effective for losing weight. The Seattle Times, Retrieved from Haller, C. A., & Benowitz, N. L. (2000). Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. The New England Journal of Medicine, 343. Retrieved from Gurley, B. J., Wang, P., & Gardner, S. F. (2000). Ephedrine-type alkaloid content of nutritional supplements containing ephedra sinica (ma-huang) as determined by high performance liquid chromatography. Journal of Pharmaceutical Sciences, 87(12), Retrieved from The pharmacokinetics of phentermine and chlorphentermine in chronically treated rats. (1973). Journal of Pharmaceutical Pharmacology, 25(3), Retrieved from Guerciolini, R. (1997). Mode of action of orlistat. Int J Obes Relat Metab Disord. , 21(3), Retrieved from Bray, G. A. (1999). Sibutramine produces dose-related weight loss. Pennington Biomedical Research Center, 7(2), Retrieved from James, Philip. (2000). Effect of sibutramine on weight maintenance after weight loss: a randomised trial. The Lancet, 356(9248), Retrieved from Duenwald, M. (2005). Bitter orange under scrutiny as new ephedra. The New York Times, Retrieved from Shekelle, P. G., & Hardy, M. L. (2003). Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance. JAMA, 289(12), Retrieved from Gokcel, A., & Gumurdulu, Y. (2002). Evaluation of the safety and efficacy of sibutramine, orlistat and metformin in the treatment of obesity. Diabetes, Obesity and Metabolism, 4(1), Retrieved from Lee, A., & Morley, J. E. (1998). Metformin decreases food consumption and induces weight loss in subjects with obesity with type ii non-insulin-dependent diabetes. Obesity Research, 6(1), Retrieved from

50. Works Cited – Celebrity Endorsements and Problems with Diet Drugs
Ashton, J. (2010, September 16). CBS News Health Watch. New Diet Drugs Await Approval. Retrieved from
Blatner , D., & Bauer, J. (2007, October 5). Weight Loss Drugs: How Much Do Diet Pills Help? . American Dietetic Association, Retrieved from
Bowdler, N. (2010, July 7). BBC News Health. The booming market in counterfeit slimming pills. Retrieved from
Diet and Nutrition. (2007, January 4). Diet pill makers fined millions for false claims . Retrieved from
Diet Pills Report & Review [The Use of Retail (non-prescription) Diet Pills & Appetite Suppressants]. (2010). Retrieved from
Kardashians QuickTrim Resource [Online forum post]. (2010). Retrieved from kardashiansquicktrim.com
Kotz, D. (2010, January 19). The Dangers of Kardashian-Endorsed QuickTrim. U.S. News & World Report of Health on Women, Retrieved from
QuickTrim. (n.d.). Retrieved March 6, 2011, from getquicktrim.com
Wong, C. (2007, September 19). Does Trimspa Work? Trimspa Review. Retrieved March 6, 2011, from

51. Works Cited – Ads for Male Audiences and Children and Teens
Zaslow, Jeffrey.  (2009).  Girls and Dieting, Then and Now.  Wall Street Journal online.  Beauty and Body Image in the Media (n.d.)  Media Awareness Network, CA. Erfurt, Barbara.  (2010).  How Does Xenadrine work?  Livestrong.com A Skinny Man hasn't a chance.  Picture from Ronnie Magro facebook Wall Street Journal.  Picture from Stars:  Too thin for TV? (2008) Marris, Sid. (2007).  Ban on Weight Loss Drug Ads.  The Australian online. Xenadrine information: 8 Zone information: Extreme Weight Loss Techniques.  Askmen.com