3Late 1800’s and Early 1900’s 2nd Century AD: Late 1800s: 1920’s: Soranus of Ephesus prescribes laxiatives and purgatives for obesityLate 1800s:The first diet pills based off of thyroid extract were marketed as "fat reducers“Discontinued due to causing side effects such as hyperthyroidism1920’s:Trend of using laxatives for weight loss.Gimmicky weight-loss products advertised.
4Early-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 It claimed that it prevented food energy from being turned into fat.1938:Dinitrophenol was voluntarily withdrawn by manufacturers.Enactment of the Food, Drug, and Cosmetics Act.1940’s:Appetite suppressant candy called Ayds was marketed
5Mid 1900’sLate 1930s s:Doctors began prescribing amphetamines for its side effect of appetite suppression1950’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
6Mid 1900’s1960’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Withdrawn from the market two years later due to pulmonary hypertension side effects.1970’s:Adderall was used as a diet drug, marketed under the name Obetrol.
7Late 1900’s1973:the Food and Drug Administration approved the drug fenfluramineFDA began the recall of diet drugs containing amphetamines.1979:Fenfluramine and phetermine have been combined into Fen-Phen and gained popularity.
81990’s1992:Fen-phen gained more popularity when a report stated that it caused a 10% weight loss.1994Dietary Supplement Health and Education Act is passed, which adds the "dietary supplement" category.Ephedra classified as a herb and use for weight loss increases.1995Dexfenfluramine (Redux) was developed as an alternative to fenfluramine with less side-effects.
91990’s1997Removal 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.1998Meridia is put on the market.
102000’s2004:Ephedra removed from the US market from concerns with raising blood pressure which could lead to strokes and death.2009Hydroxycut 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.
112000’s2010Orlistat (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.
13Prescription Drug Pharmacodynamics Orlistat (Xenical)Basic Function:Prevents the absorption of fats, reducing caloric intakeSaturated version of LipstatinInhibits pancreatic lipases which break down fat moleculesOTC version: AlliHalf the dose of prescription XenicalSide Effects:Oily discharge/fatty stoolsLower absorption of fat soluble vitamins
14Prescription Drug Pharmacodynamics Sibutramine (Meridia)PhentermineBasic Function:Inhibits NT reuptake in brainSerotoninNorepinephrineDopamineEnhances feeling of satietyIncreased risk of heart attack and strokesPulled from US market in October 2010Still present in many counterfeit productsBasic Function:Causes release of norepinephrine in hypothalamusReduces feeling of hungerSimilar structure to amphetaminesPart of Fen-Phen combination drug
15Prescription Drug Pharmacodynamics Metformin (Glucophage)Diabetes drugFor people overweight and suffering from diabetes to aid in weight lossBasic function:Lowers glucose levelsIncrease insulin sensitivityAppetite suppressant
16Common Side Effects for Prescription Drugs Nausea (minor or severe)Constipation/DiarrheaDry mouthHeadachesInsomniaIncreased blood pressure and heart rate (minor or severe)Nervousness, confusion, and irritability
17Prescription Drug Results Very minimal results without diet and exerciseMost show loss of about 8-12 lbs/yearLifestyle changes needed for more serious resultsAll 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)
18OTC Supplement Pharmacodynamics Ephedra/Ephedrine Ephedra: plant with 2 active constituents:EphedrinePseudoephedrineEphedrine is normally paired with caffeine in OTC diet supplementsBasic function of Ephedrine:Appetite suppressantActs on adrenergic receptorsSide Effects:High blood pressureHeart attacks, strokes (can be fatal)Tremors/seizuresInsomniaBanned by FDADrugs now contain “legal ephedra”Epehdra without ephedrine
19OTC Supplement Pharmacodynamics Ephedra Replacements Bitter orangeEssential oil from an type of orangeSimilar health concerns as ephedrineLack of evidence about effectivenessHoodia gordoniiSouth African spiny succulent plantIncreases hypothalamic ATPNo published scientific evidence demonstrating use as appetite suppressant
21Celebrity SponsorsMarketed products claim weight loss through celebrity endorsementsMuch of the popularity of diet drugs is due to clever marketing and ad campaigns… such as TrimSpa
22Anna 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
23TrimSpa Baby! Potential TrimSpa Side Effects and Concerns Original TrimSpa formula contained the stimulant herb ephedraExpensive (>$48/month)No longer individually lists the ingredientsSide 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 drugsWhat’s good about TrimSpa?Contains glucomannan, a water-soluble dietary fiber derived from konjac root
24Keeping 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 bodyKim and Khloe Kardashian use sex to sell their QuickTrim diet pills http://www.youtube.com/watch?v=Q69Igo7xcGA
25QuickTrim“This product isn’t intended to be a complete replacement for having a reasonably healthy diet and lifestyle” (kardashiansquicktrim.com)Dangers of Kardashian-Endorsed QuickTrim4 QuickTrim productsSculpting gel for cellulite14-day "burn and cleanse“48-hour cleanse8-hour weight loss formula that burns calories 300% x fasterAll 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.
26QuickTrim Weight Loss Supplement Burn & Cleanse 14-Day Diet System- burns calories by day and cleanses by nightDaytime pills are mostly caffeine: contains thermogenic complex, black pepper, white willow barkNighttime supplements are laxatives: contains stimulant laxatives (senna, cascara, rhubarb) and bulk laxatives (fig extracts, oat fiber)May get diarrhea, loss of nutrients, dehydrationIso-Flush- taken along with Burn & CleanseHerbal diuretics to shed water from body: contains horsetail extract, juniper berryIf taken for long periods can be toxic.Can reduce kidney function & may suffer from severe dehydration.
27Lose it on the QT!Fast Cleanse- “48-hour Super Diet Detox” to drop a dress sizeFiber-rich drink 4x/day b/w mealsPrimarily a digestion-resistant polysaccharidesExtreme Burn- supposed to be used long term after finishing 14-day planContains a lot of caffeine and herbs to boost potencyPowerful 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 diureticsSince 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
29Diet 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, osteoporosisFTC challenges marketing of claims -> required to back up claims with the scienceFines levied against 4 over-the-counter non-prescription diet pills:Xenadrine, One a Day Weight Smart, CortiSlim, TrimSpaA combined $25 millionReceive money back when consumers have been deceivedEx: Bayer Corp. paid $3.2 million civil penalty to settle claims and agreed to stop ads that say “multivitamins can increase metabolism”
30Trying to lose weight? Don’t turn to pills! FTC claims there are NO scientific evidence that diet pills cause weight lossTestimonials from individuals are not a substitute for scienceFTC 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!
31Counterfeit Diet Pills Booming trade in counterfeit slimming pillsMedicines and Healthcare Regulatory Agency(MHRA) sited 2 prescription-only anti-obesity pills: Xenical, ReductilVery commonly counterfeited in UKThrough illegal pharmacies and illegal websites where demand is high and maximum profits are madeFake prescription obesity pills contain little active ingredient, some may cause harmMade in substandard conditions, contain impuritiesNo true regulation (no prescription necessary)
32Problems 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.
33Advertisements 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
34Apolo Ohno and 8 Zone Apolo Ohno Founder/owner of 8 Zone Pills for each 8-hour segment of day
35Apolo Ohno and 8 Zone Step 1: Aggressive (Red Zone) For the most active part of your day (during work)For healthy, sustained energyAnd for thermogenic fat-burningStep 2: Subtle (White Zone)To keep you going after workFor wholesome nutritional replenishmentTo promote anti-aging and combat oxidative stressStep 3: Downtime (Blue Zone)For full rest and recoveryFor great sleepFor muscle recuperation
36Some of the Disclaimers Apolo Ohno and 8 ZoneSome of the DisclaimersWe 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.
37XenadrineSince Ronnie has started, his GTL routine is now XGTL-Xenadrine. Gym. Tan. Laundry.
38XenadrineXenadrine 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-trimethylxanthineContain 200 milligrams of caffeineExcite body functions, result in short-term weight lossVitamins in Xenadrine don’t impact weight loss
39Xenadrine 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 XenadrineWe are sure that Ronnie is happy CSP is “lossing” the weight with Xenadrine.
40Xenadrine Studies published on website all have reduced calorie diet… Mentions that Xenadrine is best combined with diet and exercise!Promotes the unachievable bodyPromotes weight management with minimal effortStudy showed placebos more effective than Xenadrine
42Advertisements Obesity drug ads misleading teens “Xenical” Ads aired during popular show, Australian Idol.ControversialThe Australian National Drugs and Poisons Schedule Committee banned OTC commercials as they were targeted to average weight people
43Effects in SocietyQuestioned UCSF study that 80% of fourth-grade girls were dietingAt 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 fatResults have not changed much
44TV Shows and Media Icons 90210 stars although labeled by magazines ‘too skinny’ still very popular showDr Aric Sigman’s article in The BiologistThe media is a causal risk factor for body dissatisfactionStudied female reactions to TV shows with thin characters around the world
45Cost/Common Statistics US weight loss market1992 $30 billionNow estimated $40-60 billionPrescription and over-the-counter diet drugs altogether took in $381.5 million in 2009, according to data from IMS Health.
46Diet Pill for Dogs… Substitute for exercise and food reduction Slentrol is the first FDA-approved diet pill for dogs
47Final Thoughts Rule: Do NO harm Question: Do benefits outweigh the risks?No Quick fixNot for people who want to lose 5-10 lbsFor morbidly obeseMust include lifestyle change; diet and exercise!!!!!!
48Works Cited - History"Diet Pills - Overview." Encyclopedia of Drugs and Addictive Substances. Ed. Barbara C. Bigelow. Gale Cengage, eNotes.com Mar, 2011 <http://www.enotes.com/drugs-substances-encyclopedia/diet-pills/overview>Whittemore, Frank. (January 18, 2010). The History of Diet Pills. In Livestrong.com. Retrieved March 2011, fromGrabianowski, Ed. "Have people ever really eaten tapeworms for weight loss?" 16 December 2008. HowStuffWorks.com. <http://health.howstuffworks.com/wellness/diet-fitness/weight-loss/tapeworm-weight-loss.htm> 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
49Works 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
50Works Cited – Celebrity Endorsements and Problems with Diet Drugs Ashton, J. (2010, September 16). CBS News Health Watch. New Diet Drugs Await Approval. Retrieved fromBlatner , D., & Bauer, J. (2007, October 5). Weight Loss Drugs: How Much Do Diet Pills Help? . American Dietetic Association, Retrieved fromBowdler, N. (2010, July 7). BBC News Health. The booming market in counterfeit slimming pills. Retrieved fromDiet and Nutrition. (2007, January 4). Diet pill makers fined millions for false claims . Retrieved fromDiet Pills Report & Review [The Use of Retail (non-prescription) Diet Pills & Appetite Suppressants]. (2010). Retrieved fromKardashians QuickTrim Resource [Online forum post]. (2010). Retrieved from kardashiansquicktrim.comKotz, D. (2010, January 19). The Dangers of Kardashian-Endorsed QuickTrim. U.S. News & World Report of Health on Women, Retrieved fromQuickTrim. (n.d.). Retrieved March 6, 2011, from getquicktrim.comWong, C. (2007, September 19). Does Trimspa Work? Trimspa Review. Retrieved March 6, 2011, from
51Works 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