Overweight and obesity are linked to a number of negative health consequences: the risk of heart disease, osteoarthritis and diabetes are much greater in those who are obese than in normal-weight people. While weight loss and healthy weight maintenance may be achieved by alterations in lifestyle, such long-term changes can be difficult for many. Thus no prescription weight loss drugs (also called over-the-counter or OTC products) appeal to those who struggle with weight problems. According to a report in the August 23 issue of the Journal of the American Medical Association (JAMA), little is known about the characteristics of the people who use such products, whether they are used in conjunction with prescription medications, or if they are used instead of or in addition to lifestyle changes.
Heidi Michels Blanck, Ph.D. and colleagues from the Centers for Disease Control and Prevention (CDC) in Atlanta examined data on OTC and prescription weight loss products collected by five state health departments from 1996-1998. They were particularly interested in use of products containing phenylpropanolamaine (PPA), and the herbal product ephedra. PPA has since been withdrawn from the OTC market because of indications that it might increase the risk of stroke among users, and ephedra has been associated with numerous adverse health effects.
Respondents to the telephone surveys included 8,133 men and 8,546 women over 18 years of age. In addition to information about their use of these products, the subjects also specified their height, weight, dietary intake, typical physical activity level, and presence or absence of diabetes.
The researchers report that 7 percent of the subjects reported using at least one OTC weight loss product in the previous 2 years; women and younger people were more likely to report such use, as were obese individuals. Two percent of the subjects used an OTC product containing PPA, and 1 percent used products containing ephedra. Over one third of respondents who reported taking prescription drugs for weight loss reported using some type of OTC product as well.
OTC product use was not correlated with intake of fruits and vegetable, but the investigators did find that respondents who reported at least some physical activity were more likely than inactive people to use OTC products. Of the subjects who reported that they were diabetic, 5.9 percent said that they had used an OTC weight loss product. In addition, 8 percent of normal weight women used OTC weight loss products.
Government statistics document an alarming increase in the prevalence of obesity among Americans over the last two decades. The National Institutes of Health report that over one half of adults are overweight, and nearly one quarter are obese. Dr. Blanck and her coauthors estimated that, based on their data, between 1996-98, 17.2 million Americans used OTC weight loss products, 5 million used procucts containing PPA, and 2.5 million used ephedra products.