Did you know that . . .
- The
herbal alkaloid ephedra is a central nervous system (CNS) stimulant that acts
on the appetite control center of the brain, the hypothalmus,
suppressing the desire to eat. Like all CNS stimulants, ephedrine causes the
heart and blood vessels to constrict, increasing blood pressure and heart
rate.
- Sixty
percent of deaths reported from dietary supplements between January 1993-February
2001 have been linked to the ephedrine alkaloids (EA) [1].
- An
FDA study from January 1993-February 2001 shows the EA dietary supplements
are associated with more deaths, myocardial infarctions, cardiac arrhythmias,
hypertension, stroke, and seizure events than all other dietary supplements
combined [1].
- EA
is contained in more than 200 hundred dietary supplements used by an estimated
12 million people last year [2].
- Some
appetite suppressants can create psychological dependence because they contain
phentermine, which is chemically similar to amphetamines. Others can cause
insomnia, drowsiness, irritability or depression [3].
- Drugs
that prevent fat absorption can cause cramping, diarrhea, flatulence, and
intestinal discomfort [3].
- Dietary
supplements are classified as foods under federal law and they are assumed
to be safe. They are subjected to limited regulatory oversight [4].
- Under
the Dietary Supplement Health and Education Act of 1994 (DSHEA): [5]
- The
dietary supplement manufacturer is responsible for ensuring that a dietary
supplement is safe before it is marketed. FDA is responsible for taking
action against any unsafe dietary supplement product only after it reaches
the market.
- Manufacturers
do not need to register with FDA nor get FDA approval before producing
or selling dietary supplements.
- Unlike
dietary supplements, all prescription and over-the-counter drugs must be proved
effective and safe before the FDA approves the them for marketing. A drug
is deemed safe when the benefits outweigh the risks [6].
- The
AMA urges Congress to require that dietary supplements be regulated in a manner
similar to prescription and over-the-counter drugs. [4].
Dietary
supplements like the ones that suppress the appetite may be widely used in the
US because obesity is a serious health concern.
-
Results
from the 1999-2000 National Health and Nutrition Examination Survey (NHANES)
indicate that an estimated 64 percent of US adults are either overweight
or obese [
7].
- Among
children and teens ages 6-19, 15 percent (almost 9 million) are overweight
according to the 1999-2000 data [8].
Those
seeking to lose weight should consult a physician before taking weight-loss
pills or appetite suppressants.
References
1. Petition to the Food and Drug Administration (FDA) requesting the ban of
production and sale of dietary supplements containing ephedrine alkaloids. Available
at: http://www.citizen.org/publications/release.cfm?ID=7053.
Accessed October 14, 2002.
2. Irby HE. Health hazards and abuse with herbal dietary supplements. Journal
MSMA. 2002;43:241-242.
3. Obesity drugs alone won’t do it. Available online.
Accessed October 14, 2002.
4. AMA to Congress: FDA should ban epehdra diet aids.
5. U.S. Food & Drug Administration: center for food safety and applied nutrition.
Dietary supplements. Available at: http://www.cfsan.fda.gov/~dms/supplmnt.html.
Accessed October 22, 2002.
6. Benefits vs. Risk: How FDA Approves New Drugs. Available at: http://www.fda.gov/fdac/special/newdrug/benefits.html.
Accessed October 22, 2002.
7. Prevalence of Overweight and Obesity Among Adults: United States, 1999-2000.
Available at: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese/obse99.htm.
Accessed October 22, 2002.
8. Prevalence of Overweight and Obesity Among Children and Adolescents, 1999-2000.
Available at: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overwght99.htm.
Accessed October 22, 2002.
The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.
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