The misuse of over-the-counter (OTC) weight loss products is common among adolescents in many countries. However, the associated health effects cannot be overlooked, making it a public health concern. A new study published in JAMA Network Open explores the prevalence of such use.
Teenage and childhood eating disorders are particularly problematic, as they occur during crucial periods of human growth and development. Furthermore, these disorders often indicate other psychological issues that affect social functioning. Additionally, they frequently contribute to abnormal weight gain, which has negative health implications.
Adolescent weight control behavior can cross the line into abnormality when they employ potentially unhealthy or dangerous methods, including the use of over-the-counter weight control medications. Taking such medications is associated with abnormal weight gain in adults and a higher risk of later diagnosis of an eating disorder.
Adolescents exhibiting such behavior often experience low self-esteem, have poor dietary habits, and are at risk of depression. They also face an increased risk of substance abuse.
Worldwide, adolescents may have used such products without a prescription within the past week, with prevalence ranging from less than 2% in Australia to 2-6% in the past month and about 3.5% in the past year. The current study was motivated by the absence of a global prevalence study in this area.
Researchers utilized four major databases to compile relevant studies on the use of non-prescription weight loss aids by teenagers worldwide. They acquired 90 studies, including 50 from North America. Most studies were of moderate or good quality.
Over 75% of the studies described the use of such products by both boys and girls, with the remaining exclusively focused on girls. Around two-thirds reported prevalence in the overall adolescent population, and the rest examined groups with risk factors such as diabetes, substance abuse, or previously diagnosed eating disorders.
More than three-quarters of the studies reported the use of diet pills. Almost half focused on the use of laxatives, and one-fifth on the use of diuretics.
The results show that about 6% of adolescents use OTC products for weight loss. The usage was more prevalent among girls than boys.
In the week prior, 2% of the general population reported consumption, but this doubled when the survey period was extended to the last month. Over 6% reported using such products in the past year, and 9% indicated using them at least once in their lifetime.
Diet pills were taken more frequently (6%) than laxatives (4%) or diuretics (2%), especially among girls compared to boys.
About one-tenth of the girls reported ever using nonprescription weight loss products. Importantly, girls with such a history also have a higher risk of low self-esteem, parental pressure to lose weight, poor body image, and generally surrounding themselves with friends who esteem being thin. They also report being influenced by media or social media posts that glorify unhealthy and unrealistic notions of attractiveness.
Furthermore, the use of nonprescription weight loss medications was higher in North America than in Asia or Europe. Asian studies showed a higher prevalence of past-year use compared to European studies, indicating risk factors at play in these subgroups.
The „easy access to these products without a prescription, medical orders, or restrictions for individuals under 18 years“ raises significant concerns and underscores the need for strict regulation of such products, especially in children and adolescents.
These weight loss products are not intended for children, are detrimental to health, are associated with excessive weight gain in adults, and do not result in long-term or healthy weight loss. Furthermore, they are linked to a high risk of later diagnosis of an eating disorder or depression.
Individuals who consume these products during adolescence are also associated with substance abuse and unusually low food intake.
These findings suggest that action is required to reduce the use of weight loss products in this group, given the ineffectiveness of these products and their harmful long-term health consequences.