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Fraudulent Drugs and Devices for Weight Reducing*
Fraudulent Drugs and Devices for Weight Reducing *
T
H E A ME RICA
MEDICAL ASSOCIA-
has estimated that overweight Americans are being fleeced of $100,000,00 a year in their purchase of spurious diet aids and useless mechanical dev ice . P o tmaster General Arthur E . ummerfield has stated that reducing scheme are probably the most lucrative of medical frauds today , and that use of the mails to promote medical quackery is at the highest level in history. Weight control is a serious medical problem for many people, and for many others it is a cosmetic or an esthetic problem with an important relationship t o mental health and well-being. But these facts merely create an intense demand for an article that science has not yet produced: a simple, safe and sane food, drug, or device which will bring about loss of body weight without exercise of the will to cut down the food intake. There is no such article. But unscrupulous promoters by the scores have rushed into the vacuum with their worthless pills, potions, freak diets, mechanical gadgets, and the like. The Food and Drug Administration has at one time or another encountered most of these types of products and al o ha recently found even cigarettes and chewing gum with label claims for weight reducing. While most such products are harmless, although worthIe s, some have been outright dangerous and others would not be safe for persons wi th certain diseases . T o summarize the important facts about reducing : Medical guidance can be important to almost anyone who needs to lose weight. This may be true even for the person wi hing to lose only a few pounds. The po sibility of undetected chronic disease or the continuing need for health coun~ seling and guidance, indicates the wisdom of con ulting a doctor. The individual who wishes to lose a large amount of weig~t has a serious medical problem, and wlthout exception needs expert guidance. Restriction of food is the principal factor in reducing. Lowered caloric intake is necessary for anyone to reduce ~nd cer~ainly there is ample dietar; mformatlOn available. The person who wants to reduce should be sure to obtain dietary information from competent sources. The U.S. Public Health Service, the American Medical Association and family physicians are among such sources. Exercise has a role in reducing, and TI ON
* Released by Arthur S. Flemming. Secretary of Health , Education , and Welfare, at News Conference , Washington, D.C. , Wednesday Septembe 2, 1959. ' 504
moreover can be of general health benefit. Authorities point out that to be beneficial exercise need not be violent or prolonged. Mild exercise of short duration can be helpful in reducing and to the general health condition. Here again, however, the amount and kind of exercise best suited to the individual's needs and health can best be determined by a physician. Finally, don't believe those false promises that one can eat as he pleases and still lose weight simply by using some food, drug, or mechanical gadget. The person who needs or desires to lose weight is often unable to determine the truth or falsity of claims made for the infinite variety of products offered for this purpose. The following information about types of products currently or recently marketed for weight reducing represents the consensus of informed medical opinion about the usefulness and the limitations and hazards of use if any of these products. " Electric Vibrator Devices-These include hand units, pillows, chairs, tableseven mattresses. All furnish vibration by means of an electric motor with a rotating mechanism off-center from the drive shaft. Some also contain a heating element. There is no device which will be effective for "spot reducing," for "melting away fat," or for "breaking up fatty deposits." Vibration or other massage should not be applied to inflamed or irritated areas and would be dangerous if applied to legs or thighs in cases of thrombophlebitis (milk leg). Girdles and Garments-These have no value in weight reduction. They may have the effect of redistributing the bulges to make them less noticeable. Rubber Suction Cups-There is no basis for claims that any device will "pound" or "massage" weight off in a particular spot. Purgatives and Laxatives-It doesn't make sense to overeat and then try to offset the effects by taking purgatives or laxatives to rush the food through the body before it can be absorbed. Frequent or continued use of. laxatives produces undesirable effects on the gastrointestinal tract. And if laxatives were taken in sufficiently high dosage and for a sufficient period of time to be effective in weight reduction the balance in the absorption of nutri~ional factors would be upset. Bulk Laxatives-These have been sold with claims that they fill the stomach and thus depress the appetite. But such products do not produce bulk in the stomach-they work only in the intestine. Hence they are not effec-
JOURNAL OF THE AMERICAN PHAR~ACEUTICAL ASSOCIATION
tive in cutting down the appetite or in weight reducing. Drugs to Stimulate Metabolism-Any drug which would stimulate metabolism to such an extent that it would cause weight loss is much too dangerous for use without medical supervision. Conversely, any drug which is safe enough to be bought without a prescription will not have any value for weight reducing based on its effect on the body metabolism. Drugs to Depress the Appetite-The active ingredient of several of the popular drugs sold without a prescription as appetite-depressants is phenylpropanolamine. Medical evidence now available indicates that this drug produces no useful appetite-depressing effect. In low dosage the net effect in reducing weight would be negligible. In dosages high enough to produce a significant effect in reducing weight (available only upon prescription in any event), the undesirable side effects nullify its usefulness. The active ingredient of a chewing gum sold as an appetite depressant is benzocaine. This ingredient is supposed to anesthetize the taste buds or the hunger mechanism of . the stomach. This is a theoretical effect which has not been scientifically verified. There are certain drugs, safe only for use on a doctor's prescription, which will depress the appetite temporarily. These are of real value in a properly designed dietary program while a person is being re-educated in his eating habits. But the effects of these drugs gradually wear off unless the dosage is increased. Dehydrating Drugs-There are drugs on the market which will cause a temporary loss of water and a corresponding weight reduction. However, this is not a reduction in the amount of body fat, and the weight loss is therefore an illusion without real significance. And as a practical matter many of the products as marketed contain dosages which may actually cause weight gain rather than weight loss. Vitamin-Mineral Preparations; Proteins; Other Food Supplements-There is no vitamin, mineral, protein, or other food supplement which will produce a reduction in body weight. Protein, of course, has roughly half the energy-producing (caloric) value of fats, and to the extent that protein can be substituted for fat in the diet, the diet will be less fattening. People on an extremely restricted diet, limiting the variety of food eaten, may need vitamin or mineral supplementation to maintain good nutrition. But even a moderately severe diet, such as would normally be prescribed for weight reduction, does not require vitaminmineral supplementation if it is properly chosen to include a good variety of foods. •
(
T
H E A ME RICA
MEDICAL ASSOCIA-
has estimated that overweight Americans are being fleeced of $100,000,00 a year in their purchase of spurious diet aids and useless mechanical dev ice . P o tmaster General Arthur E . ummerfield has stated that reducing scheme are probably the most lucrative of medical frauds today , and that use of the mails to promote medical quackery is at the highest level in history. Weight control is a serious medical problem for many people, and for many others it is a cosmetic or an esthetic problem with an important relationship t o mental health and well-being. But these facts merely create an intense demand for an article that science has not yet produced: a simple, safe and sane food, drug, or device which will bring about loss of body weight without exercise of the will to cut down the food intake. There is no such article. But unscrupulous promoters by the scores have rushed into the vacuum with their worthless pills, potions, freak diets, mechanical gadgets, and the like. The Food and Drug Administration has at one time or another encountered most of these types of products and al o ha recently found even cigarettes and chewing gum with label claims for weight reducing. While most such products are harmless, although worthIe s, some have been outright dangerous and others would not be safe for persons wi th certain diseases . T o summarize the important facts about reducing : Medical guidance can be important to almost anyone who needs to lose weight. This may be true even for the person wi hing to lose only a few pounds. The po sibility of undetected chronic disease or the continuing need for health coun~ seling and guidance, indicates the wisdom of con ulting a doctor. The individual who wishes to lose a large amount of weig~t has a serious medical problem, and wlthout exception needs expert guidance. Restriction of food is the principal factor in reducing. Lowered caloric intake is necessary for anyone to reduce ~nd cer~ainly there is ample dietar; mformatlOn available. The person who wants to reduce should be sure to obtain dietary information from competent sources. The U.S. Public Health Service, the American Medical Association and family physicians are among such sources. Exercise has a role in reducing, and TI ON
* Released by Arthur S. Flemming. Secretary of Health , Education , and Welfare, at News Conference , Washington, D.C. , Wednesday Septembe 2, 1959. ' 504
moreover can be of general health benefit. Authorities point out that to be beneficial exercise need not be violent or prolonged. Mild exercise of short duration can be helpful in reducing and to the general health condition. Here again, however, the amount and kind of exercise best suited to the individual's needs and health can best be determined by a physician. Finally, don't believe those false promises that one can eat as he pleases and still lose weight simply by using some food, drug, or mechanical gadget. The person who needs or desires to lose weight is often unable to determine the truth or falsity of claims made for the infinite variety of products offered for this purpose. The following information about types of products currently or recently marketed for weight reducing represents the consensus of informed medical opinion about the usefulness and the limitations and hazards of use if any of these products. " Electric Vibrator Devices-These include hand units, pillows, chairs, tableseven mattresses. All furnish vibration by means of an electric motor with a rotating mechanism off-center from the drive shaft. Some also contain a heating element. There is no device which will be effective for "spot reducing," for "melting away fat," or for "breaking up fatty deposits." Vibration or other massage should not be applied to inflamed or irritated areas and would be dangerous if applied to legs or thighs in cases of thrombophlebitis (milk leg). Girdles and Garments-These have no value in weight reduction. They may have the effect of redistributing the bulges to make them less noticeable. Rubber Suction Cups-There is no basis for claims that any device will "pound" or "massage" weight off in a particular spot. Purgatives and Laxatives-It doesn't make sense to overeat and then try to offset the effects by taking purgatives or laxatives to rush the food through the body before it can be absorbed. Frequent or continued use of. laxatives produces undesirable effects on the gastrointestinal tract. And if laxatives were taken in sufficiently high dosage and for a sufficient period of time to be effective in weight reduction the balance in the absorption of nutri~ional factors would be upset. Bulk Laxatives-These have been sold with claims that they fill the stomach and thus depress the appetite. But such products do not produce bulk in the stomach-they work only in the intestine. Hence they are not effec-
JOURNAL OF THE AMERICAN PHAR~ACEUTICAL ASSOCIATION
tive in cutting down the appetite or in weight reducing. Drugs to Stimulate Metabolism-Any drug which would stimulate metabolism to such an extent that it would cause weight loss is much too dangerous for use without medical supervision. Conversely, any drug which is safe enough to be bought without a prescription will not have any value for weight reducing based on its effect on the body metabolism. Drugs to Depress the Appetite-The active ingredient of several of the popular drugs sold without a prescription as appetite-depressants is phenylpropanolamine. Medical evidence now available indicates that this drug produces no useful appetite-depressing effect. In low dosage the net effect in reducing weight would be negligible. In dosages high enough to produce a significant effect in reducing weight (available only upon prescription in any event), the undesirable side effects nullify its usefulness. The active ingredient of a chewing gum sold as an appetite depressant is benzocaine. This ingredient is supposed to anesthetize the taste buds or the hunger mechanism of . the stomach. This is a theoretical effect which has not been scientifically verified. There are certain drugs, safe only for use on a doctor's prescription, which will depress the appetite temporarily. These are of real value in a properly designed dietary program while a person is being re-educated in his eating habits. But the effects of these drugs gradually wear off unless the dosage is increased. Dehydrating Drugs-There are drugs on the market which will cause a temporary loss of water and a corresponding weight reduction. However, this is not a reduction in the amount of body fat, and the weight loss is therefore an illusion without real significance. And as a practical matter many of the products as marketed contain dosages which may actually cause weight gain rather than weight loss. Vitamin-Mineral Preparations; Proteins; Other Food Supplements-There is no vitamin, mineral, protein, or other food supplement which will produce a reduction in body weight. Protein, of course, has roughly half the energy-producing (caloric) value of fats, and to the extent that protein can be substituted for fat in the diet, the diet will be less fattening. People on an extremely restricted diet, limiting the variety of food eaten, may need vitamin or mineral supplementation to maintain good nutrition. But even a moderately severe diet, such as would normally be prescribed for weight reduction, does not require vitaminmineral supplementation if it is properly chosen to include a good variety of foods. •
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