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Looking to downsize? FDA recommends avoiding these tainted weight-loss products

If your New Year's resolution includes cutting some pounds, you'll do well to avoid a list of some 30 weight-loss products that the FDA says are tainted. The alert, issued just before Christmas, advised consumers to stop using these products immediately and to consult their physicians.

Let me save you the effort of getting an appointment: Doctors don't have a lot of time to stay sharp on the bazillion health tonics and elixirs that can wash up on any Internet surf. Take your chances buying a sofa or food processor on eBay or craigslist, but be extremely cautious about purchasing something — be it on the Internet or in a health-food store — that you plan to ingest.

Label reading is always a good start, but these weight-loss supplements were tainted with pharmacologically active compounds that didn't show up on the list of ingredients, active or otherwise. Each product contained at least one of the following four undeclared substances.

Sibutramine. This is the active ingredient in Meridia, a prescription obesity drug. What a deal — you're getting prescription weight-loss therapy on the cheap! Problem is, some of the products on the FDA's alert list included three times the recommended daily dosage of sibutramine. That's a very dangerous "deal," given that sibutramine at standard doses can increase blood pressure and heart rate, and thereby increase the risk for heart attack, heart failure or stroke. The drug can also cause seizures and worsening of glaucoma. It's these potent stimulant effects that make sibutramine a Schedule IV controlled substance.

Rimonabant. Approved for weight loss in Europe under the name Acomplia, in 2007 the FDA voted not to approve the drug because of the increased risk of seizures, depression, anxiety, insomnia, aggressiveness and suicidal thoughts. The British linked the drug to five deaths and 720 adverse events over two years of use, and the European Medicines Agency recently recommended pulling the drug.

Phenothalein. This chemical was included in some over-the-counter laxatives until 1999, when the FDA pulled it because of its ability to damage DNA and cause genetic mutations. Stick with prunes.

Phenytoin. This is the generic name for the drug better known as Dilantin, one of the most frequently prescribed anti-seizure medications. I have no idea why this drug might be intentionally included in a weight-loss product, other than to counteract the risk of seizures caused by any clandestine sibutramine.  Regardless of how or why the phenytoin got there, these products contained just trace amounts of the drug. So although a toxic effect is unlikely, the tainted products could cause problems for someone with an established phenytoin allergy.

No registration required
So how could all of this happen? Unlike conventional foods and drug products, manufacturers of dietary supplements don't need to register their products with the FDA. Nor do they need FDA approval prior to producing and selling the likes of 999 Fitness Essence, Imelda Perfect Slim, Lida DaiDaihua, or my personal favorite, Venom Hyperdrive 3.0.

Although many of the products on the FDA alert list did not list the manufacturer, most appeared to be manufactured in China. This is the country that in 2008 brought us the Summer Olympics and yet another outbreak of melamine contamination. The first came in 2007, when pet-food products tainted with melamine put scores of cats and dogs into lethal renal failure by virtue of the drug's tendency to precipitate out into crystals and stones inside the kidneys and the urine collecting system. This year's outbreak involved contaminated infant formula and put 50,000 Chinese infants into the hospital.

Melamine can be found (intentionally) in plastics, resins, adhesives, glues and laminated products such as plywood; it's frequently used in crop fertilizers. Its ubiquitous nature means melamine keeps popping up in trace amounts in various places, but the median level found in the tainted Chinese formulas was 40 to 200 times the recently established Tolerable Daily Intake (TDI).

One can understand the business motive behind adding a prescription weight-loss medication or a laxative to a weight-loss product, by why add melamine to milk? An article in the New England Journal of Medicine suggests one possible scenario: Melamine has a very high nitrogen content, which is often used as a surrogate marker for measuring the protein content of food. The Chinese government had recently issued directives mandating increased protein content in infant formulas, seeing as some formulas were so "thin" that infants were developing signs of protein deficiency. Melamine may have been added to falsely increase the measured protein content; for added allure, it also made the formula appear milkier.

Pet food, weight-loss supplements, infant formula — welcome to the new world order. Hot, flat, crowded, and tainted.

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