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Dietary supplements can hurt health, wallet

As posted on May 31, 2009 on www.ajc.com

By Alison Young

Like millions of Americans, Shirley Lewis of Woodstock wants to lose some weight. So when she saw an ad on the Internet for inexpensive trial offer of two natural weight loss supplements, she said it seemed like a good deal.

If the acai and colon cleanser capsules didn’t work, she wasn’t out much money, she figured as she gave the firm her bank card number to cover a $5.99 fee.

But like many consumers, Lewis didn’t read the fine print and her bank account was soon being hit with charges for about $42, then $72. To top it off, the pills didn’t work, she said.

As swimsuit season heats up, consumers need to beware financial schemes, bogus effectiveness claims and sometimes dangerous ingredients when buying weight loss remedies, federal officials say.

Supplement industry officials acknowledge the problems, but say the perpetrators are companies operating on the fringe. Consumers can protect themselves, they said, by purchasing from established, brand-name companies they trust.

In recent months, the Food and Drug Administration has issued warnings about more than 70 “natural” weight loss supplements after sporadic testing by the agency found they were secretly spiked with a variety of pharmaceuticals. They ranged from the active ingredient in the prescription drug Meridia, to an experimental obesity drug currently undergoing clinical trials and lacking safety and effectiveness data, to potent diuretics and a laxative that is a possible carcinogen.

None of the chemicals were disclosed on the labels, putting consumers at risk of serious side effects and interactions with other drugs they may take.

Beyond health risks, consumers are taking financial risks — spending money on products that don’t live up to over-hyped claims and giving credit cards to firms that hit them with recurring charges they didn’t expect.

This spring, the Federal Trade Commission and other consumer groups issued warnings about various firms promoting “free” trials of acai, hoodia and other weight loss supplements. The firms take a credit card to cover shipping and handling charges for the free pills, then, without the consumer’s knowledge, enroll them in a program that charges them repeated fees for future shipments.

“The bottom line here is that it is impossible for consumers to have confidence in either the claims or the ingredients of these products given the current regulatory status,” Rich Cleland, assistant director of the FTC’s division of advertising practices, said in an interview with Spotlight last week.

“And that relates to everything from having drug ingredients in the products, to contaminants like lead in the products, or not even having the active ingredient in the products. There’s no way the consumer can check that,” Cleland said. “So consumers are taking all that on faith and that would seem to be risky business.”

Consumers often believe that dietary supplements are approved by a government agency before they’re sold — but they’re not. Unlike drugs, most supplements do not have to prove to the FDA they are safe or effective.

The Government Accountability Office, which serves as the investigative arm of Congress, in January issued a report recommending the FDA be given greater authority over the supplements, including multivitamins, herbal remedies and minerals.

But supplement industry officials say the FDA doesn’t need more authority; rather it needs more resources to enforce laws already on the books.

“What they really need is more manpower and more money,” said Steve Mister, president and CEO of the Council for Responsible Nutrition, a Washington-based trade association for supplement manufacturers.

Since last year, new FDA rules have required the nation’s largest supplement companies to test their ingredients and finished products to make sure that they are what they say they are. Next month the rules take effect for all other supplement companies — except those with fewer than 20 employees, which must begin testing next year, he said.

It’s unclear, however, how frequently the FDA will inspect the companies’ records. FDA officials were not available for an interview. Mister said the rules should go a long way toward giving consumers more confidence in the products they buy.

But many watchdogs said consumers should be very skeptical of weight loss products.

“They don’t work,” said Bruce Silverglade, director of legal affairs for the Center for Science in the Public Interest, a Washington-based consumer advocacy group that is urging the Obama administration to prohibit weight loss claims for dietary supplements.

“Nothing burns fat. Nothing makes you lose weight while you sleep. These are known false claims. The agencies have taken action against them, but only on a case-by-case basis,” Silverglade said.

An estimated one-third of U.S. adults are considered obese, creating a significant market of people looking for something to help them shed the pounds.

“The best approaches are changing our diet and exercise,” Silverglade said. Even the few FDA-approved weight loss medications, he noted, need to be combined with eating less and exercising more.

Mister agrees that consumers should avoid products that make fantastic weight loss claims. But he said some supplements can help users feel fuller or raise their metabolism when used with diet and exercise.

The National Institutes of Health’s National Center for Complementary and Alternative Medicine posts fact sheets on its Web site about some widely used supplements.

For example, the fact sheet for hoodia, a cactus-like plant widely marketed for weight loss, notes: “There is no reliable scientific evidence to support hoodia’s use. No studies of the herb in people have been published.”

The NIH hasn’t published a fact-sheet yet on acai, a berry that’s currently all the rage on the Internet for being an antioxidant weight loss superfood.

The problem is that for most supplements touted for weight loss, evidence of effectiveness is lacking, said David Allison, director of the Clinical Nutrition Research Center at the University of Alabama at Birmingham. Allison, a professor of biostatistics, has conducted evidence-based reviews of supplements.

Other than ephedra, a supplement banned in the U.S. due to health concerns, Allison said he’s not aware of any with clear evidence they are effective for weight loss. Too often, he said, the science touted in marketing claims involves small studies or studies on mice and does little to answer the key question: Does it cause humans to lose weight?

Allison suggests consumers ask companies to share with them any randomized, double-blind, placebo-controlled studies — in humans — they have to support their claims.

For now Shirley Lewis, 63, said she’s going to stick with losing weight the old fashioned way: by watching what she eats.

Lewis had to close her bank account to stop the firm that sold her the acai capsules and colon cleanser in January from continuing to withdraw money with her check-card number.

After complaining to the Better Business Bureau and the Governor’s Office of Consumer Affairs this spring about the Las Vegas firm Fit Factory/Self Help FF, Lewis said she got her money back. Company officials did not respond to requests for interviews.

“It was a hassle,” she said.