Weight loss and muscle-building supplements can contribute to disordered eating in young people

California Lawmakers on the Senate Health Committee passed AB-1341, which would prohibit the sale of diet pills to anyone under the age of 18 in California. The bill was passed Wednesday with unanimous support of eight to zero in the Senate Health Committee.

With the advent of social media, body image issues in adolescents have risen dramatically. A study conducted by the Florida House Experience, a health institution, found that 50% of women and 37% of men compare their body to the media unfavorably.

Assemblywoman Cristina Garcia (D-Bell Gardens), right, introduced AB-1341 in 2021. (Image from virtual briefing of AB-1341)

Eating disorders have risen during the pandemic. An analysis published in Forbes in 2021 found a 25% increase of diagnoses in adolescence since March 2020. Many youth are turning to weight loss and muscle-building supplements without knowing the health risks.

Amid this increase in eating disorders, youth have taken action to create change. Kelsey Wu, 17-year-old founder of the international nonprofit organization For You, works on policy translation to protect youth from being harmed by dangerous weight loss supplements. She testified at the hearing, sharing her past struggles with an eating disorder.

“[Diet pill and muscle-building supplement companies] deliberately exploit our naïvety and vulnerability for their profit and benefit,” Wu said. “It is our health and future at stake, so it is up to us to fight for regulations on these harmful products.”

Although the American Academy of Pediatrics strongly cautions against young people using these products, a survey published in the Journal of Adolescent Health revealed that 11% of teens have used weight loss supplements and 5% have used muscle-building supplements.

Despite the lack of research supporting the use of over-the-counter diet and muscle-building supplements, they are easily accessible in stores and online venues. Currently, the U.S. Food and Drug Administration severely underregulates dietary supplements in general, according to a research study published in the National Library of Medicine. Although general food products and medicines must be approved by the FDA before they can be sold, supplements do not require the same review.

Passed by President Clinton, the Dietary Supplement Health and Education Act of 1994, prohibited the FDA from requiring rigorous prescreening of dietary supplements before they enter the market. Without strict regulation, the industry grew from 4,000 products on the market in the United States at the time that law was passed to over 85,000 products on the market today.

“Current federal regulation is woefully inadequate and had led to a dietary supplements
marketplace rife with risk,” said Bryn Austin, a professor at the Harvard Chan School of Public Health.

Due to the lack of FDA oversight on dietary supplements, weight loss and muscle-building supplements particularly are often laced with unlisted and toxic ingredients. Researchers publishing in the journal of Clinical Toxicology analyzed 17 brands of sports and weight loss supplements sold online and in venues and found nine prohibited stimulants. Most of these products contained more than one prohibited simulant and many of them had not been tested prior to market release.

According to Austin, the repercussion of consuming these toxic ingredients and prohibited stimulants can be deadly. Every year, roughly 23,000 Americans end up in hospital emergency departments every year due to supplements, and a quarter of those cases are due to weight-loss supplements.

“These products increase the risk of heart attack, stroke, kidney and liver injury, and even death,” Austin said.

In addition to physical harms of consuming weight loss and muscle-building supplements, these harmful products have been linked to eating disorders. Austin said that teens who use weight-loss supplements or over-the-counter diet pills have 4 to 6 times the risk of being diagnosed with an eating disorder within just a few years.

Apart from increasing the risk of developing an eating disorder, weight loss and muscle-building supplements can also worsen existing eating disorders.

Alexandra Xu, a rising freshman at Rice University, battled orthorexia — a disordered eating pattern characterized by a fixation on clean eating — throughout middle school and high school.

As a child, Xu remembers constantly reading wellness articles advertising weight loss products that would provide quick fixes and transformations. In the depths of her eating disorder and bombarded by unrealistic standards on social media, she said she strongly contemplated using these products on multiple instances.

“Ads establish these products as alleged golden tickets to health,” Xu said.

Although Xu was fortunate enough not to fall prey to products manufactured by the diet industry, many of her friends were not so lucky. Xu said one of her friends who was struggling with anorexia used multiple weight loss supplements and ultimately had to be hospitalized.

“It very much damaged her physical health, and also further fueled her eating disorder to the point that she can no longer function [normally],” Xu said.

Another one of Xu’s friends, an athlete who regularly went to the gym, experienced the negative repercussions of using muscle-building supplements. According to Xu, her friend developed a negative body image, experiencing symptoms of anxiety and depression as a result.

“He always felt he had to use more and more [supplements] because of his increasing tolerance,” she said. “He needed more doses to get the same effects.”