California and New York are on the cusp of going further than the FDA in restricting the sale of non-prescription diet pills to minors as pediatricians and public health advocates try to protect kids from extreme weight-loss gimmicks online.<\/p>\n

A bill before Gov. Gavin Newsom would bar anyone under 18 in California from buying over-the-counter weight loss supplements \u2014 whether online or in shops \u2014 without a prescription. A similar bill passed by New York lawmakers is on Gov. Kathy Hochul\u2019s desk. Neither Democrat has indicated how he or she will act.<\/p>\n

If both bills are signed into law, proponents hope the momentum will build to restrict diet pill sales to children in more states. Massachusetts, New Jersey, and Missouri have introduced similar bills<\/a> and backers plan to continue their push next year.<\/p>\n

Nearly 30 million<\/a> people in the United States will have an eating disorder in their lifetime; 95% of them are between ages 12 and 25, according to Johns Hopkins All Children\u2019s Hospital. The hospital adds that eating disorders pose the highest risk of mortality of any mental health disorder. And it has become easier than ever for minors to get pills that are sold online or on drugstore shelves. All dietary supplements, which include those for weight loss, accounted for nearly 35% of the $63 billion<\/a> over-the-counter health products industry in 2021, according to Vision Research Reports, a market research firm.<\/p>\n

Dietary supplements, which encompass a broad range of vitamins, herbs, and minerals, are classified by the FDA as food<\/a> and don\u2019t undergo scientific and safety testing as prescription drugs and over-the-counter medicines do.<\/p>\n

Public health advocates want to keep weight loss products \u2014 with ads that may promise to \u201cDrop 5 pounds a week!\u201d<\/a> and pill names like Slim Sense \u2014 away from young people, particularly girls, since some research has linked some products to eating disorders. A study in the American Journal of Public Health<\/a>, which followed more than 10,000 women ages 14-36 over 15 years, found that \u201cthose who used diet pills had more than 5 times higher adjusted odds of receiving an eating disorder diagnosis from a health care provider within 1 to 3 years than those who did not.\u201d<\/p>\n

Many pills have been found tainted with banned and dangerous ingredients that may cause cancer, heart attacks, strokes, and other ailments. For example, the FDA advised the public to avoid<\/a> Slim Sense by Dr. Reade because it contains lorcaserin, which has been found to cause psychiatric disturbances and impairments in attention or memory. The FDA ordered it discontinued and the company couldn\u2019t be reached for comment.<\/p>\n

\u201cUnscrupulous manufacturers are willing to take risks with consumers\u2019 health \u2014 and they are lacing their products with illegal pharmaceuticals, banned pharmaceuticals, steroids, excessive stimulants, even experimental stimulants,\u201d said Bryn Austin, founding director of the Strategic Training Initiative for the Prevention of Eating Disorders, or STRIPED, which supports the restrictions. \u201cConsumers have no idea that this is what\u2019s in these types of products.\u201d<\/p>\n

STRIPED is a public health initiative based at the Harvard T.H. Chan School of Public Health and Boston Children\u2019s Hospital.<\/p>\n

An industry trade group, the Natural Products Association, disputes that diet pills cause eating disorders, citing the lack of consumer complaints to the FDA of adverse events from their members\u2019 products. \u201cAccording to FDA data, there is no association between the two,\u201d said Kyle Turk, the association\u2019s director of government affairs.<\/p>\n

The association contends that its members adhere to safe manufacturing processes, random product testing, and appropriate marketing guidelines. Representatives also worry that if minors can\u2019t buy supplements over the counter, they may buy them from \u201ccrooks\u201d<\/a> on the black market and undermine the integrity of the industry. Under the bills, minors purchasing weight loss products must show identification along with a prescription.<\/p>\n

Not all business groups oppose the ban. The American Herbal Products Association, a trade group representing dietary supplement manufacturers and retailers, dropped its opposition to California\u2019s bill once it was amended to remove ingredient categories that are found in non-diet supplements and vitamins, according to Robert Marriott, director of regulatory affairs.<\/p>\n

Children\u2019s advocates have found worrisome trends among young people who envision their ideal body type based on what they see on social media. According to a study commissioned by Fairplay<\/a>, a nonprofit that seeks to stop harmful marketing practices targeting children, kids as young as 9 were found to be following three or more eating disorder accounts on Instagram, while the median age was 19. The authors called it a \u201c pro-eating disorder bubble<\/a>.\u201d<\/p>\n

Meta, which owns Instagram and Facebook, said the report lacks nuance, such as recognizing the human need to share life\u2019s difficult moments. The company argues that blanket censorship isn\u2019t the answer. \u201cExperts and safety organizations have told us it\u2019s important to strike a balance and allow people to share their personal stories while removing any content that encourages or promotes eating disorders,\u201d said Liza Crenshaw, a Meta spokesperson, in an email.<\/p>\n

Dr. Jason Nagata, a pediatrician who cares for children and young adults with life-threatening eating disorders, believes that easy access to diet pills contributes to his patients\u2019 conditions at UCSF Benioff Children\u2019s Hospital in San Francisco. That was the case for one of his patients, an emaciated 11-year-old girl.<\/p>\n