Australia’s regulator has banned FatBlaster Max, an over-the-counter pill that claimed (with no evidence) to be able to help you lose weight. FatBlaster Max can no longer be purchased, after the Therapeutic Goods Administration (TGA) found the company behind the pills registered the medicine with no mention of weightloss properties and failed to produce any evidence substantiating its advertised claim it led to weight loss.
The ban has put over-the-counter weightloss pills back in the spotlight, shining light on an unregulated area that is immensely popular. Studies show one in seven people have tried an over-the-counter weightloss pill, undoubtedly enticed by their promises of helping people lose weight easily and rapidly. But do over-the-counter weightloss pills really work? Here’s everything you need to know about the weightloss supplements currently claiming a big share of Australia’s billion-dollar weight-loss industry.
What exactly are over-the-counter weightloss pills?
Broadly speaking, over-the-counter pills are anything you buy from a pharmacist without a prescription, like cold and flu remedies and paracetamol. Some over-the-counter medications are also available at retailers like supermarkets, service stations and health food stores. Over-the-counter weightloss pills are essentially dietary and herbal supplements marketed and sold with claims of assisting with weight loss.
The important distinction between over-the-counter weightloss pills and weightloss medications prescribed by a doctor is that prescription weightloss drugs – like all pharmaceutical drugs – must go through clinical trials and provide Australia’s drug regulator with evidence of their effectiveness and safety. Worryingly, the distributors of over-the-counter diet pills and supplements are not required to produce any evidence of their products’ efficacy and safety before they hit the Australian market. The TGA only requires them to hold, but not necessarily make freely available, evidence substantiating their claims.
How do over-the-counter weightloss pills help you lose weight?
Over-the-counter weightloss pills usually claim to have several herbal or natural ingredients that help you lose weight in one of four ways:
- by suppressing your appetite or making you feel full using ingredients like a tropical fruit called Garcinia cambogia or glucomannan, a dietary fibre made from the root of the konjac plant
- by speeding up your metabolism and your body’s ability to burn fat using components like the herb Ephedra sinica or a fatty acid (conjugated linoleic acid) found in meat and dairy products
- by blocking your body’s ability to digest things like carbohydrates and fat using Phaseolus vulgaris (also known as the common bean) or a variety of green tea leaf called Camellia sinensis
- by absorbing fat in the foods you eat, relying on ingredients like chitosan, a product created using the shells of crustaceans and insects.
Do these weightloss pills work?
In a word: no.
Most advertising for over-the-counter weightloss pills and dietary supplements will proudly claim a product’s results are backed by “clinical trials” and “scientific evidence”, but the reality is a host of independent studies don’t support these claims.Two recent studies by the University of Sydney examined data from more than 120 placebo-controlled trials of herbal and dietary supplements for weight loss, including products featuring the ingredients described above. None of the supplements provided clinically meaningful weight loss.
If they don’t work, why are they allowed to be sold?
Given there are few to no checks and even less accountability when compared to prescription weightloss drugs, the researchers’ findings should come as no surprise.
Recent studies suggest weightloss supplement companies have conducted very few high-quality studies. Many trials are too small, poorly designed and don’t accurately report the composition of the supplements being investigated. This is because there are no guidelines currently covering how these types of trials should be conducted.
The good news is the Australian regulator is taking some action on the claims made by distributors of these weightloss supplements, with the TGA recently banning the sale of FatBlaster Max. While the reality is the most likely thing to be damaged by over-the-counter weightloss pills is your hip pocket, the TGA’s action also serves as an important reminder that the safety of over-the-counter weightloss supplements can never be guaranteed.
Several products have been banned from sale around the world after causing serious health problems. This includes the TGA and America’s Food and Drug Administration banning dietary supplements containing ephedra in 2018, when supplements containing this stimulant herb were associated with cases of heart attack, seizure, stroke and sudden death.
Real harm is also caused by the over-the-counter weightloss industry feeding on people’s desire for a quick fix to achieve rapid weight loss. The reality is there is no wonder pill. Losing weight and achieving lasting results comes down to: following evidence-based care from health-care professionals and making meaningful changes to your diet, exercise and lifestyle that you can sustain for life. A spokesperson for FatBlaster said the company is disappointed with the TGA’s decision and it is evaluating options for next steps.
It said the TGA’s requirements had changed during the years that FatBlaster Max Tablets have been on the market and the company has taken great care to update all packaging, advertising and claims to ensure compliance with these requirements. The listing cancellation does not impact the wider FatBlaster range.
Critics Mayo Clinic Staff
Are you an adult who has serious health problems because of your weight? Have you tried diet and exercise but haven’t been able to lose enough weight? If you answered yes to these questions, a prescription weight-loss drug may be an option for you. You should know, however, that prescription weight-loss drugs are used in addition to — not instead of — diet and exercise.
Who is a candidate for weight-loss drugs?
Your doctor may consider a weight-loss drug for you if you haven’t been able to lose weight through diet and exercise and you meet one of the following:
- Your body mass index (BMI) is greater than 30.
- Your BMI is greater than 27 and you have a serious medical problem related to obesity, such as diabetes or high blood pressure.
Before selecting a medicine for you, your doctor will consider your history and health challenges. Then your doctor will talk with you about the pros and cons of prescription weight-loss drugs. It’s important to note that weight-loss drugs aren’t for everyone. For example, prescription weight-loss drugs shouldn’t be used if you’re trying to get pregnant, are pregnant or are breast-feeding.
How well do weight-loss drugs work?
Prescription weight-loss drugs approved for long-term use (more than 12 weeks) produce significant weight loss compared with placebo. The combination of weight-loss medication and lifestyle changes results in greater weight loss than lifestyle changes do alone. Over the course of a year, that can mean a weight loss of 3% to 7% of total body weight above that achieved with lifestyle changes alone. That may seem like a modest amount. But a sustained weight loss of 5% to 10% can have important health benefits, such as lowering blood pressure, blood sugar and triglyceride levels.
What you should know about weight-loss drugs
Mild side effects, such as nausea, constipation or diarrhea, are common. They may lessen over time. Rarely, serious side effects can occur. For this reason, it’s important to thoroughly discuss treatment options with your doctor.Weight-loss drugs can be expensive and aren’t always paid for by insurance. Ask your insurance company about coverage. Many people gain back some of the weight they lost when they stop taking weight-loss drugs. However, adopting healthy lifestyle habits may help limit weight gain.
How long does drug therapy last?
How long you’ll take a weight-loss drug depends on if the drug helps you lose weight. If you’ve lost enough weight to improve your health and you haven’t had serious side effects, your doctor may suggest that you take the drug indefinitely. If you haven’t lost at least 5% of your body weight after three to six months on the full dose of a drug, your doctor will probably change your treatment and may switch you to a different weight-loss drug.
What drugs are approved for weight loss?
Four weight-loss drugs have been approved by the U.S. Food and Drug Administration for long-term use:
- Bupropion-naltrexone (Contrave)
- Liraglutide (Saxenda)
- Orlistat (Xenical)
- Phentermine-topiramate (Qsymia)
Most prescription weight-loss drugs work by decreasing appetite or increasing feelings of fullness. Some do both. The exception is orlistat. It works by interfering with absorption of fat.
Bupropion-naltrexone is a combination drug. Naltrexone is used to treat alcohol and opioid dependence. Bupropion is an antidepressant and quit-smoking aid. Like all antidepressants, bupropion carries a warning about suicide risk. Bupropion-naltrexone can raise blood pressure, and monitoring is necessary at the start of treatment. Common side effects include nausea, headache and constipation.
Liraglutide is also used to manage diabetes. Unlike other weight-loss drugs, liraglutide is given by injection. Nausea is a common complaint. Vomiting may limit its use.
Orlistat is also available in a reduced-strength form without a prescription (Alli). Orlistat can cause bothersome gastrointestinal side effects, such as flatulence and loose stools. You need to follow a low-fat diet when taking this medicine. Rare cases of serious liver injury have been reported with orlistat. However, no cause-and-effect relationship has been established.
Phentermine-topiramate is a combination of a weight-loss drug (phentermine) and an anticonvulsant (topiramate). Phentermine has the potential to be abused because it acts like an amphetamine. Other possible side effects include an increase in heart rate and blood pressure, insomnia, constipation, and nervousness. Topiramate increases the risk of birth defects. Phentermine by itself (Adipex-P, Lomaira) is also used for weight loss. It’s one of four similar weight-loss drugs approved for short-term use (less than 12 weeks). The other drugs in this group aren’t widely prescribed.
- Alli weight-loss pill
- Apple cider vinegar
- Bariatric surgery
- Biliopancreatic diversion with duodenal switch (BPD/DS)
- Coconut oil for weight loss
- Dietary supplements for weight loss
- Ear stapling for weight loss
- Endoscopic Intragastric Balloon
- Endoscopic sleeve gastroplasty
- Endoscopic Sleeve Gastroplasty (Gastric Sleeve)
- Gastric bypass (Roux-en-Y)
- Weight-loss surgery
- Intragastric balloon
- Phentermine for weight loss
- Protein shakes
- Biliopancreatic diversion with duodenal switch
- Roux-en-Y gastric bypass
- Sleeve gastrectomy
- Vitamin B-12 injections
- Natural diuretics
- Weight-loss surgery
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