The Ease of Selling Bunk for Weight Loss

Federal oversight of dietary supplements is modest and insufficient. This gentle understatement summarizes a new perspective from the Obesity Society on dietary supplements and alternative therapies for obesity. It comes with a systematic review of the evidence – or lack of it – for these products. Nonetheless, people keep selling this bunk for weight loss because they can.

It doesn’t take much to bring a dietary supplement to market. The ingredients have to be safe. The term of art is GRAS. But the law requires no pre-approval to sell such dubious products. FDA regulation is minimal. Companies are supposed to adhere to good manufacturing practices. So the appearance of regulation is there. Reality is that it’s “modest.”

Systematic Review

John Batsis and colleagues found 20,504 citations for dietary supplements and alternative therapies. In fact, they looked at everything from acupuncture to pyruvate. However, all those papers yielded only 315 actual randomized studies of safety and effectiveness. Only 16 of those studies found any effect on weight. In the end, none of these studies offer high-quality evidence for effectiveness for any of these products. Batsis explains:

“Despite the high usage of these products, our data suggest a dearth of high-quality RCTs evaluating weight loss outcomes. Published studies are of small sample sizes, short study follow-up, and poor study design, and they often lead to inconsistent conclusions and reported results. Our findings underscore the need for well-designed and well-powered trials to minimize bias and provide definitive clinical efficacy.”

Availability

With so little data to support their use, why does this bunk persist in the marketplace? Two factors explain it.

For one thing, lax regulations make it possible to sell nonsense that has no real benefits. The standard allows just about anything that doesn’t cause obvious harm to fly into the market. Drugstores are happy to make a buck from this nonsense. Consumers lap it up.

On top of that, the restrictions on real treatments for obesity are severe. Health plans won’t pay for it. Or they set up barriers to humiliate people who need it. Self-stigma often means that people believe they deserve this humiliation. Friends and family are more likely to discourage than support people seeking care.

So the path of least resistance is DIY self-care and weight loss bunk. Under this scheme, the growing burden of obesity is no surprise. In fact, it’s the inevitable result.

Click here for the systematic review and here for the perspective.

Hamlin’s Wizard Oil, public domain image from Jim Griffin / flickr

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July 2, 2021