Diet pills and the FDA

Phenylropanolamine was initially believed to have a very low risk of side effects, and the FDA allowed it to be available over the counter, without a prescription. After some time, phenylpropanolamine became the active ingredient in many nonprescription diet pills, such as Acutrim , Dexatrim , and Protrim. Early studies demonstrated that the drug s main side effect was an increase in energy that sometimes led to insomnia or agitation. 

Natural and herbal diet pills available in the United States today are considered dietary supplements and are not subject to FDA review prior to being sold. Although these agents may have drug-like activity in the body, they do not need to be proven safe or effective like conventional drugs do. Unlike conventional drugs, natural and herbal diet pills can only be withdrawn from the market when they are proven to be dangerous. As a result, many herbal products reach the market without any scientific evidence that they are safe or effective. These products are discussed in more detail in Chapter 6. 

The diet pills developed to replace amphetamines became known as anorectics or appetite suppressants and are central nervous system stimulants. The FDA approved phentermine in 1959, fenfluramine in 1973, and dexfenfluramine in 1996. 

Another type of diet pill received FDA approval in 1999. Orlistat, sold under the name of Xenical, was a lipase inhibitor. It affects the body s lipase enzyme and blocks about 30% of fat absorbed by the body. 

The FDA approves Alii, an OTC version of orlistat. It is the first-ever approved OTC weight loss drug of its kind, and the only approved OTC diet pill. 

The Food and Drug Administration, the agency that oversees pharmaceuticals, alerts consumers to heart-related risks associated with newly developed medications such as antidiabetes drugs, attention deficit hyperactivity disorder drugs, and diet pills. The FDA oversees the manufacturing of medical devices and takes action when devices such as stents or pacemakers are suspected of acting in a faulty manner. 

In this country and in most of the western world there is plenty of food to go round, why then do we have to eat junk The FDA said, in an unlikely turn of phrase, there is more nutrition in the carton than in the contents of a packet of cornflakes so many products sold in our shops seem to be mere vehicles for the addition of more fat and sugar to our diet. It was many years before some of the instant potato powders began to reintroduce the vitamin C lost from what had in the winter been the main provider of vitamin C to the English diet. 1 doubt whether this vitamin C is included in the bulk pack sold to institutions where, with a few exceptions, white bread is invariably given at the beginning of the day and laxative pills at the end of it. In fact some heavily promoted consumer products, are still without added vitamin C. 

---