The Unregulated and Potentially Harmful World of Dietary Supplements: A Call for Regulation and Awareness
Dietary supplements have become a booming industry, raking in nearly $39 billion in revenue in 2022. However, with minimal regulation and oversight, this industry poses potential risks to consumers. Despite this, 77% of Americans still trust the supplement industry, drawn to the idea of taking control of their own health. Athletes, parents, and individuals seeking quick recovery from illnesses are among the many who turn to supplements for various reasons.
A study conducted in 2024 revealed that approximately 1 in 10 adolescents have used nonprescribed weight loss and weight control products, including dietary supplements. Shockingly, the use of nonprescribed diet pills was found to be significantly higher than the use of nonprescribed laxatives and diuretics for weight management. These unhealthy weight control behaviors have been linked to worsened mental and physical health outcomes.
As experts in the field of anxiety disorders and eating disorders, we have witnessed firsthand the detrimental effects of these supplements based on unfounded beliefs. The unregulated market of dietary supplements leaves consumers vulnerable to deception and potential harm.
The current state of the supplement industry can be likened to the wild west. While the Food and Drug Administration (FDA) mandates that supplements must contain dietary ingredients such as vitamins, minerals, herbs, and more, manufacturers can still label products as supplements even if they do not meet these criteria. Some products even contain highly addictive drugs like tianeptine, which mimics the biological action of opioids. Additionally, substances like kratom, which have opioid-like effects, are mislabeled as herbal supplements.
Unlike drugs, dietary supplements are classified as food under a 1994 law. This means that they are not required to prove efficacy and regulators only take action when harm has been demonstrated. However, the FDA acknowledges that many dietary supplements contain ingredients that can interact with medications or have hidden drugs not listed on the label, putting consumers at risk.
Manufacturers of dietary supplements can make claims about their products without providing supporting evidence. Misbranding and false advertising are rampant in the industry, with supplements claiming to cure cancer, improve immune health, enhance cognitive functioning, boost fertility, promote cardiovascular health, and aid in weight loss and weight control.
In August 2021, the FDA took action against weight loss products that contained undeclared drugs. Out of the 72 products recalled, 68 were found to contain the drug sibutramine. However, the FDA admits that it cannot test every weight loss supplement for drug contamination.
While progress has been made through these crackdowns, issues such as misleading advertising and inadequate warning labels persist. Warning labels are often not prominently displayed on product labels, making it less likely for consumers to notice them. Adverse effects from ingredients in weight loss supplements have led to emergency room admissions for cardiovascular and swallowing problems, even in seemingly healthy individuals.
The rise of mental health concerns and eating disorders has prompted researchers to examine unhealthy weight control behaviors, including the use of dietary supplements. Doctors may prescribe dietary supplements like calcium, vitamin D, and nutritional shakes to individuals with eating disorders who suffer from related health issues. However, the concern lies with supplements that promote weight loss or muscle building.
People with eating disorders may be drawn to dietary supplements that promise quick and effortless weight loss or muscle gain. These supplements can also contribute to an increase in compulsive exercise and other unhealthy weight control behaviors. The use of diet pills and supplements has been linked to an increased risk of developing eating disorders, disordered eating, low self-esteem, depression, and substance abuse.
Protein powders and fitness supplements have gained popularity among both genders. Research shows that girls are more at risk for using weight loss supplements, while boys are increasingly turning to fitness supplements like protein powder and creatine products. The use of fitness supplements often signifies a preoccupation with body shape and size. In fact, a study conducted in 2022 found that protein powder consumption in adolescence was associated with future use of steroids in emerging adulthood.
While protein itself is not harmful when consumed at recommended doses, protein powders may contain unknown ingredients or excessive sugar. Overuse of creatine can lead to health problems and is not recommended for minors. The long-term effects of these supplements, especially in adolescents, remain unstudied.
To address these issues, researchers at Harvard University propose taxing dietary supplements that claim weight loss benefits. Another policy recommendation involves banning the sale of dietary supplements and weight loss products to minors. New York has already successfully passed legislation banning the sale of these products to minors, and other states like Colorado, California, and Massachusetts are considering similar actions.
Medical professionals recommend that parents and caregivers encourage their children to obtain protein and vitamins from whole foods rather than relying on supplements and powders. They also emphasize the importance of balanced nutrition, adequate sleep and recovery, and a variety of resistance, strength, and conditioning training for teenagers
