By Carolyn Crist

(Reuters Health) – Teens and young women who use diet pills and laxatives for weight control are five to six times more likely to be diagnosed with an eating disorder in the next three years, a U.S. study suggests.

Using these medications for weight loss can be dangerous and may be a warning sign to consider counseling because there is an increased risk for developing an eating disorder such as anorexia or bulimia, the study authors write in the American Journal of Public Health.

“Advertising for these products is common on social media, and the products are easily accessible at local pharmacies and groceries, which gives young people the mistaken idea that they are safe to use,” said Jordan Levinson of Boston Children’s Hospital’s Division of Adolescent and Young Adult Medicine, the study’s lead author.

“But this could not be further from the truth. These products are not medically recommended for healthy weight management and can even be dangerous,” she told Reuters Health by email. “When young people get their hands on these easily accessible yet harmful products, they are put at risk for disordered weight control behaviors and, as our study suggests, may even put them on a path to develop an eating disorder.”

Levinson and colleagues analyzed data on more than 10,000 U.S. women between ages 14 and 36, who were participating in a long-term study. The women were surveyed annually about whether they had used diet pills or laxatives for weight loss during the past year, and whether they’d received a new diagnosis of an eating disorder.

Researchers excluded young women already diagnosed with an eating disorder from the analysis, and adjusted for overweight status, age, and other factors.

They found that eating disorders developed in just 1% of women who did not report diet pill use for weight control during the past year, and 1.8% of those who did use diet pills.

Similarly, 0.8% of women who did not report laxative use for weight loss were later diagnosed with an eating disorder, compared to 4.6% of those who did use laxatives.

Using these kinds of products may increase the likelihood of eating disorders by creating irregular eating behaviors, physical disruptions to digestion or psychological issues, the study authors speculate.

“Eating disorders have among the highest mortality rate of any mental health condition, so our finding that these products may be gateway drugs to a serious and life-threatening mental health condition is cause for alarm,” Levinson said.

Policymakers and public health professionals should work together to restrict access to diet pills and laxatives for adolescents through bans or taxes, the study authors argue. For instance, Instagram and Facebook recently banned ads targeting minors for over-the-counter weight loss products, and retailers should do the same, the authors note. The research team is working with legislators in Massachusetts to ban the sale of these products to people under 18.

“Dietary supplements claiming all types of health benefits or functional properties – including weight loss, appetite suppression, and muscle building – are virtually unregulated. Most people do not know the extent (to which) these products are not regulated or approved by the FDA,” said Jennifer Pomeranz, a public health lawyer and researcher at New York University in New York City, who wasn’t involved in the study.

“Unfortunately, in the U.S., industry’s interests in selling products is often more valued than government’s responsibility to protect the public from harmful products,” she told Reuters Health by email. “Even if people do not suffer health harms from dietary supplements claiming unachievable benefits, consumers waste money on them and may not take other actions to protect their health, relying on the false promise of over-the-counter products instead.”

SOURCE: American Journal of Public Health, online November 21, 2019.