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A new survey confirms what many researchers long have thought: American adults are confused about how dietary supplements are regulated and think weight-loss supplements are safer and more effective than they actually are.
The national survey included 3,500 Americans, was developed collaboratively by the University of Connecticut's Center for Survey Research & Analysis (CSRA) in Stamford and the University of Pennsylvania's Center for Weight Loss in Philadelphia, and was funded by GlaxoSmithKline (GSK) Consumer Healthcare. Survey results were presented in October at the 2006 Annual Scientific Meeting of NAASO, The Obesity Society.
The Food and Drug Administration (FDA) defines dietary supplements, in part, as products that contain one or more of the following dietary ingredients: a vitamin; a mineral; an herb or other botanical; an amino acid; a dietary substance that increases total dietary intake; or a concentrate, metabolite, constituent, extract, or a combination of any ingredient mentioned above. Dietary supplements are intended for ingestion, are not represented for use as a conventional food, and are labeled as dietary supplements.1
A drug is a therapeutic agent or any substance, other than food, used in the diagnosis, cure, mitigation, treatment, or prevention of disease. For a drug to receive FDA approval, the manufacturer must show that it is safe and effective. Currently, there are no over-the-counter (OTC) weight-loss drugs approved by the FDA, but that could change soon. Last year, the FDA granted conditional approval for GSK to market a low dose of the prescription weight-loss drug orlistat (Xenical, Roche) for OTC use under the brand name Alli.
The growing chorus of researchers calling for increased oversight of dietary supplements now has an ear in Congress. After the November 2006 midterm election, Rep. John Dingell (D-Mich.), slated to chair the House Energy and Commerce Committee, announced a series of health-related issues the House would tackle as the 110th Congress convenes in January. Congress needs to scrutinize the FDA's licensing process, especially regarding the diet supplement industry, as Americans are dying because of lax oversight, Dingell says.
PATIENTS, PHYSICIANS AT ODDS OVER WEIGHT
For health care providers, one of the more important survey findings is the apparent lack of connection with patients when it comes to losing weight. Less than one-third of those surveyed say they consult their physicians as a resource when attempting to lose weight. Only 15% report using an FDA-approved treatment to aid in weight loss. And more than twice that many—34%—say they use unproven weight-loss supplements.
"It is encouraging that so many patients realize the importance of losing weight as part of a healthy lifestyle, but alarming that so few discuss weight-loss options with their physician," says Christine Kraus, PhD, associate director for CSRA. "The result, it seems, is that patients are lacking accurate information on the best programs and products to help them achieve their weight-loss goals."
Meanwhile, physicians aren't advising patients on weight-loss strategies, the researchers conclude. Almost 72% of overweight respondents and 40% of obese respondents report that their doctor never has advised them to lose weight. Even fewer respondents say they are inclined to consult their doctor regarding weight loss. Of those who self-identify as being overweight and using prescription weight-loss medications, one in six views their physician's counseling as incomplete.
Patients seek weight-loss supplements out of desperation, says Madelyn Fernstrom, PhD, CNS, founder and director of the University of Pittsburgh Medical Center Weight Management Center. "Patients are desperate to lose weight, and while the sound start to any weight-loss plan is lifestyle—eating less and moving more—it's difficult, and we all look for something to make the effort easier. Supplements offer a quick fix with little effort, but only sell false hope."
Fernstrom suggests physicians have an open discussion with patients about their weight by asking what type of supplements they've tried and assuring them there is no shame or embarrassment in attempting weight loss with supplements.
"It's not the job of the physician to cure obesity, but to guide the
patient on other resources to help with their lifestyle changes," she
says. At the very least, physicians can advise against particular supplements
that might be dangerous. Above all, the physician should make sure the patient
understands that these supplements are not replacing a lifestyle effort.
Weight-Loss Supplement Misconceptions
Findings from the first national survey on the safety and regulation of dietary supplements for weight loss include:
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Source: University of Connecticut CSRA
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