Most weight loss-promoting dietary supplements contain inaccurate ingredient labels
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Key takeaways:
- Of 30 dietary supplements marketed online for weight loss, 80% had ingredients listed on the label that were absent from the product.
- Ingredients that were not listed on the label were found in 23% of products.
Dietary supplements marketed online to promote weight loss commonly have inaccurate labels and may include unsafe ingredients for the public to use, according to findings published in JAMA Network Open.
In a case series study, researchers purchased 30 dietary supplements and analyzed the products to confirm whether they consisted of the ingredients listed on the supplement facts label. Research found 25 of the products had some type of inaccuracy, with some supplements missing ingredients, others containing ingredients not listed on the label and some containing substances listed on the U.S. Department of Defense’s prohibited dietary supplement ingredients list.
“Predatory marketing and low quality of weight-loss supplements pose a threat to military members and the public,” Patricia A. Deuster, PhD, MPH, FACSM, professor in the department of military and emergency medicine at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, told Healio. “No one should be put in harm’s way with predatory marketing of such supplements. Consumers should be confident that the products they might choose will not negatively impact their health, performance or readiness to serve.”
Deuster and colleagues searched on Google for dietary supplement products that were marketed for weight loss. Thirty dietary supplements were found and purchased from 12 companies that were advertising discounts for military members. Liquid chromatography-mass spectrometry was conducted on one sample of each supplement at the University of Mississippi’s National Center for Natural Products Research. All ingredients on each supplement’s label except for lipids and minerals were analyzed. The list of ingredients found in the analysis was compared with each product’s supplement facts label to determine accuracy. The Operation Supplement Safety risk assessment scorecard was used to determine each product’s safety.
Of the 30 purchased products, 83% had inaccurate labels. Eighty percent of samples had ingredients listed on the label that were not found in the product, and 23% had additional hidden components that were not listed on the label. Of the supplements, 20% had both ingredients listed on the label that were not found in the product and ingredients in the product that were not listed on the label.
Ten supplements contained ingredients on the DOD’s prohibited list. Nine supplements contained stimulants of phenethylamine and its derivatives, which are prohibited for use in sports according to the World Anti-Doping Agency.
“We have been aware of the fraudulent marketing of weight-loss supplements, but were surprised by the marketing claims made with language directed specifically at service members, and the offerings of military discounts for products with inaccurate labels,” Deuster said. “Some products listed illegal ingredients right on the labels and ones associated with significant safety concerns.”
None of the supplements in the study had an independent, third-party certification stating that they had been tested by an independent laboratory for quality or contaminants. There were 14 products with a good manufacturing practice seal or text on their label, but the researchers noted the seals were not associated with a third-party organization. All 30 supplements were deemed as no-go or risky according to the Operation Supplement Safety risk assessment scorecard.
Deuster said better education for the public is needed to help people determine whether a supplement is safe to use. She said supplements should have a seal on the product label from a reputable third-party organization. People can also use the Operation Supplement Safety scorecard to assess the safety of a supplement solely based on the label claims.
“Consumers interested in using weight-loss supplements should first discuss their goals with a qualified health care provider,” Deuster said. “Dietary supplements are meant to supplement the diet, they are not intended to treat, diagnose, prevent or cure any condition or disease, including obesity.”
For more information:
Patricia A. Deuster, PhD, MPH, FACSM, can be reached at patricia.deuster@usuhs.edu.
Perspective
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Katherine H. Saunders, MD, DABOM
Lifestyle interventions are not sufficient for most individuals with obesity to lose a significant amount of weight and maintain that weight loss long-term. Most people with obesity require medical intervention, which may include anti-obesity medications, for successful weight management.
Access to medical obesity treatment is limited by many barriers — lack of providers (I’m still one of fewer than 150 fellowship-trained obesity medicine physicians in the U.S.), insufficient insurance coverage for obesity care as well as both high cost and shortages of anti-obesity medications. As a result, it is not uncommon for individuals with obesity, and people without obesity, to experiment with dietary supplements marketed for weight loss.
Interest in supplements promising weight loss is nothing new. It’s a huge market with a vulnerable population. The exploding publicity about anti-obesity medications currently available and in the pipeline may have encouraged more individuals to recognize that obesity is a treatable condition and seek a variety of potential treatments. Unfortunately, most people taking dietary supplements won’t lose as much weight as they hope.
A few years ago, I conducted a systematic review on supplements marketed for weight loss with a group of obesity researchers associated with The Obesity Society (Batsis JA, et al. Obesity. 2021;doi:10.1002/oby.23110). We concluded that there is very limited high-quality evidence for the use of dietary supplements for weight management. Furthermore, we published a perspective piece from The Obesity Society warning health care providers about the lack of efficacy and — more importantly — deficiencies in regulatory oversight (Kidambi S, et al. Obesity. 2021;doi:10.1002/oby.23189).
I caution my patients about dietary supplements for weight management. Due to the lack of regulatory oversight, it is impossible to know what is contained in dietary supplements —actual amount of the marketed compound, other ingredients, etc. Some dietary supplements contain amphetamines or anti-obesity medications that have been withdrawn. I appreciate Dr. Deuster and colleagues’ research, which adds to the body of evidence supporting our concerns.
Please ask your patients which supplements they are taking and discuss the risks and benefits. Sometimes a simple question of “Is it working?” will prompt discontinuation. If a supplement is working, ask about side effects and check labs. I have had many patients over the years with tachycardia, hypertension, transaminitis or undetectable thyroid-stimulating hormone from supplements.
My hope is that as we remove barriers to access to medical obesity interventions — train more health care providers to deliver evidence-based treatment, improve insurance coverage, reduce medication prices and solve supply challenges — fewer people will seek unregulated, ineffective and potentially unsafe options.
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