It's a billion-dollar industry that uses photos of svelte bodies and flashy fat-busting claims to peddle its products:
"Lose 30 pounds in 8 weeks!"
"Pound-for-Pound, The Most Powerful Weight-Loss Formula on Earth!"
"Lose 10.65 pounds fast!"
And it works: Thousands of overweight and obese Canadians are lured to store shelves and strip malls by these promises of perfection.
Weight-loss companies have, at the height of the obesity epidemic, gotten good at cashing in on people's desperate desires to lose weight. But there are few regulations to govern this booming industry in Canada and not enough people to enforce the ones that exist.
A growing number of obesity experts are calling for more stringent regulations to protect Canadians. They say the vast majority of weight-loss programs and products on the market are not effective, and warn that many are unsafe.
Right now, anybody can set up a weight-loss centre and sell almost anything they want, says Arya Sharma, a professor of medicine at McMaster University who holds a Canada Research Chair in cardiovascular obesity research and management.
"Treating the disease has to be up to (health) professionals, not up to people who could be selling a scam or selling products that are dubious in terms of safety," he said.
Many of the active ingredients in over-the-counter weight-loss supplements are derived from plants, minerals and other natural sources, and range from aloe to licorice, crustacean shells to the mineral chromium picolinate. Although many people assume natural means safe, the products can have drug-like properties and cause serious health problems. But unlike pharmaceuticals, natural weight-loss remedies don't have to go through rigorous clinical trials to prove they are safe and effective before hitting stores.
One of the most popular – and dangerous – weight-loss supplements in the early 2000s relied on chemicals in a shrub native to China and Mongolia. Ephedra sinica, or Ma huang in Chinese, contains ephedra alkaloids that, when combined with caffeine, caused weight loss.
Consumers clamoured for the heavily advertised supplement, but scientists only found out about its associated health problems after it was on the market. Ephedra has been shown to increase the risk of high blood pressure, seizures, heart attack and stroke. In the U.S., in one two-year period, the Federal Drug Administration received 87 reports of ephedra causing adverse health events. Ten of those led to death and 13 to permanent disability.
Health Canada, which banned ephedra weight-loss products in 2001, is charged with overseeing elements of the weight-loss industry. The agency regulates prescription weight-loss drugs and natural weight-loss supplements, and works with the Competition Bureau to watch out for weight-loss fraud. Diet shakes and meal replacement bars sold at grocery and drug stores and weight-loss outlets come under the Canadian Food Inspection Agency.
But there are no over-arching regulations for the industry, and none at all for the hundreds of weight-loss centres found in strip malls across the country.
Sharma, who is also director of the Canadian Obesity Network, a non-profit education organization made up of obesity clinicians and researchers, says this is unacceptable, especially since the industry has the potential to affect the health of millions of obese Canadians.
"People who are selling things to patients as a cure or a treatment for obesity have an obligation to make sure the treatments they are offering work," he says. "They need to make sure the claims about their treatments are validated in the same manner and at the same level of scientific validity that we do for pharmacological or surgical treatments."
Natural weight-loss supplements and over-the-counter diet remedies make up the largest portion of the weight-loss industry. Health Canada launched the Natural Health Products Directorate on Jan. 1, 2004 to make sure all natural health products sold in Canada are reviewed for quality, safety and efficacy. But critics say the review process isn't stringent enough. York University health policy expert Joel Lexchin says over-the-counter medications should receive the same scrutiny as prescription drugs, whose manufacturers have to submit reams of scientific data, including rigorous human trials, to prove a potential drug is safe.
In a 2004 study, Robert Saper, director of integrative medicine at Boston University Medical Center, found none of the 26 most common ingredients in over-the-counter weight-loss supplements, including green tea, chromium, and guar gum, met acceptable criteria for safety and efficacy. He also said companies skirted the ephedra ban by using related chemicals, such as those found in bitter orange plants, which can also cause cardiovascular problems.
Saper has since turned his attention to analyzing active ingredients in weight-loss supplements. Right now, he says, many of the products imported into North America contain impurities, such as pesticides and heavy metals, or are adulterated with prescription drugs.
Unlike Health Canada's Natural Health Products Directorate, the Federal Drug Administration in the U.S. has no system in place that requires weight-loss companies to prove their products are safe or effective.
David Schardt, a senior nutritionist at the Center for Science in the Public Interest, based in Washington D.C., applauds Health Canada for trying to regulate natural products. But he also says many of the approved product claims are "goofy" and agency officials don't conduct accurate or thorough scientific reviews.
"They approved European pennyroyal to treat giddiness," he says, based on herbal folklore references and Health Canada also approved the plant, a species of mint native to Europe and Asia, to treat flatulence, headaches and nervousness.
"Not only is it goofy, but the evidence (for its efficacy) wasn't very good," says Schardt.
Any obesity drug – either prescription or over-the-counter – that doesn't prevent or reduce a person's risk of developing the health problems associated with the disease, including Type 2 diabetes, heart disease and stroke, shouldn't be sold, says York University's Lexchin.
"They are garbage. They are not effective," he said. "If something is not effective, and it is not 100 per cent safe – and nothing is 100 per cent safe – there are no grounds for keeping it on the market."
Via www.thestar.com
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