Concerns flagged for ‘alarming’ teen weight loss trend

New research has highlighted a need for better interventions for the use of weight-loss products obtained without a GP prescription among adolescents.
 
The Melbourne-led study set out to determine the global prevalence of non-prescription weight-loss product use in this cohort, finding that almost one in 10 adolescents have used ineffective and potentially harmful non-prescribed weight-loss products in their lifetime.
 
While the authors acknowledge that use of non-prescribed weight-loss products in adolescents is a public health concern ‘associated with negative physical and psychological consequences’, the prevalence of use is not well known.
 
Their meta-analysis included 90 studies comprising 604,552 participants aged 18 years or younger from the US, Australia, Asia and Europe, finding that the use of weight-loss products occurs at high levels – particularly among females.
 
‘Given the ineffectiveness of these products for weight loss, coupled with their harmful long-term health consequences, interventions are required to regulate and reduce use of weight-loss products in this group,’ the authors state.
 
Dr Terri-Lynne South is a Queensland GP with a special interest in dietetics, and Chair of RACGP Specific Interests Obesity Management.
 
She told newsGP the results of this study are ‘alarming’ and generate a need for GPs to be more aware of such risk-taking behaviours among young people. 
 
‘We know that adolescents are very vulnerable – more so than adults or children – in regard to having any sort of weight issues, whether that is related to body image, eating disorders, [or] having excessive weight gain during this time,’ she said.
 
‘So GPs in particular, being that person at the coalface who not only the young person can come to but also their family members, need to be aware of the vulnerability of that adolescent and knowing these are risk-taking behaviours that can be part of that spectrum, which is also using unproven, unscripted, over-the-counter unregulated medications or supplements.’
 
Diet pills were the most frequently used weight-loss products in the study, followed by laxatives and diuretics. Overall prevalence of non-prescription weight-loss product use across all the studies was 5.5%, ranging from 2% used in the past week to 8.9% lifetime use, with use more common among girls.
 
Aside from the underlying related mental health issues, Dr South has concerns about the potential harms of using these products and progressing to stronger products such as injectables.
 
Prolonged laxative use can cause long-term problems such as megacolon, worsening of constipation or malabsorption of micronutrients, she points out, while concerns related to diuretic use include kidney health issues and dehydration.
 
‘Those are the two [products] mentioned in the research, and we know it takes a couple of years for research to be published, but my concern is these adolescents [may be] currently also accessing some of the more powerful medications that are on the market in the last two years, including some of the injectable medications,’ she said.
 
‘It doesn’t mention that in the research, but that would be my concern … that adolescents are being driven to take things into their own hands, and might be getting access to GLP-1 injections as well.’
 
The study’s findings come in the wake of an ongoing nationwide shortage of diabetes medication following certain medications being used off-label for weight loss and promoted by social media influencers.
 
Dr South has also previously warned GLP-1 injections should only be prescribed after careful consideration as part of holistic care with a patient’s regular GP.
 
In the global study, prevalence of weight-loss product use was higher in North America compared with Asia and Europe, and was higher in Asia compared with Europe. The authors note that further research is required in African, South American, and Middle Eastern countries.
 
As the meta-analysis captures of a number of different countries, Dr South said it’s important to understand that Australian adolescents are likely represented as part of a global review.
 
‘This is a concern that Australian GPs need to be aware of,’ she said.
 
‘GPs are primed to be able to look at health concerns throughout the lifetime that are weight related, and certainly in adolescence it is more risky in regard to inappropriate weight loss that can worsen body image and make an adolescent vulnerable to mental health concerns, primarily disordered eating.
 
‘And we always just need to be very sensitive to that and to know that these adolescents are partaking in risk-taking behaviour.’
 
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