Panel Told of Diet Pill Risks for Teen-Agers

Over-the-counter diet pills pose a serious health risk, especially to body-conscious adolescents who consume them in large quantities, doctors and victims of eating disorders told a congressional panel Monday.

A stream of witnesses told the regulation, business opportunity and energy subcommittee of the House Small Business Committee that diet aids available in most drug stores “play a significant role” in adolescent eating disorders. The pills should be taken off the market or sold only with a doctor’s prescription, they declared.

Many appetite suppressants contain an amphetamine-like drug called phenylpropanolamine, commonly called PPA, that has been implicated in the deaths of several dieters.

“The unsupervised use of over-the-counter diet aids containing PPA pose a threat to the millions of obese Americans, most specifically our adolescents, who are innocently seeking a quick-fix for a very complex problem,” said Denise Bruner, a physician with expertise in obesity and weight loss.

In a related matter, the subcommittee also heard testimony from the Federal Trade Commission concerning ongoing investigations of 13 major commercial diet centers across the country. Although the firms were not identified by name during the testimony, officials familiar with the investigations said that they include several national franchises.

Richard F. Kelly, assistant director of the FTC’s bureau of consumer protection, said the commission is concerned that many commercial diet programs falsely represent their rates of success and may not be adequately supervised by medical professionals.

On Sept. 17, the FTC filed suit against Pacific Medical Clinics Management Inc., a San Diego-based chain of commercial diet centers. The suit takes issue with the firm’s advertising claims that their treatment will alter a customer’s metabolism, enabling them to lose as much as 1 1/2 pounds a day without exercise or dieting. The U.S. District Court in San Diego has granted a temporary restraining order prohibiting further advertisements of those claims.

In emotional testimony before subcommittee members, Tony and Diane Smith of State Center, Iowa, described how their daughter, Noelle, died in 1989 of a heart attack resulting from the abuse of diet pills bought over the counter. They asked the lawmakers to restrict the availability of such diet aides to minors.

“I don’t know if we could have done anything, or if she could have done anything, to stop her massive misuse of these drugs,” her father told the subcommittee. “But she might have had a chance had these products been denied her as a child.”

Jessica McDonald, a 20-year-old from Washington, D.C., who suffered from anorexia nervosa and bulimia for five years, told the subcommittee that while she was in high school, “everybody was doing something, trying some diet or taking some pill, in an effort to lose weight.”

Diet pills are “the crutch so sorely needed to keep these youngsters on the diets they’ve convinced themselves they must be on,” said Vivian Meehan, president of the National Assn. of Anorexia Nervosa and Associated Disorders.

In a 1988 study by the National Institute on Drug Abuse, 8% of female high school students reported using diet pills in the previous month.

PPA, the active ingredient in many over-the-counter diet aids, is an antihistamine that also tends to reduce appetite. Medical experts who testified before the panel said that PPA does not have a proven track record as an aid to long-term weight loss.

Thaddeous Prout, chairman of the department of medicine at the Greater Baltimore Medical Center, told the committee that although dieters who take PPA tend to lose an additional half pound per week more than dieters who do not use suppressants, after the first several months the benefits disappear. Over the course of a year, he said, those who use the drug show no more weight loss than those who do not.

“PPA is an anachronism,” Prout said. “It is not an agent that needs to remain on the market.”