Of the several million people with eating disorders in this country, 90% are female, and one in six children between eighth and 10th grade have tried diet pills at least once, according to the Centers for Disease Control. Many experts feel these pills can lead to eating disorders such as anorexia nervosa or bulimia.
"Diet pills teach kids that solutions for their problems lie outside of themselves," says Doris Zachary, executive director of the Center for Eating Disorders at the Center for Counseling Services in Plantation, Fla. "For impressionable adolescents, diet pills deliver false hope and potential dependency. They say, 'We will control your hunger.' "
How effective the pills are at promoting weight loss hasn't been proved, but according to Dr. James Rosen, a professor of psychology at the University of Vermont, if a user believes they work, she is much more likely to become psychologically dependent on them.
Most diet pills contain phenylpropanolamine (PPA), a mild stimulant chemically similar to amphetamines. Some studies suggest the drug may cause headaches, anxiety, cardiac irregularities and strokes.
PPA is the fifth most-used drug in the country, says Dr. Denise Bruner, an internist and obesity specialist at Arlington Hospital in Virginia. Studies show that even minor overdoses of PPA, which is also found in over-the-counter decongestants, can cause side effects. Even people who don't abuse diet pills may unintentionally overdose when using several different products that contain PPA, she says.
Diet pill manufacturers insist PPA is safe and effective and does not lead to eating disorders.
Some package labels include warnings that minors should consult a doctor before using the product. But a study by Dr. Lawrence Krupka, a professor of biology at Michigan State University, found that not one of 465 women he interviewed who had tried diet pills before age 18 had followed the instructions to consult a physician.
While the link between diet pills and eating disorders remains circumstantial, what seems clear is that many teen-age girls are unhappy with perfectly acceptable bodies. In a study of 500 girls age 9 to 18, Laurel Mellin, an assistant clinical professor of family medicine and pediatrics at the University of San Francisco, found that 58% believed they were overweight, even though only 15% actually were. About 80% of the 10-year-olds she surveyed reported that they had dieted.
"Little girls learn that being larger is bad," says Dr. Thomas Cash, a professor of psychology at Old Dominion University. "Yet women need a certain amount of body fat to menstruate. Our cultural definition of beauty contradicts biology."
"No diet will remove all the fat from your body because the brain is entirely fat. Without a brain, you might look good, but all you could do is run for public office." --Covert Bailey