Madeleine Hull
Diet pills have been available since the late 19th century, when they were referred to as fat reducers. These pills were based on thyroid extract, which can increase the metabolic rate. While they were thought to be effective for weight reduction, they also had unexpected and dangerous side effects, including abnormal heartbeats, increased heart rate, weakness, chest pains, high blood pressure, and even death. Despite the risks, these pills remained available until the 1960s. Today, there are still diet pills available, both over-the-counter and by prescription, but the history of these pills is fraught with dangerous side effects and shady business practices.
| Characteristics | Values |
|---|---|
| First diet pills | Became available during the patent medicine era of the late 1800s |
| First diet pills composition | Based on thyroid extract |
| First diet pills side effects | Abnormal heartbeats, increased heart rate, weakness, chest pains, high blood pressure and even death |
| Diet pills in the 1960s | Aminorex fumarate, thyroid hormone, diuretics, laxatives, amphetamines |
| Diet pills in the 1970s | Ephedrine in combination with caffeine |
| 1990s | Off-label use became an issue when doctors began prescribing fenfluramine or dexfenfluramine in combination with phentermine |
| 2001 | According to a report from the United States Department of Agriculture (USDA), about half of American adults are overweight or obese |
| 2007 | Orlistat became available over the counter |
| 2010 | FDA recommended against the continued use of Meridia (sibutramine) |
| 2021 | PhenGold, LeanBean, and PhenQ are some of the modern alternatives to old diet pills |
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What You'll Learn
History of diet pills
The history of diet pills can be traced back to ancient times, including the ancient Greeks, who used plants, berries, and natural remedies to induce nausea, vomiting, and diarrhea for weight loss. In the late 19th century, thyroid extract was used for weight reduction due to its potential to boost metabolism. This was followed by the introduction of dinitrophenol (DNP) in the 1930s, which interfered with cells' energy production and led to dangerous side effects, including organ damage and death. During the same period, amphetamines gained popularity for weight loss, marketed as Benzedrine, and were used to suppress appetite and increase alertness.
In the 1940s, the rainbow diet pill regimen was introduced, which included amphetamines, thyroid hormones, laxatives, diuretics, and digitalis. These pills were banned in the US in the late 1960s due to health risks and strict regulations, but they reappeared in South America and Europe in the 1980s. In 1959, the FDA approved phentermine, marking a significant development in modern-day medical treatments for obesity. Phentermine and similar drugs like diethylpropion were widely used in the 1950s and 1960s but were later superseded by agents like fenfluramine and dexfenfluramine due to concerns about cardiovascular risk and abuse potential.
In the early 1990s, the combined treatment of phentermine and fenfluramine gained popularity in the United States, but it was soon withdrawn due to reports of cardiac valvulopathy. More recently, in the early 2000s, GLP-1 receptor agonists like tirzepatide, semaglutide, and liraglutide have become popular for weight loss, and medications like orlistat and naltrexone/bupropion have been approved by the FDA for weight management alongside lifestyle changes. While the development of anti-obesity medications has faced many challenges, ongoing research continues to explore innovative treatments for obesity.
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Safety concerns
Diet pills have been available since the late 19th century, but their use has always been a controversial topic due to safety concerns and abuse potential. Over the years, various diet pills have been linked to adverse health effects, including:
Thyroid Extract Derivatives: The first diet pills, introduced in the late 1800s, were derivatives of thyroid extract. While they were effective for temporary weight loss, they caused serious side effects such as hyperthyroidism, which can lead to heart damage and even death.
Amphetamines: Amphetamine use for weight loss became popular in the 1940s. However, these drugs, including methamphetamines, carried a high risk of addiction, as well as adverse neurological and psychological effects.
Phenylpropanolamine (PPA): Over-the-counter appetite suppressants containing PPA became widely sold in the 1970s and 1980s. However, concerns arose about its potential link to hypertension and strokes. In 1980, the Food and Drug Administration (FDA) requested that companies withdraw products containing PPA due to potentially dangerous side effects, including sudden attacks of very high blood pressure, posing risks to individuals with heart disease or diabetes.
Orlistat: Orlistat, sold as Xenical by prescription and Alli over the counter, inhibits the absorption of dietary fats. However, it can cause unpleasant side effects such as oily rectal discharge, passing gas with oily discharge, and an urgent need to have a bowel movement. Researchers have also expressed concerns about its potential for abuse by individuals with eating disorders.
OxyELITE Pro: This dietary supplement for weight loss and muscle gain has been linked to acute hepatitis and liver failure, with 24 out of 29 confirmed cases reporting its use within 60 days before illness onset.
Acacia Rigida and β-methylphenylethylamine (BMPEA): Many supplements marketed as containing the herbal ingredient acacia rigidula were found to contain BMPEA, a stimulant that has not been assessed for safety or efficacy in humans. It is closely related to DMAA, a compound associated with several deaths.
Tapeworms: In the early 1900s, before the diet pill fads of the 1960s and 1970s, there was a trend of intentionally ingesting tapeworms for weight loss. Tapeworms affect how much food is absorbed and stored as calories. However, they are parasites and can cause significant health issues.
While modern alternatives like PhenGold, LeanBean, and PhenQ claim to be safe, legal, and effective, it is important to exercise caution and consult a healthcare professional before taking any dietary supplements or pills.
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Prescribed alternatives
Diet pills have evolved since the patent medicine era of the late 1800s, when they were referred to as "fat reducers" based on thyroid extract. While these pills were thought to be effective for weight reduction, they also had unexpected and dangerous side effects, including abnormal heartbeats, high blood pressure, and even death. Despite the risks, these pills continued to be available until the 1960s.
Today, there are several prescribed alternatives to the old-time diet pills that have been deemed safer and more effective. Here are some examples:
Phentermine
Phentermine is a weight loss drug that has been approved by the FDA since 1959 and is still used today to treat obesity. It is available by prescription only and is typically taken before or after breakfast. Phentermine is often used in combination with other drugs, such as fenfluramine or dexfenfluramine, for weight loss. However, it is important to note that phentermine has a high potential for abuse and is usually prescribed only if other weight loss treatments have been unsuccessful.
Orlistat
Orlistat, sold by prescription as Xenical and over-the-counter as Alli, is another alternative to old-time diet pills. It works by reducing the absorption of dietary fat in the digestive tract. Orlistat is typically taken three times daily with meals containing fat and may be taken an hour before the meal. While it can be effective for weight loss, common side effects include oily rectal discharge, passing gas with oily discharge, and an urgent need to have a bowel movement.
Metformin
Metformin is a drug that has been found to promote weight loss in people with obesity. It is often prescribed for this purpose, although initially, weight loss was only noted as a potential side effect of the drug. Metformin provides a new treatment option for individuals struggling with obesity.
Sibutramine
Sibutramine, also known by the brand name Meridia, was once a popular prescription diet pill. However, it lost favour when clinical trial data linked it to an increased risk of adverse effects. Sibutramine was typically prescribed for longer-term use, ranging from six months to one year, for the treatment of significantly obese individuals.
Benzphetamine, Diethylpropion, Mazindol, and Phendimetrazine
These are prescription diet pills typically prescribed for short-term weight loss. They are taken before meals, with specific dosage instructions for each drug. For example, benzphetamine is taken one to three times daily, while diethylpropion is typically taken in 25-mg tablets one to three times daily, an hour before eating. Mazindol is taken once a day, and the dose may be adjusted by a physician. Phendimetrazine is taken in 35-mg tablets one hour before breakfast.
It is important to consult a healthcare professional before taking any weight loss medication to ensure safe and effective use.
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Over-the-counter availability
Diet pills have been available over the counter since the late 1800s. Initially referred to as fat reducers, these pills were based on thyroid extract, which can increase the metabolic rate. However, they were found to have serious side effects, including abnormal heartbeats, increased heart rate, weakness, chest pains, high blood pressure, and even death. Despite the risks, these pills continued to be available until the 1960s.
In the 1970s, a combination of ephedrine and caffeine, initially used to treat asthma, was prescribed for weight loss. In 1994, the United States passed the Dietary Supplement Health and Education Act, classifying ephedra as an herb that did not require FDA approval.
In the 1980s, over-the-counter appetite suppressants containing phenylpropanolamine (PPA) became popular. An expert FDA panel recognised PPA as generally safe and effective for weight control. However, concerns emerged about the safety of PPA, with some people experiencing strokes, hypertension, and psychoses. Despite this, diet pills containing PPA remained on the market, with manufacturers claiming they were effective and safe when used as directed.
In the 1990s, a short-lived weight loss medication called fen-phen, a combination of fenfluramine and phentermine, emerged. However, it was quickly discontinued due to evidence linking it to valvular heart disease.
Today, there are various over-the-counter weight loss supplements available, such as Dexatrim, which contains caffeine, green tea extract, and ginseng root extract. However, it's important to note that none of these supplements have met the criteria for recommended use by physicians, and side effects and adverse reactions are possible, especially with prolonged use or higher-than-recommended doses.
Some modern alternatives to old diet pills include PhenQ, Leanbean, and PhenGold, which are considered safer and more effective options. These modern products are backed by scientific research and typically have safety guarantees in place.
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Effectiveness and side effects
Diet pills have been available since the late 1800s, when they were referred to as "fat reducers" and were based on thyroid extract, which can increase the metabolic rate. While these pills were thought to be an effective form of weight reduction, they carried significant risks, including abnormal heartbeats, increased heart rate, weakness, chest pains, high blood pressure, and even death. This early form of diet pills remained available until the 1960s.
In the 1930s, a new medication called dinitrophenol became popular for weight loss due to its thermogenic effects. However, several deaths from hyperthermia, as well as severe rashes, damage to taste buds, and eye cataracts, were reported, leading to concerns about its safety.
Amphetamines, which gained popularity during World War II for their stimulant effects, also found use as diet pills in the mid-1950s due to their appetite-suppressing side effects. However, the risks of abuse and adverse neurological and psychological effects outweighed their benefits.
In the 1960s, "rainbow pills" became a popular regimen, combining stimulants, thyroid hormones, diuretics, heart medications, and other drugs in various sequences throughout the day. While these regimens were effective in promoting weight loss, they also carried dangerous and sometimes fatal consequences.
By the 1970s, fenfluramine gained approval as a weight-loss treatment, and its combination with phentermine, known as fen-phen, became extremely popular in the early 1990s. However, adverse effects on the heart, including pulmonary hypertension, heart lesions, and valve abnormalities, led to the voluntary removal of both drugs from the market in 1997.
More recently, orlistat, sold by prescription as Xenical and over-the-counter as Alli, has emerged as a weight-loss option. Orlistat inhibits the absorption of dietary fats in the digestive tract, promoting weight loss. However, it can cause side effects such as oily rectal discharge, passing gas with oily discharge, and an urgent need to have a bowel movement, which have been colloquially referred to as "Alli-oops."
While older diet pills were often associated with significant side effects and, in some cases, low efficacy, modern alternatives like LeanBean, PhenQ, and PhenGold are marketed as safe, legal, and effective, backed by scientific research. These newer products aim to provide weight loss solutions without the dangerous consequences associated with their predecessors.
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Frequently asked questions
Old-time diet pills are no longer available due to their dangerous side effects, which included abnormal heartbeats, increased heart rate, weakness, chest pains, high blood pressure, and even death.
"Rainbow pills" were a combination of several pills of different colours, including diuretics, heart medications, and amphetamines. They were prescribed in the US and Spain from clinics and pharmacies in the 1960s through to the 1980s.
The "rainbow pills" had extremely dangerous and sometimes fatal consequences. In one instance, a 19-year-old patient died after being prescribed a daily regimen that included amphetamine and digitalis leaf.
Modern alternatives to old-time diet pills include LeanBean, PhenGold, and PhenQ. These products are considered safe, legal, and effective.
Yes, prescription diet pills are available for the treatment of obesity. These include phentermine, Meridia (sibutramine hydrochloride monohydrate), and
