Madeleine Hull
The perception of beauty has changed over time, and, beginning in the late 19th century, attitudes concerning weight, particularly among women, shifted toward a slimmer, more athletic appearance. This change brought about a search for solutions that would make losing weight easier. In the 1940s, amphetamine use for weight loss began, and by the 1950s, Obetrol, a popular diet pill containing amphetamine mixed salts and methamphetamine, was approved by the FDA. In 1959, phentermine, a central nervous system stimulant and amphetamine analogue, was approved by the FDA for weight loss. Amphetamines were also combined with drugs like barbiturates and marketed as rainbow diet pills in the 1960s and 1970s. Fenfluramine was approved as a weight loss treatment in 1973 and was combined with phentermine in 1992 to create fen-phen. However, due to adverse effects on the heart, both drugs were voluntarily removed from the market in 1997.
| Characteristics | Values |
|---|---|
| Drugs | Amphetamines, Obetrol, Adderall, Fen-phen (Fenfluramine and Phentermine), Orlistat, Phenylpropanolamine, Thyroid hormones, Metformin |
| Side effects | Pulmonary hypertension, heart lesions, valve abnormalities, hemorrhagic stroke, hypertension, oily rectal discharge, diarrhoea, addiction |
| Availability | Prescription, over-the-counter |
| Timeline | 1930s, 1940s, 1950s, 1960s, 1970s, 1990s, 2007 |
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What You'll Learn
Rainbow pills contained amphetamines and other drugs
The use of amphetamines and other drugs in diet pills dates back several decades, with a particularly notable history in the United States. Beginning in the 1940s, "rainbow diet pills" were aggressively promoted by pharmaceutical companies to both physicians and patients. These pills were typically prescribed at walk-in clinics, where patients seeking weight loss would receive a short consultation and a prescription for a rainbow of pills, supposedly tailored specifically for them.
The term "rainbow pills" refers to the variety of colours in which these diet pills were produced. They were often a combination of stimulants and other medications to counteract the side effects of the stimulants. The colourful pills were marketed as being personalised for each patient, with doctors being instructed to prescribe multiple colours and avoid repeating the same combination.
Amphetamines, which were a key ingredient in these rainbow pills, had been recognised for their anorectic effects in the 1930s and 1940s. They were combined with other drugs such as diuretics, laxatives, thyroid hormones, benzodiazepines, barbiturates, and antidepressants. The stimulant effects of amphetamines were also prized by patients, and they were even consumed by eating or injecting the drug from Benzedrine inhalers, which were available without a prescription.
The dangers of amphetamines, including dependence, elevated blood pressure, and stimulant-induced psychosis, became increasingly known by the 1960s. By that time, rainbow pills had caused dozens of deaths, and the US Food and Drug Administration (FDA) began removing them from the market. Despite this, the legacy of amphetamine use in diet pills continued, with drugs like fenfluramine and phentermine being prescribed well into the 1990s before being removed due to adverse effects.
Today, amphetamines and their derivatives are tightly controlled substances, and safer alternatives like PhenQ and LeanBean are available, backed by scientific research and refinement.
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Fen-phen was a combination of fenfluramine and phentermine
Fenfluramine, an appetite suppressant, was first introduced in the 1970s as a standalone drug for weight loss. However, it did not gain much traction as it only offered temporary weight reduction. Phentermine, on the other hand, is a type of amphetamine that functions as a norepinephrine-releasing agent. It was also introduced in the 1970s for short-term weight management but was later withdrawn due to the emergence of valvular heart disease when used in combination with fenfluramine.
The idea to combine the two drugs came from Dr. Michael Weintraub in 1979. He hypothesized that using two mediocre weight-loss drugs with different actions on the brain might yield more powerful results than either drug alone. Additionally, he suggested that obesity be treated as a chronic disease, requiring patients to take drugs for life.
The fen-phen combination proved to be highly effective for weight loss, resulting in significantly greater weight reduction compared to placebo, fenfluramine, or phentermine alone. Furthermore, the combination regimen was associated with fewer adverse effects and better appetite control. This led to the medication's soaring popularity, with over 18,000,000 prescriptions written in 1996 alone.
However, the miracle solution was short-lived. In 1996, a 30-year-old woman developed heart problems after using fen-phen for a month and subsequently died in February 1997. This tragic event, along with emerging clinical findings, sparked concerns about the safety of fen-phen. It was eventually withdrawn from the market in 1997 due to its association with cardiac valvular lesions, pulmonary hypertension, and heart valve abnormalities.
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Obetrol was a popular diet pill in the 1950s and 1960s
Women have always been pressured to conform to restrictive beauty ideals, and the perception of beauty has changed over time. Beginning in the late 19th century, attitudes concerning weight, particularly among women, began to shift towards a slimmer, more athletic appearance. This change brought about a search for solutions that would make losing weight easier.
In the 1950s, Obetrol was manufactured by Obetrol Pharmaceuticals in Brooklyn, New York. The company later became a division of Rexar Pharmacal Corporation, which was also headquartered in Brooklyn. Obetrol was also sold directly to physicians under the brand name Oby-Rex.
The ready availability of methamphetamine-based medications in the 1960s led to their use and abuse as recreational drugs. By 1970, the FDA issued an order requiring new drug applications for previously approved amphetamine products. The FDA was critical of the combinations of amphetamines and non-amphetamines, and in September 1973, it withdrew approval for Obetrol, citing vague and incomplete research.
Other popular diet pills in the 1960s and 1970s included fen-phen, which was found to cause untreatable and often fatal heart conditions, and amphetamines, which were also combined with drugs like barbiturates and had dangerous and sometimes fatal consequences.
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Ephedra was used for weight loss but was deemed unsafe
Ephedra is a stimulant herb usually derived from the stem and branches of Ephedra sinica. It contains the chemical ephedrine, which is responsible for its therapeutic effects. People have used ephedra for weight loss and athletic performance enhancement. However, it has also been linked to adverse cardiovascular and neurological side effects, leading to concerns about its safety.
In 1994, the United States passed the Dietary Supplement Health and Education Act, classifying ephedra as an herb that did not require FDA approval. This led to a significant increase in the use of ephedra for weight loss. However, as reports of adverse reactions emerged, the FDA was forced to reevaluate its stance.
Ephedra has been associated with serious side effects, including high blood pressure, heart attacks, seizures, strokes, irregular heartbeat, and even death. The combination of ephedra with other stimulants like caffeine can further increase the risk of severe side effects. As a result, the FDA banned ephedra in April 2004, and it remains prohibited in the United States today.
The story of ephedra highlights the potential dangers of diet pills and weight-loss supplements. While ephedra showed promise as a weight-loss aid, the lack of comprehensive research and understanding of its long-term effects led to unforeseen consequences for those who used it. This incident serves as a reminder of the importance of thorough scientific evaluation and regulation to ensure the safety of those seeking weight-loss solutions.
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Phentermine was approved by the FDA in 1959
In the 1960s, patients seeking weight loss would receive a short consultation and a prescription that was filled in a compounding pharmacy, which was usually one that gave kickbacks to the prescribing doctor. Doctors would prescribe a ""rainbow" of pills, which were stimulants combined with other medications to counteract the side effects of the stimulants. These rainbow pills included diuretics, heart medications, amphetamines, and barbiturates.
In 1994, the United States passed the Dietary Supplement Health and Education Act, classifying ephedra as an herb that did not require FDA approval. However, adverse reactions to the medication in the form of cardiovascular and neurological problems forced the FDA to declare ephedra an unsafe substance. Fenfluramine, which was approved as a weight-loss treatment in 1973, was combined with phentermine in 1992 to create fen-phen. In 1997, after 24 cases of heart valve disease in fen-phen users, fenfluramine and dexfenfluramine were voluntarily taken off the market at the request of the FDA. Phentermine was also voluntarily removed from the market at this time.
Phentermine is still available in most countries, including the US, but only with a prescription and only for short-term use. It is approved for up to 12 weeks of use, with most weight loss occurring in the first weeks. It is also available in combination with topiramate, which was approved by the FDA in 2012 to treat obesity.
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Frequently asked questions
Old diet pills contained a variety of drugs, including amphetamines, barbiturates, diuretics, heart medications, and methamphetamines. These pills were often referred to as "rainbow pills" due to their multiple colours.
Obetrol was a popular diet pill in America in the 1950s and 1960s. It was a combination of amphetamine mixed salts and methamphetamine. Fen-phen, a combination of fenfluramine and phentermine, was also popular in the 1990s until it was removed from the market due to adverse effects on the heart.
Yes, in the late 1800s, physicians used thyroid hormones to treat obesity, particularly in people with underactive thyroids. Amphetamine use for weight loss began in the 1940s, and in 1959, phentermine was approved by the FDA for weight loss.
