California legislators will vote on a bill to prohibit the sale of dietary supplements for weight loss and diet pills to anyone under the age of 18 in a move that could patch what Stanford professors are calling severe under-regulation in the diet pill industry. 

California Assemblywoman Cristina Garcia (D-Bell Gardens) proposed the bill to the state legislature in April amid rising scrutiny of the diet pills industry. If passed, the bill, AB-1341, would prohibit the sale of over-the-counter diet pills or weight-loss supplements to minors online or in stores.

Experts are optimistic that the legislation could help rectify what they see as a problem that stretches back decades. According to Harvard University social and behavioral sciences professor Bryn Austin, pharmaceutical companies have sold under-regulated weight-loss supplements and over-the-counter diet pills to minors in California for years despite the associated health risks.

According to pediatrics professor Thomas Robinson ’83 M.D. ’88, much of the under-regulation stems from the 1994 Dietary Supplement Health and Education Act (DSHEA) that permitted firms to determine whether a dietary supplement was safe for distribution. 

After similar measures were adopted by the U.S. Food and Drug Administration (FDA), dietary supplements no longer required the same regulations as drugs, meaning dietary supplements do not need a pre-market review from the FDA. 

Dietary supplement manufacturers “don’t have to show any evidence of safety or efficacy which would be required if they did have to go to the FDA,” Robinson said. “Because they’re not regulated … they may not include even the ingredients that are on the label.” 

Robinson added that studies have found a number of discrepancies between the ingredients shown on the label and those contained in the supplement. After analyzing 17 brands of weight-loss and sports supplements sold in the United States, researchers publishing in the scientific journal Clinical Toxicology found nine prohibited stimulants in the supplements.

Due to the lack of regulations, dietary supplements sold for weight loss are associated with health risks, ranging from high blood pressure to arrhythmias, Robinson said. 

Most diet pills that have the greatest effects are amphetamine-based stimulants used to reduce appetite, according to psychiatry and behavioral sciences professor Eric Stice. Though amphetamine is effective in temporarily suppressing appetite, Stice said that he does not generally recommend adolescents to use amphetamine due to its high addictive potential. 

“There is an increased risk for addiction to an amphetamine-based medication,” he said. “I’ve worked at a lot of alcohol and drug treatment centers, and people develop very unhealthy relationships with those drugs.”

Another concern with adolescents using weight-loss supplements and other compensatory weight control behaviors is the risk of potentially developing an eating disorder. A study conducted by researchers at Stanford found that all compensatory weight control behaviors including dieting, vomiting and use of diet pills are correlated with future eating disorder symptoms. 

Stice added that it is important to be aware of the lobbying efforts by the pharmaceutical industry that encourage the public to take drugs. 

“I am very dubious about anything that comes out of the pharmaceutical industry and their lobbying efforts,” he said. “I’m sure that they are going to fight very hard to prevent this bill from passing in California because of the financial interest at stake.”

Austin echoed Stice’s sentiments and cautioned minors against purchasing over-the-counter diet pills and weight-loss supplements. The current lack of regulation allows “unscrupulous companies in California to hawk” these products to children regardless of whether or not they are medically recommended according to Austin. 

“Youth, parents and pediatricians in the state know that California’s youth deserve better,” Austin wrote. “It’s time for bold action by state lawmakers to support Assemblymember Cristina Garcia’s vital legislation to ban the sale of these predatory products to minors in the state.”

This article has been updated to clarify that the sale of over-the-counter dietary supplements to minors would be illegal under AB-1341.