Do not buy weight-loss pills, weight-loss coffee, slimming candies, or enzyme plums (plums claimed to have been soaked in enzymes) that promise you will get thin fast

These products are often found with a diet drug (sibutramine) added in secret. It used to be a weight-loss drug, and China stopped it in 2010. Overweight people aged 55 or older, who had heart disease or diabetes, took it for more than 3 years. Non-fatal heart attacks were about 30% higher, and strokes were about 36% higher. The weight lost was only 1.7 kg more. By the time a spot check finds it, you have already swallowed it.

Cost

No money. You also save what you would have spent on these products. The hard part is accepting that there is no such thing as dropping several jin (a Chinese unit of weight, about half a kilogram) in 1 week.

Benefit

The SCOUT trial enrolled 9804 people. All were 55 or older, overweight or obese, and had cardiovascular disease or type 2 diabetes. They drew lots and were split into a group that took the drug and a group that did not. Treatment lasted 3.4 years on average. The main endpoint was a set of bad events chosen in advance: non-fatal heart attack, non-fatal stroke, coming back after cardiac arrest, and cardiovascular death. The rate of these events was 11.4% vs 10.0%. HR 1.16 (95% CI 1.03-1.31, P=0.02). The chance of an event was about 16% higher for the people who took the drug. The true value roughly sits between 3% higher and 31% higher. Non-fatal heart attack was 4.1% vs 3.2%, HR 1.28 (1.04-1.57), about 30% higher. Non-fatal stroke was 2.6% vs 1.9%, HR 1.36 (1.04-1.77), about 36% higher. Cardiovascular death and all-cause death did not increase. All-cause means every cause added together. After the draw, the sibutramine group lost 1.7 kg more on average. The former State Food and Drug Administration, on the basis of a safety assessment, held that "the risks of weight-loss treatment outweigh the benefits," and in October (10) 2010 it notified a stop to the production, sale, and use of sibutramine preparations and the raw drug. Both sibutramine and phenolphthalein (a laxative chemical) are prohibited as additives in food, and health food counts as food.

Notes

SCOUT enrolled a high-risk group who already had heart disease or diabetes. This trial did not prove that healthy young people would have the same events. But because you cannot tell who is high-risk, the regulator simply took it off the market. Another ingredient often added in secret is phenolphthalein. It was originally a laxative. Taking too much of it for a long time can throw off the body's electrolytes and trigger an irregular heartbeat. How to tell: a real weight-loss drug is a prescription drug, and the approval number can be looked up at a pharmacy or a hospital. Something sold under the name of "coffee," "candy," "plums," or a "meal replacement," that also promises you will drop several jin in 1 week, should by definition have no drug effect. If it has a drug effect, something was added. The original text that stopped sibutramine is notice «国食药监办» [2010] No. 432, posted on the National Medical Products Administration website. What is cited here is a page on which the Tianjin market supervision administration retells it. The 2 sentences "risks outweigh the benefits" and "production, sale, and use stopped in October (10) 2010" can be checked word for word there.

Sources · 2

1. James WPT et al. (2010). Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects. NEJM. doi.org/10.1056/NEJMoa1003114
2. 天津市市场监督管理委员会. 警惕部分食品中违法添加「盐酸西布曲明」和「酚酞」. scjg.tj.gov.cn/tjsscjdglwyh_52651/hdpt/cjwtyx…