Encyclopedia of Drugs and Addictive Substances | Diet Pills - Overview

Overview

The obsession with thinness seen throughout Europe and North America in the twentieth and early twenty-first centuries is a trend that developed during the late 1800s. The concept of beauty prior to that time was completely different. In fact, a full figure for women was actually quite desirable. Art from the 1700s and 1800s depicts women as well-endowed, curvaceous, and quite proud of their bodies. A few extra pounds on an individual were considered a sign of good health and high economic status. Fine French chocolates were all the rage among the rich, while the less fortunate and painfully thin lower classes barely had enough food or money to sustain themselves.

The image of beauty has changed over the centuries. A full figure for women was actually quite desirable in the 1700s and 1800s. Art from this era depicts women as well-endowed, curvaceous, and proud of their bodies. The painting shown here was created by Franz Xavier Winterhalter in 1855 and depicts Empress Eugenie and her friends. © Archivo Iconografico, S.A./Corbis.

Early Diet Pills

By the late 1800s, however, attitudes about weight were beginning to change, especially among women. The first diet pills, referred to at that time as "fat reducers," showed up on the market in 1893. These pills were thyroid extracts.

The thyroid is an important gland in the body. It secretes chemical messengers called hormones that control metabolism. Metabolism is the process by which food is converted to energy that the body uses to function. Thyroid extracts are used to correct problems with the thyroid gland. Their use causes people to lose weight, but produces dangerous side effects in people with normal thyroids. These effects include muscle weakness, chest pains, an increased heart rate, abnormal heart rhythms, high blood pressure, and even death. Despite the risks, overweight people continued to seek out the thyroid hormone as a weight-loss remedy until the 1950s.

The "New" Drug of the 1930s: Dinitrophenol

"Weight-loss pills in general have a rather alarming history," wrote Denise Grady in the New York Times. In 1933, a drug called dinitrophenol (DY-NY-troh-FEE-noll) went on the market. It became a popular weight-loss remedy, despite the fact that it was originally used as a pesticideA chemical agent designed to kill insects, plants, or animals that threaten gardens, crops, or farm animals.. "During the 1930s," noted Grady, "about 100,000 Americans took … dinitrophenol, which prevented food energy from being turned into fat." But the drug turned out to be poisonous for humans as well as pests. It caused damage to the taste buds, blindness, serious skin rashes, extremely high fevers, and even death.

Despite all the dieting fads that come and go, one method remains the most successful and healthy—regular exercise and limiting calorie intake. © Roger Ressmeyer/Corbis.

Dangerous and sometimes fatal side effects associated with drugs like dinitrophenol led the U.S. Congress to enact the Food, Drug, and Cosmetics Act in 1938. The act gave the U.S. government powers to regulate substances marketed as drugs. However, some people still managed to purchase dinitrophenol through mail-order companies through the 1940s.

From Dinitrophenol to Amphetamines to "Amphetamine-Like" Diet Drugs

The use of dinitrophenol dropped as dieters discovered amphetamine, a medication developed in 1887. Historically, doctors prescribed amphetamines as an appetite suppressant. Amphetamines tend to decrease feelings of hunger in people who take them, making them an often-abused drug among dieters. Although the use of amphetamines for weight control was popular in the 1950s and again in the 1980s and part of the 1990s, this practice is no longer very common. Amphetamine use for weight loss is dangerous because it can become addictive. Some overweight individuals may resort to illegal means to obtain prescription-only amphetamines and even methamphetamine. (An entry on methamphetamine is also available in this encyclopedia.) Most doctors agree that the best way to regulate weight is through moderate exercise and a healthy diet.

The dangers of amphetamine addiction prompted drug companies to develop "amphetamine-like" diet pills—medicines containing chemicals similar to amphetamines. Although not quite as powerful as amphetamines, these pills did reduce users' appetites and were considered safer, with less potential for misuse or abuse.

Into the Twenty-first Century

As of 2005, "in weight-obsessed America … two-thirds of adults are overweight or obese," wrote the authors of an MSNBC.com article on fitness. In the same article, Dr. JoAnn Manson, chief of preventive medicine at Boston's Brigham and Women's Hospital, stated: "A prescription for exercise may be the most important prescription a physician writes all day."

Dozens of prescription diet pills have come and gone over the years. A large number of them are no longer available for use by patients. Physicians can no longer write prescriptions for them because they have been "discontinued." As of 2005, according to the FDA, approximately twenty-five prescription diet pills had been categorized as "discontinued." A discontinued drug product is one that has been removed from the market in the United States for reasons other than safety or effectiveness. The exact reason or reasons for their removal are not stated on the FDA Web site.

The large number of these drugs only serves to highlight America's cultural obsession with weight. For a list of discontinued prescription drugs, see the table on this page.