Among young women without an eating disorder
diagnosis, those who use diet pills and laxatives for weight control had higher
odds of receiving a subsequent first eating disorder diagnosis within one to
three years than those who did not report using these products, according to a
new study led by researchers from Harvard T.H. Chan School of Public Health and
Boston Children's Hospital.
"We've known that diet pills and
laxatives when used for weight control can be very harmful substances. We
wanted to find out if these products could be a gateway behavior that could
lead to an eating order diagnosis," said senior author S. Bryn Austin,
professor in the Department of Social and Behavioral Sciences at Harvard Chan
School and director of STRIPED (Strategic Training Initiative for the Prevention
of Eating Disorders). "Our findings parallel what we've known to be true
with tobacco and alcohol: starting harmful substances can set young people on a
path to worsening problems, including serious substance abuse disorder."
The study will be published online November
21, 2019 in the American Journal of Public Health (AJPH).
Use of over-the-counter diet pills or
laxatives is not recommended by health care providers as a healthy way to
manage weight and can have severe health consequences, including high blood
pressure and liver and kidney damage.
The researchers analyzed data from 10,058
women and girls ages 14 to 36 who participated in the U.S.-based Growing Up
Today Study (GUTS) from 2001 to 2016.
They found that among participants without an
eating disorder, 1.8% of those who used diet pills during the past year
reported receiving a first eating disorder diagnosis during the next one to
three years compared to 1% of those who did not use the products. They also
found that among these participants, 4.2% of those who used laxatives for
weight control received a subsequent first eating disorder diagnosis compared
to 0.8% of those who did not use these products for weight control.
The researchers called for policies that restrict access to these products, including banning the sale of diet pills to minors. They write that use of these products for weight control may serve as a "gateway" to further disordered eating practices by dysregulating normal digestive function and fostering dependence on unhealthy and ineffective coping methods.
"Our findings are a wake-up call about
the serious risks of these products. Instagram took a step in the right
direction recently by banning ads to minors for over-the-counter diet pills and
'detox' teas, which are often laxatives," said first author Jordan
Levinson, clinical research assistant, Division of Adolescent Medicine, Boston
Children's Hospital. "It's time for retailers and policymakers to take the
dangers of these products seriously and take steps to protect youth."
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