Is it time to regulate over-the-counter weight-loss formulations?

Many products claiming to promote weight loss are freely available to purchase over the counter and are used by a substantial proportion of the population in many countries, who are often seeking rapid weight loss without long-term lifestyle changes. While there are multiple outlets for these products, surveys in England and Australia have found that at least 70% of community pharmacies stock these products and they are also available through internet pharmacies. Since the products are formulated as tablets and capsules, consumers may regard them as medicines, particularly when sold from a pharmacy. Manufacturers often make extravagant claims for their products, suggesting they suppress appetite, increase metabolism, block absorption of fat or carbohydrates and/or bring about diuresis, but there is little robust evidence of efficacy. Most products contain a variety of herbal ingredients and are not without adverse effects. Since very few of the hundreds of products sold in pharmacies are licensed medicines, they are not subject to the controls required for over-the-counter medicines, in terms of efficacy, safety, quality or provision of a standardised patient information leaflet. Pharmacists themselves perceive these products to be unsafe, but have little knowledge about them, other than that supplied by manufacturers. The role of community pharmacy in supporting effective weight management is increasingly important, given the rise in obesity. We question the widespread supply through pharmacies of ineffective products with extravagant claims and suggest that tighter regulation of their promotion and supply may be required.