Diet Pills: High Risk, Low Reward

Diet pills stacked in rows
Photo by Anna Shvets on

An Introduction

Picture this: you could swallow a pill that would help you lose weight, prevent diabetes, heart disease, and cancers. It would help you balance out your hormones, and it would make you happy, confident, and finally feel worthy of love. That would just be the bees knees, wouldn’t it? Many people turn to diet pills because they promise to do all of these things.

America is one of the only countries in the world that allows drug manufacturers to advertise drugs on tv and in print, which is why we see so many pill-pushing commercials of happy people playing tennis or camping with their grandkids.

Group of older adults dancing and looking happy, like they would in a drug commercial
How med commercials look

Diet pill commercials may show a shy person in a larger body in grayscale with sad music playing in the background. The camera blurs and pans out dramatically to a conversation they have at the doctor’s office, where they are given a prescription for their savior pill. Suddenly, the world has color and they feel confident and happy, and thinner. Some cheesy xylophone music blares as someone with an auctioneer voice rushes through the long list of possible side-effects. Did I nail it or what?

Diet pills prescribed by doctors aren’t the only diet pills that are technically avaialbe to the public. Some people literally sell these drugs on the black market/dark internet, and other diet pills line shelves at the store magazines that say “lose weight, look good.”

Lisa Simpson saying "you can use weight subliminally" while looking at a fitness magazine

Today’s post has come about after an enjoyable deep-dive on my part into the world that is diet pills. I love digging into research for this blog, and I hope you enjoy reading this half as much as I enjoyed researching and writing it.

The Diet Pill Craze Started With Amphetamines

Amphetamines are stimulants that are commonly prescribed to people with narcolsepy and attention deficit hyperactivity disorder (ADHD). These drugs work by increasing the release and activity of dopamine and norepinephrine. Dopamine plays a major role in reinforcing behaviors and serves as a reward center of our brain, and norepinephrine affects our circulatory system (heart, blood vessels) and breathing.1

Man taking pills and saying "looks like I picked the wrong week to quit amphetamines"

Amphetamines, like all prescription drugs, have a time and a place, and they can help for people who actually need them. Some people abuse amphetamines and take them in higher doses for a feeling of euphoria. Amphethamine overdoses can occur when taken in large doses, resulting in deadly consequences. Overdoses can consist of rapid breathing, aggression, confusion, hallucinations, and more. These are serious drugs, yet despite the risk, people widely abused amphetamines for weight loss not so long ago.1

In the 1950’s, people could walk into a clinic and come out with a colorful bottle of these amphetamines in a matter of minutes. *Sigh* those were the days…

One brave journalist, Susana McBee, went undercover in the 1960’s and systematically visited several doctor’s offices to ask for amphetamines. She did this as research to later expose the public about how easily one could obtain these drugs, and how widely they were used by Americans.2 After visiting 10 clinics, she had obtained over 1,500 pills with few questions asked.3

Cartoon diet pills falling

Before all of this, amphetamines became very widely used during WWII, as they helped stabilize soldiers’ moods and stay awake when they weren’t able to get adequate sleep. Upon returning home from war, amphetamines became incredibly popular with the general public, especially among women.2 Drug companies pushed these products on doctors, the way opioids manufacturers did in more recent memory. Eventually doctors prescribed amphetamines to virtually anyone who wanted them.

They were revered for their ability to speed up a person’s metabolism, while also suppressing appetite and promote energy levels and wakefulness. They came in all kinds of eye-catching colors, like m&ms, which also increased their allure.

All M&M colors

After reports of deaths from amphetamines arose in 1968, the U.S. senate began an investigation into the use of “rainbow” pills, and found them to be linked with dozens of deaths across America.3 Eventually, they fell under Schedule II medications, making them more difficult to obtain for the general public.

That’s not the end of the story, but check out A Speedy History of America’s Addiction to Amphetamine and The Return of Rainbow Diet Pills for more in-depth analyses of this topic. It’s fascinating, you won’t regret it!

Despite this history, some people still abuse amphetamines for the purpose of weight loss. Doctors cannot prescribe them for weight loss, but people can still buy them from friends, family members, or acquaintances that have a prescription for its intended purposes.

Alexis Rose saying "this is all feeling very sketchy"

Amphetamines can potentially facilitate meager short-term weight loss, but those effects are short lived, often leading to people increase their self-prescribed dosage once they stop working. There is no approved dosage for amphetamines for the purpose of weight loss. Plus, amphetamine abuse can lead to addictions by changing the brain’s wiring, creating a much more complicated situation all around.4

Amphetamine toxicity can have very real, lasting effects, and for what? A potential temporary loss of a few pounds? Perhaps people do not understand the risks amphetamines can pose. Many people who take them, and other substances, for weight lost just don’t care. The risks of trips to the emergency room pale in comparison to the “benefit” of potential weight loss in their minds. And that shows how much our culture prioritizes smaller bodies.

Our history of taking pills for weight loss started with amphetamines, but several other types of weight loss pills exit. Some of which you can get with a prescription or over-the-counter.

FDA Approved Diet Pills and Weight Loss Drugs

Orlistat, an FDA approved weight loss drug, works by blocking the absorption of fat in the diet.5 This means your body absorbs fewer calories from the food you ingest, which might sound like a pretty good deal. But, this also means your body will have a harder time taking in fat-soluble vitamins and nutrients that depend on fat for absorption. This can lead to nutritional deficiencies even if you eat a well-balanced diet.

Homer Simpson saying "a little vitamin G" and holding up gas tank

Plus, having fat rush through the digestive system without being absorbed can cause a digestive disasters… One pamphlet that comes with alli, another name for orlistat, recommends people wear a panty liner for the first couple of days in case you can’t trust your farts anymore. It also comes with a handy chart that tells you which foods you should not eat, like creamy soups, fatty meats, or baked goods, if you want to avoid pooping a lot of fat.6

A more delicate way to put these side effects would be:

  • Oily spotting in underwear
  • Gas with oily spotting
  • Oily or fatty stools
  • Loose stools
  • Urgent need to have a bowel movement
  • Difficulty controlling bowel movements
  • Pain in the rectum

People who take orlistat may experience other unpleasant side effects, but the above struck me as the most memorable.7

Bryan Cranston saying "I just have to go to the bathroom", a diet pill side effect

If a person decides they want to take alli and their doctor approves of it, that’s their choice. It’s FDA approved, and it’s probably a far safer option than some of the other diet pills available on the dark web or in the streets.

I sincerely hope that people who decide to use this drug get the results they are looking for, but I’m still uneasy about it all. According to Mayo Clinic, those who used alli for a year, with a low calorie diet and exercise, lost about 6 pounds more than those who just did the low calorie diet and exercise regimen. Does it feel acceptable to have oily gas and difficulty controlling BMs just to lose, on average, 6 “extra” pounds over the course of the year? To some, yes. If so, why does that trade off feel like a good deal?

Clint Eastwood saying "hell no"

Interestingly, I haven’t found studies that look at the use of Alli for over a 1 year period, so can we really say it works for long-term weight loss? The same can be said for low-calorie diets, which can also “work” in the short term, but don’t yield the long-term results many strive for.

Moving on from an FDA approved drug, let’s check out ones you can find on the shelves.

Woman dumping all kinds of foods into her shopping cart

Over-the-counter Weight Loss Pills

My day job involves teaching nutrition classes to families with low incomes in my city. I see people of various backgrounds at a wide variety of agencies. One thing that I will never forget is when a participant told me that she tried some of the weight loss pills that she got from the dollar store. She told the class they made her feel nauseous, so she didn’t eat much while she took them. She did remark, however, that she lost a few pounds before she got tired of feeling ill.

My jaw metaphorically dropped when she told this story. This woman struggling to put food on the table, but in her mind, weight loss pills seemed like a more important purchase. Her doctor repeatedly told her weight loss would help her get healthier. She understandably thought that meant that she needed to lose weight by any means necessary. But I do not feel disgusted with her for thinking that or purchasing those pills.

Parks and Rec character saying "pills baby"

I feel disgusted with the society and culture that makes losing weight while food insecure the priority instead of getting enough nourishment and nutrients. This is a memorable case, but there have been other instances where my participants truly want to lead healthier lifestyles, and they think the only way to do that is by eating very little or shelling out what little money they have on weight loss products.

Anyway, how nuts is it that weight loss pills are even sold at the dollar store or in the checkout line at the grocery store? As we talked about in 3 Reasons Why Supplements Can Be Sketchy, the FDA does not regulate supplements. There is no telling what is even in a supplement, as we just have to trust that it contains whatever the label says it does.

Man saying "c'mon son" as son lets go of ladder. Man turns around before catching son as he falls and says "rule number one, never trust anybody"

Some over-the-counter weight loss pills contain things like green tea extract, which sounds natural and healthy, but has its own host of side effects. For instance, the potential to cause liver damage.8 Others contain weird plants like garcinia cambogia, high doses of caffeine, and raspberry ketones. Raspberry ketones have apparently only shown effectiveness in super high doses in rats, so I think I’ll sit this one out.9

People who want to believe that a magic pill will help them lose weight are much more vulnerable to marketing and pyramid schemes that acquaintances from high school may push on Facebook. I guess that’s true about anything, though. The desire to believe in something makes it easier to believe despite a major lack of evidence.

Danny Devito stuck in playground equipment and saying "it's a pyramid scheme"

The FDA may deem over-the-counter weight loss pills as “generally recognized as safe”, but that phrase lacks tangible meaning. Supplement manufacturers can sell a supplement until there is evidence to prove that it causes harm. Please use caution if you do choose to take a supplement.

Supplements may have a dark sides, but one weight loss supplement takes the cake for sketchiness.

The Horrors of DNP

I had never heard of DNP before researching the topic of diet pills for this post, but it turns out, this is one scary substance. DNP, also known as 2,4-Dinitrophenol, was first created during WWI for weapons and other important warfare tools. After that, it was used for a variety of purposes, like dyes, wood preservatives, and pesticides. Sounds just like something I want to put in my body.

Hazardous materials truck driving by

A few years later, a researcher named Maurice Tainter discovered its weight loss properties when consumed by humans by increasing their basal metabolic rate. Not long after that, companies manufactured and sold it over-the-counter. For awhile, all appeared well and good. At least until significant side-effects occurred. Cataracts were reported in large numbers, and DNP was then labeled “not fit for human consumption” in 1938.10 Since then, researchers have found that DNP can lead to leave permanent heart and nervous system damage as well.11

DNP is alluring because of its ability to help people burn more calories and lose some fat without changing one’s lifestyle, but it has a history of creating nasty side effects. Taking DNP can cause:

  • Excessive sweating
  • Rapid heart rate
  • Fever
  • Dehydration
  • Nausea/vomiting
  • Dizziness
  • Confusion

DNP has been known to put people into a coma, and eventually cause an agonizingly painful death.12 When people overdose on the stuff, they begin to experience the above symptoms about 3 hours after taking it. If it’s severe enough, the average length of time before death is about 14 hours.10

Deaths attributed to the consumption of DNP largely dropped off between the 1950’s and the 2000’s, but there was a spike of reported cases between 2001-2010.10 DNP toxicity rates have also increased since 2010, and 2018 saw the highest mortality rate for DNP toxicity in the U.K. in a five year span. It’s banned in the US and UK for weight loss, but that doesn’t mean people don’t still find it.

Its resurgence was also due to the fact that body builders were buying it from gym owners who would purchase it in bulk from India or China.11 Like any good illicit substance, it has a bunch of fun nicknames or street names, like “Dinosan”, “Solfo Black”, and “Dnoc”. People can purchase DNP online, especially on the dark web, or they can purchase manufacturing instructions. It’s often sold in bulk drums, and the recipient then packs the powder into pills, selling them for a profit.

Cartoon man saying "yeah, it's a great nickname"

Apparently, people who sell it online sometimes fully acknowledge that it is a poisonous substance, yet continue to make dosing recommendations for weight loss. To be clear, there is no safe dosage of DNP, but that doesn’t stop people pretending to be pharmacists from “helping” people on online forums. People even post things like “this is literal poison” so, “it doesn’t hurt to start small”, or “respect the chemical and you will be OK.”11

Some even explicitly state “not fit for human consumption” on their website, but continue to sell it anyway. Their customer service goes above and beyond too, as they offer “stealth shipping”, and pack it in misleading boxes to avoid suspicion from the post office.11 That deserves 5 stars on their black market profile.

Man in uniform saying " 5 stars"

In the past, I may had resorted to excessive exercise or cutting out sugar to try to change my body, but I never reached the point where I ventured onto the dark web to buy mysterious pills or powders from somebody. Thank goodness, too. The dark web feels too spooky, and it seems like the FBI would show up at my door if I even Googled “how to get to the dark web”. Maybe you just visit I’m only speculating, of course.

Regardless, the sketchy hoops a person has to jump through to obtain the stuff, along with admissions from the seller that it is literally poison, aren’t enough to deter people who are desperate for weight loss.

Black and white photo of poison

People who decide to purchase this drug often know it can cause irreversible harm, or even death, but that isn’t enough to deter them from taking it because it may help them lose weight. It may also cause blindness or death, but pros and cons, I guess. When people get so desperate that they put their life on the line to drop a few pounds, it’s very telling of how we perceive people in larger bodies as a whole. In DNP takers’ minds, it’s almost as if being fat is worse than being dead. That’s pretty messed up.

Knowing what I now know about DNP and other weight loss drugs, I feel defeated and heart-broken about the lengths people will go for a shot at small amounts of weight loss. Dieting, purging, and abusing laxatives are incredibly harmful measures to take to “get thin”, but intentionally logging onto the dark web to buy illicit substances, despite explicit warnings of death, feels different somehow.

Randy from Say Yes to the Dress sliding down a wall in disappointment

In Conclusion

Sure, meager amounts of weight loss are associated with reduced risks of certain diseases, but there are always confounding factors at play. Perhaps better habits (like regular, not excessive exercise) are what reduces risk, even if weight loss didn’t occur.

Person and dog jumping rope together.
The cutest form of exercise

Take, for example, the fact that liposuction, the vacuuming of fat tissue out of one’s body, does not reduce a person’s risk for heart disease and others.13 Simply getting rid of fat, doesn’t have the same health effects as good habits, like eating more fruits and veggies, being physically active when possible, and having a strong support system. I still believe very strongly that habits foster health, not weight itself.

In the end, though, this post was interesting for me to write because it really, like really, put into perspective the lengths people are willing to go if they believe they have a little shot at losing a few pounds.

You can tell people about the scary side effects of amphetamine abuse or addiction, but once their mind is made up, it doesn’t really matter. Health professionals can provide resources and fact sheets about how dangerous compounds like DNP are, but if there is some promise of weight loss, it doesn’t really matter if they are determined to use it. You can show people research about how diets don’t work for the vast majority of people, and can also have dangerous consequences, but it doesn’t really matter either if they have decided to give it a go. They’ll do what they want to do, or at least what diet culture tells them to do, and that’s scary.

I usually like to end my posts on a hopeful note, but after learning about all of this, I’m not so sure I have it in me right now. My hope is that spreading awareness on these issues will help combat them, and will maybe nudge people toward discontinuing supplements or seeking treatment for addictions if need be. But when it comes down to it, these issues are still rooted in diet culture. If people didn’t feel the need to be thin, they wouldn’t reach for these substances. Taking pills and powders are just symptoms of the overall condition that is diet culture.

It’s a very steep, uphill fight to take down diet culture, but I’m in it for the long haul, and I hope you’re with me.

Pokemon slapping another Pokemon
Me slapping diet culture every chance I get

As Always, a Book Recommendation

Because I was unable to end my post with strong notes of hope, here is a humorous book to lighten the mood that made me laugh out loud multiple times while listening to the audiobook version: Me Talk Pretty One Day by David Sedaris.

I love David Sedaris’s writing. His style is honest, dry, and relatable, and the stories themselves are funny in their own right, yet the way he tells them makes them even more hilarious. His descriptions of people and places, his word choice, and the flow of his writing combine to create numerous literary masterpieces, and Me Talk Pretty One Day is one of his best. If you like dark, inappropriate humor, check this book out when you could use a laugh. I think we all could right now, actually.

As a proud Indie Bound affiliate, I get a small commission on books and products sold using the links on my website. It doesn’t cost you anything extra! I only recommend books that I truly love and believe in, and your purchases on Indie Bound through my website support both my work and small bookstores. Thanks!


  1. Amphetamine Abuse for Weight Loss – Addiction Hope
  2. A Speedy History of America’s Addiction to Amphetamine
  3. The Return of Rainbow Diet Pills
  4. What’s An Amphetamine? Addiction: Signs, Symptoms, and Treatment
  5. Alli Weight-Loss Pill: Does it Work? Mayo Clinic
  6. Alli Companion Guide
  7. Medline Plus: Orlistat
  8. Green Tea- NCCIH
  9. Further Research on the Biological Activities and the Safety of Raspberry Ketone is Needed
  10. 2,4-Dinitrophenol (DNP): A Weight Loss Agent with Significant Acute Toxicity and Risk of Death
  11. ‘Knowing it could kill you isn’t a deterrent’: the deadly trade in diet pills
  12. Warnings issued over deadly DNP ‘diet drug’

Thanks for visiting The Diabolical Dietitian! If you’d like to stay up-to-date on the latest posts, please enter your email below to subscribe!

Success! You're on the list. Make sure you check your junk mail folder for the confirmation email if you didn't receive one.

One thought on “Diet Pills: High Risk, Low Reward

Leave a Reply