Page 15 - Layout 1

LIFESTYLE
MEDICINE

loss supplements can interact with certain medications, such as anti- shame but to provide realistic expectations past those advertised by
coagulants, SSRIs and even chemotherapy drugs. Such interactions companies leaning on weak data to promote their claims. We can re-
could have severe consequences, and individuals are encouraged to mind them that many factors impact weight loss, and lifelong success
mention all supplements they are taking to their physicians as part of is achieved through Lifestyle Medicine, dietary management, exercise
their medication history. The verification of product content also con- prescription and pharmacologic/surgical intervention if needed. Great
tributes to potential risk. Several lawsuits against popular brands have resources to help gain further information on these topics include the
been launched due to evidence indicating their products contained Exercise Is Medicine initiative, which is a collaboration between the
controlled substances and untested pharmaceuticals that were not men- American Medical Association and American College of Sports Med-
tioned on the nutrition label. If someone is considering taking supple- icine, and the Obesity Medical Association, just to name a few.

ments, it helps to select a brand that participates in third-party References:
certification of dietary supplement quality, such as NSF® (National San-
1. HOP. (2023, February 23). Centers for Disease Control and Prevention.
itation Foundation) and USP (U.S. Pharmacopeia). https://www.cdc.gov/nccdphp/dnpao/state-local-programs/fundingopp/2023/
The meteoric rise of GLP-1 and associated Incretin agonists use for hop.html#:~:text=Poor%20diet%20and%20low%20levels,in%20annual%20health
weight management driven by evidence-based data has unfortunately re- %20care%20costs
2. Nutrition, C. F. F. S. a. A. (2023, March 6). Dietary supplements. U.S. Food and Drug
sulted in a concomitant rise in medication shortages. As a result, numerous Administration. https://www.fda.gov/food/dietary-supplements
clinics and online retailers have been selling compounded peptides man- 3. Dietary Supplements for Weight Loss: Limited Federal Oversight Has Focused More
ufactured by compounding pharmacies. Traditionally, the utilization of on Marketing than on Safety. (n.d.). U.S. GAO. https://www.gao.gov/products/gao-
02-985t
compounded medications is to develop a medication based on the needs
4. Crescioli G, Lombardi N, Bettiol A, Marconi E, Risaliti F, Bertoni M, Menniti Ip-
of the individual patient whereas a factor of the original medication limits polito F, Maggini V, Gallo E, Firenzuoli F, Vannacci A. Acute liver injury following
the ability for the patient to take it (for example, a pill needing to be a liq- Garcinia cambogia weight-loss supplementation: case series and literature review. In-
uid suspension). Sections 503A and 503B of the Food, Drug, and Cos- tern Emerg Med. 2018 Sep;13(6):857-872. doi: 10.1007/s11739-018-1880-4. Epub
2018 May 25. PMID: 29802521
metic Act sets conditions in which compounding pharmacies can
5. Stacy L. Haber, Omar Awwad, April Phillips, Andrew E. Park, Tam Minh
manufacture medications that are placed on the FDA drug shortages list, Pham, Garcinia cambogia for weight loss, American Journal of Health-System Phar-
of which Ozempic and Wegovy® were placed as of May 2023. Safety con- macy, Volume 75, Issue 2, 15 January 2018, Pages 17–22, https://doi-
8
cerns arise due to compounding drugs NOT being FDA-approved as they org.uiwtx.idm.oclc.org/10.2146/ajhp160915
6. Ilyas Z, Perna S, Al-Thawadi S, Alalwan TA, Riva A, Petrangolini G, Gasparri C, In-
DO NOT undergo FDA premarket reviews for safety, effectiveness or
fantino V, Peroni G, Rondanelli M. The effect of Berberine on weight loss in order to
10
quality. This fact has caused confusion at the patient level, believing the prevent obesity: A systematic review. Biomed Pharmacother. 2020 Jul;127:110137.
compound medications they may be receiving are the same peptides that doi: 10.1016/j.biopha.2020.110137. Epub 2020 Apr 27. PMID: 32353823
the STEP and SURMOUNT trials utilized. Adding to this, numerous 7. Cotten BM, Diamond SA, Banh T, Hsiao YH, Cole RM, Li J, Simons CT, Bruno
RS, Belury MA, Vodovotz Y. Raspberry ketone fails to reduce adiposity beyond de-
online retailers use terms such as “Generic Ozempic” and “Generic Moun- creasing food intake in C57BL/6 mice fed a high-fat diet. Food Funct. 2017 Apr
jaro®” to further try to establish a connection to these branded legitimate 19;8(4):1512-1518. doi: 10.1039/c6fo01831a. PMID: 28378858
peptides. The FDA has stated that many of these compounds may be aug- 8. Research, C. F. D. E. A. (2023, October 31). Medications containing semaglutide
marketed for type 2 diabetes or weight loss. U.S. Food and Drug
mented with salts (for example, Semaglutide sodium, Semaglutide ac-
Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-
etate), which have not been shown to be safe or effective, and advise patients-and-providers/medications-containing-semaglutide-marketed-type-2-dia-
patients to only obtain these peptides from state-licensed pharmacies or betes-or-weight-loss
outsourcing facilities registered with the FDA. Several national organi- 9. Fitch A, Auriemma A, et al. Compounded peptides: An Obesity Medicine Associa-
8
tion Position Stance, Obesity Pillars, Volume 6, June 2023:100061. ISSN 2667-3681.
zations have provided position stances to try and bring clarity to this sit-
doi: 10.1016/j.obpill.2023.100061
uation. The Obesity Medicine Association’s official position stance stated: 10.Research, C. F. D. E. A. (2023a, March 24). Drug compounding and drug shortages.
“The OMA recommends that anti-obesity medications, and their formu- U.S. Food and Drug Administration. https://www.fda.gov/drugs/human-drug-com-
lations, undergo clinical trial testing for efficacy and safety via processes pounding/drug-compounding-and-drug-shortages#:~:text=Compounded%
20drugs%20are%20not%20FDA,an%20FDA%2Dapproved%20drug%20product
overseen by the FDA. The FDA does not approve compounded drugs
and without their review, the FDA cannot assure that compounded drugs Edwin Davila, DO, MS, CISSN, is a senior resident physician
have the same safety, efficacy, and purity of FDA-approved medications of Internal Medicine at the Texas Institute for Graduate Medical
9
that have gone through clinical trial testing.” Education and Research. He is a CISSN holder with the Inter-
Weight loss is a challenging goal for many, and the idea of a product national Society of Sports Nutrition, a Board of Director with the Texas
that can accelerate that success is very enticing. It is crucial to open di- American College of Sports Medicine, a member of the Bexar County
alogue with our patients and ask them if they use products other than Medical Society and Board member of the American Medical Society for
those prescribed to achieve their goals. This is not to demonize or Sports Medicine.
Visit us at www.bcms.org 15