Are weight loss supplements marketed to the military mislabeled and adulterated?
Of 30 products purchased in June 2023 from 12 online companies advertising military discounts, 25 had inaccurate labels, 24 were misbranded, seven had hidden components not present on label, and a third contained substances prohibited for military use.
“These findings suggest that predatory marketing and low quality of weight loss supplements pose a threat to military members and the public,” the authors wrote.
The paper brought together research scientists from the Consortium for Health and Military Performance (CHAMP), the Henry M. Jackson Foundation for the Advancement of Military Medicine and the National Center for Natural Products Research (NCNPR) at the University of Mississippi.
Dietary supplements and the U.S. military
This investigation is part of the ongoing work of the Department of Defense’s Operation Supplement Safety (OPSS), launched in 2012 to educate the military community about dietary supplements and investigate their use among the troops.
According to results from a 2021 military survey, some 70% of the service members polled reported using dietary supplements at least once a week or more, “especially combination products and proteins/amino acids often used to purportedly enhance physical performance.”
Past case studies from the same research group have probed products marketed for immune health and cognitive performance on the market to verify if accurately labeled according to Supplement Facts listed ingredients on product labels.
Both investigations also found dietary supplements in these categories to be misbranded and adulterated, making the case that “education is required so that the public can recognize red flags while the U.S. Food and Drug Administration works to ‘modernize’ the current regulations for dietary supplements.”
Andrea Lindsey, director of OPSS, previewed this latest case study on weight loss supplements last month at the annual meeting of the Oxford International Conference on Botanical Science hosted by NCNPR.
“From our standpoint, the fact that 10 of them had substances on the prohibited list, either hidden or listed on the label, we're of course concerned,” she said, explaining that misbranded supplements can result in a performance decrement, cause serious adverse health events and jeopardize a service member’s career.
Making weight and informed decisions
Lindsey also highlighted the ever-present pressure to make weight in the military as regulations describe strict weight for height and body fat standards as a condition of service.
“Individuals who do not meet these standards receive adverse performance reports and can be discharged from service for repeated failures to achieve the standards,” the 2021 military survey noted. “This may prompt some individuals who have difficulty meeting these requirements to use DSs marketed for weight or body fat loss.”
Dietary supplements for weight loss, which sit within a market category expected to reach $135.7 billion by 2030, are promoted not only for shedding pounds but are packaged with other benefits like added energy and performance as the market trends towards all-in-one solutions.
The JAMA Network Open paper also highlighted the number and combination of ingredients “all packed into one capsule” as a rapidly expanding growth opportunity for the market, with service members as prime target for slogans like, “we offer discounts as a way to say thanks”.
"Of concern was the fact that most of the products contained multiple ingredients, and multiple combinations with stimulant effects," the authors wrote. "It is unknown how these stimulant and other ingredients interact with each other, not to mention current use of over-the-counter and/or prescription medications or additional dietary supplement products."
What’s in and not in its supplements
The study used liquid chromatography-mass spectrometry to verify whether products were accurately labeled according to the Supplement Facts listed ingredients and whether they contained any substances on the DoD Prohibited Dietary Supplement Ingredients List.
The 10 products formulated with ingredients prohibited for military use contained one to seven of these ingredients in a single product, either present or not listed on label.
They included DMHA, 1,4 DMAA, Acacia rigidula, ephedra extract listed on labels but detected as ephedrine, methylephedrine and pseudoephedrine, higenamine, hordenine, isopropylnorsynephrine, methylsynephrine, octopamine and vinpocetine. An unapproved drug, known as xanthinol, was listed on a label and detected in one product. Nine products contained stimulants of phenethylamine and its derivatives, prohibited in sport by the World Anti-Doping Agency (WADA), and seven products had ingredients on both the DoD Prohibited List and the WADA List.
Ingredients on label but not detected included bitter orange whole plant extract, a hoodia extract, Huperzia serrata extract, kola nut, raspberry ketones, Rauwolfia and white willow bark extract. One product claimed saffron, but the less expensive saffron substitute Carthamus tinctorius flower was detected instead.
“[F]raudulent marketing of weight loss products—some with exaggerated claims, some that are potentially dangerous, and some containing illegal ingredients—continues, especially through online sources,” the authors concluded. “Some sources even target service members through offering military discounts. Service members need to know that the weight loss products they access through online sources are of high quality.”
Source: JAMA Network Open
“Label Accuracy of Weight Loss Dietary Supplements Marketed Online With Military Discounts”
doi: 10.1001/jamanetworkopen.2024.9131
Authors: Cindy Crawford et al.
