Case series on a diversity of illicit weight-reducing agents: from the well known to the unexpected

Adulteration of over-the-counter proprietary medications has been reported previously. However, to date a detailed study specifically on illicit slimming products has been lacking. WHAT THIS STUDY ADDS This study showed the presence of a wide variety of illicit weight-reducing agents in over-the-counter slimming products, including registered or banned drugs and pharmaceutical analogues. These products may result in significant toxicities and even mortality. AIMS To provide an overview of illicit weight-reducing agents found in over-the-counter slimming products ingested by poisoned patients. METHODS The clinical details and analytical findings of slimming products involved in poisoning cases between 2004 and 2009 were reviewed. RESULTS Sixty-six (including one fatal) poisoning cases were encountered. Eighty-one products were analysed and found to contain undeclared prescription weight-loss drugs, drug analogues, banned drugs, drugs used for an inappropriate indication or animal thyroid tissue, with up to six illicit agents within the same product. Many products were readily available from shops or the Internet. CONCLUSIONS A rich diversity of illicit, potentially harmful weight-reducing agents was found in over-the-counter slimming products.