Avoid rapid-weight-loss pills, slimming coffee, candies and “enzyme” plums

Cost: No cost; avoiding these purchases saves money. The difficult part is rejecting promises of losing several pounds in a week.

In plain language: The source describes sibutramine as a frequently detected undeclared ingredient in these products. It was previously a weight-loss medicine and was withdrawn in China in 2010. In overweight people with cardiovascular disease or diabetes followed for over three years, nonfatal heart attacks were around 28% higher and nonfatal strokes around 36% higher, while additional weight loss averaged only 1.7 kg. Detection in a product inspection may come after consumers have already taken it.

Findings reported by the source: SCOUT enrolled 9,804 overweight or obese people aged 55 or older with cardiovascular disease or type 2 diabetes, randomized to treatment or comparison groups for a mean of 3.4 years. Its prespecified composite endpoint included nonfatal myocardial infarction, nonfatal stroke, resuscitated cardiac arrest and cardiovascular death. Events occurred in 11.4% versus 10.0%, HR 1.16 (95% CI 1.03–1.31; P=0.02). Nonfatal myocardial infarction occurred in 4.1% versus 3.2%, HR 1.28 (95% CI 1.04–1.57); nonfatal stroke in 2.6% versus 1.9%, HR 1.36 (95% CI 1.04–1.77). Cardiovascular and all-cause mortality did not increase. Additional weight loss after randomization averaged 1.7 kg in the sibutramine group. The source reports that China's former drug regulator concluded the risks outweighed the benefits and ordered production, sale and use of sibutramine products and active ingredients to stop in October 2010. It describes sibutramine and phenolphthalein as prohibited food additives, including in health foods.

Source author's evidence grade: A; not site verification or professional approval.

Notes: SCOUT studied a high-risk population with cardiovascular disease or diabetes; it did not establish the same outcomes in healthy young adults. The source links the withdrawal to the safety concerns. Phenolphthalein is another undeclared ingredient it discusses: a laxative whose excessive long-term use can disturb electrolytes and provoke arrhythmias. The source distinguishes regulated prescription weight-loss medicines with identifiable approval information from foods marketed as coffee, candy, plums or meal replacements with rapid-loss promises, and warns about undeclared pharmacologically active ingredients. The original source records a 412 access error when trying to open national regulator document 432 of 2010 and therefore cites a provincial regulator's account instead. That is a source-recorded access limitation, not a new access check by RecheckNest.

Original source bibliography (titles retained as supplied): James WPT et al. (2010). Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects. NEJM. https://doi.org/10.1056/NEJMoa1003114；天津市市场监督管理委员会. 警惕部分食品中违法添加「盐酸西布曲明」和「酚酞」. https://scjg.tj.gov.cn/tjsscjdglwyh_52651/hdpt/cjwtyxfts/202007/t20200720_2972549.html