After Fen-Phen


What is called the Fen-Phen drug therapy regimen was highly effective in promoting weight loss and control in its users, but the makers of fenfluramine pulled the drug off the market after it was linked to heart valve problems. Dieters off the drugs have had their weight soar again.

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The loss of two wildly popular weight-loss pills has left many physicians, patients and drugmakers scrambling to find safe and effective alternatives

MARGE FRIEL HAS NEVER had much luck with diets. “I can lose weight,” she says, “but keeping it off is more difficult. I lose my motivation.” Fen-phen changed that. The 48-year-old secretary started taking the popular drug combination two years ago as part of a University of Pennsylvania weight-loss program that also included counseling. The weight on her 5-foot-7-inch frame fell from 230 pounds to 160–and as long as she took her pills, it stayed there. But when Friel’s doctors lowered her dose last winter to counter minor side effects, she promptly put on 15 pounds. She was still at 175 pounds in July, when researchers at the Mayo Clinic linked fenfluramine (the “fen” in fen-phen) to heart-valve abnormalities in two dozen patients. Concerned for her safety, Friel stopped taking the drugs altogether–and put on another 15 pounds in nine weeks. Her goal, for now, is to stay under 200, but she doubts she’ll succeed on her own, and she can’t help wondering whether she made the right decision. “It’s a trade-off,” she says. “I may be safer taking those drugs than I am being really, really heavy.”

Millions of dieters now face the same dilemma. Spooked by further reports of heart-valve trouble, the makers of fenfluramine (Pondimin) and dexfenfluramine (Redux) withdrew both blockbusters from the market last week. Though no one yet knows whether the drugs have actually harmed people, personal-injury lawyers are now suiting up for a litigation fest. Drugmakers, for their part, are racing to get other obesity treatments onto the market.. And some obesity specialists are touting a new Prozac-based concoction as a safe alternative to fen-phen. Health experts agree that the questions surrounding fenfluramine were serious enough to warrant drastic action. But the withdrawal could cause harm as well as good. “It’s a fiasco for patients who have lost weight and improved their health,” says Thomas Wadden, the psychologist who heads the University of Pennsylvania’s weight and eating-disorders program. “This potentially sets back obesity treatment many years.”


Redux and fenfluramine once seemed the answer to every dieter’s dream. Like Prozac, they boost the effects of the brain chemical serotoin, curbing cravings and promoting feelings of satiety. Fenfluramine hit the U.S. market in 1973, but sales took off only recently, after researchers found that the stimulant phentermine could offset the fatigue fenfluramine induced. The combination was never reviewed for safety, but as word spread that it could zap fat, millions of Americans wanted prescriptions, and their doctors complied. Redux, a purified fenfluramine with fewer side effects, swept the country when the FDA approved it last year (chart).

Until this summer, there was no reason to think the fenfluramines could affect people’s heart valves. As far as anyone knew, the drugs’ main hazard was a rare but deadly condition called primary pulmonary hypertension; untreated obesity posed greater risks than PPH, which affects only 18 to 46 of every million fenfluramine users. But the balance changed in July, when researchers started identifying fen-phen users with waxy deposits on their heart valves. Though that condition often goes unnoticed, it can keep the valves from dosing completely, compromising the heart’s ability to pump blood. Alarmed by the reports, the FDA asked five clinics to perform echocardiograms (sonographic images that show the inside of the heart at work) on patients who’d taken Pondimin or Redux. When 92 out of 291 tests revealed valve abnormalities, the agency concluded that the drugs “present an unacceptable risk at this time,” leaving the makers little choice but to pull them.

Despite that dramatic step, it’s not yet clear whether the drugs actually damage people’s hearts or, if so, how. Diseased valves are rare among healthy young adults, but they may be more common in obese adults than anyone had previously realized. The patients in the FDA’s survey didn’t get echocardiograms before starting treatment, so before-and-after comparisons were impossible. Most experts believe the drugs are somehow to blame, since serotonin-producing tumors sometimes cause similar damage, but the evidence is still circumstantial. In coming weeks, researchers at Mayo and nine other centers will perform echocardiograms on 1,200 obese patients–400 who used fen-phen, 400 who took Redux and 400 untreated controls–to narrow the search for a culprit.

Pondimin has been sold in 85 countries for 32 years, and Redux has been circulating for 12 years. If the drugs were routinely destroying hearts, the problem would not have gone unnoticed for this long. But that won’t keep people from suing. The Association of Trial Lawyers of America has already formed a 100-lawyer fen-phen group to press for damages. Paul Rheingold, the New York attorney who leads the group, accuses American Home Products (the conglomerate that makes Pondimin and distributes Redux) of failing to warn people of the drugs’ possible hazards. That could be a hard sell, unless it turns out that the company knew of the problem. “We had no evidence of it,” says Marc Deitch, global medical director for Wyeth-Ayerst Laboratories, the American Home Products subsidiary responsible for the two drugs. “In extensive clinical trials this problem never emerged.” The lawyers also plan to go after individual doctors, whom Rheingold accuses of prescribing the drugs carelessly.

Lawsuits aside, the withdrawal will cost American Home Products an estimated $200 million to $300 million–not that big a blow to a company with annual sales of $15 billion. Many small weight-loss clinics will fail without pills to peddle. But analysts predict that such stalwarts as Weight Watchers and Jenny Craig will thrive as people who have relied on medication resume their struggles with diet and exercise (in fact, running a sewing machine is the best way to lose your waist fat, you should read some sewing machine reviews on before purchasing one) . “I think the public will have a very broad reaction against diet pills,” says David Allen of Torrey Pines Securities, “and that is sure to affect enrollment.” The fenfluramine fiasco may also raise the bar for drugmakers seeking to market new obesity treatments. They’ll face extra scrutiny from regulators, says Bill Fiala, a healthcare analyst at Edward Jones. But with the fenfluramines out of the running, the potential jackpot is now “bigger than anyone anticipated.”

Several drugs are already in the works. The first in line is Knoll Pharmaceuticals’ Meridia (sibutramine), a compound that boosts serotonin less forcefully than the fenfluramines. The drug is now in the final stages of FDA review. A second candidate is Roche’s Xenical (orlistat), which promotes weight loss by reducing intestinal absorption of dietary fat. A 1998 air proval is possible. Other treatments are still at earlier stages of development. Scientists at Amgen Inc. and Millennium Pharmaceuticals are studying synthetic versions of leptin, a hormone that suppresses appetite when released by fat cells. Pfizer, meanwhile, is working on a drug that would block the action of neuropeptide-Y, a hormone that fosters feelings of hunger.

Any one of these drugs could be the next fen-phen, but some experts insist there is already a perfectly good alternative. They call it “phen-Pro,” for phentermine (the still-available appetite suppressant) and–you guessed it–Prozac. As a serotonin booster, Prozac can help diminish food cravings, and experts agree that it’s not likely to damage heart valves, since it has a gentler effect on the serotonin system. Unlike fenfluramine, which forces cells to discharge more serotonin; Prozac and its cousins simply slow the removal of what cells have already released. None of these antidepressants has been approved as an obesity treatment, and many experts are leery of mixing them with phentermine. Eli Lilly, the maker of Prozac, says it has no plans even to study the phen-Pro combination. But since both drugs are already on the market, any doctor can prescribe them together. Dr. Michael Anchors, a clinical professor of medicine at Georgetown University and author of a new book called “Safer Than Phen-Fen,” has treated 620 severely obese patients with phen-Pro. All but 10 have achieved significant weight loss, according to a report published in the Archives of Internal Medicine last June, and none has suffered serious adverse reactions.


Is phen-Pro the next wave? Nutri/System, a chain with 500 diet centers, gave up on fen-phen and Redux last month, but some of its doctors are now writing prescriptions for phen-Pro. And if half of their customers succeed the way University of Wisconsin patient Wendy White has, they’re on to something big. The 45-year-old woman weighed 350 pounds when she started taking phen-Pro in June of 1996. Today she weighs in at 160. “I’m constantly hungry without these drugs,” she says, “but they make it possible for me to succeed. They’ve saved my life.” White is dismayed by the fenfluramine story–not because the drugs posed a hidden risk but because they were withdrawn so abruptly. Weighing 350 pounds can damage a lot more than your heart valves, she says. “And if the treatment killed me, at least I would fit in my coffin.”

Diet Pills: Risky Reduction

Phentermine and Pondimin (fenfluramine) were approved by the FDA decades ago, Redux (dexfenfluramine) in 1996. They seemed like quick fixes for the overweight–until this summer.

July 8 Mayo Clinic reports valvular heart disease in 24 fen-phen users. The FDA issues an advisory to 700,000 doctors and clinics, asking them to report new cases.

Aug. 27 Mayo Clinic and Wyeth-Ayerst announce a study to investigate fen-phen and heart-valve disease.

Aug. 28 The FDA asks that prominent warnings be added to the drugs’ labeling.

Sept. 9 Florida sets a 90-day ban on dual fenfluramine-phentermine prescriptions.

Sept. 15 The FDA requests a voluntary recall of fenfluramine and dexfenfluramine, but not phentermine. Wyeth-Ayerst complies, immediately pulling Pondimin and Redux from the market.

>>> View more: Quack alert: detecting phony health claims: become a savvy consumer and learn to protect yourself from quacks

The weight is over: need to lose weight? Here are the healthiest strategies

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When Emily W. was 12, she hated going to school.

As a sixth grader in Glasgow, Mo., she was teased constantly for being overweight. “Most days I came home crying,” Emily told Current Health. Worse, her weight was affecting her health–she had high blood pressure.

Emily is not alone. More than 17 percent of children and teens in this country are overweight–more than three times the percentage in 1980, according to the National Center for Health Statistics. But that doesn’t mean teens should all look as skinny as Hollywood stars. “Bodies come in all shapes and sizes, and everybody has a weight that’s right for [him or her],” says Lorraine Mulvihill, a dietitian at the Lucile Packard Children’s Hospital Center for Adolescent Health in Mountain View, Calif.

Nevertheless, if you think you might be medically overweight, talk to your doctor. “Make sure your physician is agreeable to your losing weight,” says Dr. Robert Pretlow, a0 Seattle-based pediatrician and director of, a resource for overweight children, teens, and parents. Doctors can help set healthy and realistic weight loss goals.


Smart Eating

Emily was unhappy and knew it was time to change. She persuaded her mom to go with her to Weight Watchers, a program that helps overweight people learn healthy eating habits. (A young person over the age of 10 can join with a note from a doctor.)

As Emily learned, there is no magic pill or wonder diet for dropping pounds. A study of the National Weight Control Registry, a database of people who’ve lost at least 30 pounds and kept the weight off for at least a year, found that daily exercise as well as changes in diet were key. “The way to lose weight is simple: Burn more calories than you take in,” Pretlow says. Here’s how:

Avoid diet crazes. Diets that force you to cut out certain foods leave you feeling deprived and are almost guaranteed to fail. A recent study found that teens who dieted were three times more likely to be overweight five years later. “Diets don’t work, period,” says Mulvihill.

Eat a balanced regimen of food. All bodies–especially growing ones–need balanced nutrition to function well. A balanced diet includes carbohydrates, protein, and some fats. “Cutting out food groups is not an option,” stresses Mulvihill.

Eat only when you’re hungry. Learn to listen to your body, Mulvihill says. It will tell you when it’s hungry and when it’s full.

Enjoy your favorite treats … within reason. You can still eat chocolate or fries–just not every day. If you can’t resist a temptation, avoid it.

Beyond the Plate

Exercise is important for maintaining a healthy weight. Physical activity burns calories, speeds up metabolism, and helps the body process food more efficiently. Aim for at least 60 minutes of activity most days, but don’t overdo it. “Exercise shouldn’t be a punishment,” Mulvihill says.

Staying active can help you deal with food cravings too. When the munchies hit, distract yourself by playing with the dog, taking a walk, or practicing the drums. After a week or two, your busy body won’t miss that extra food.

Be sure to get enough food to fuel your body, though. If you eat too little, your body will think it’s starving and will hang on to every last calorie you swallow. Losing weight gradually is the most effective way to reach a healthy weight and stay there. Aim to lose no more than 1 to 3 pounds a week.

A New, Healthy You

Emily lost 70 pounds and has maintained her weight for four years. Today, at age 16, smart choices are just part of her routine. In fact, she can hardly remember the junk foods she used to snack on. “I was really determined, and I knew I wanted out of that lifestyle,” Emily says.

Anyone can be as successful as Emily by making a commitment to be healthy. “You have to want to do it for yourself,” she says. By modifying your choices and behavior, you’ll look great and, most important, feel even better.

LOSING IT: Success Story #1

Name, age: Andrea N., 15

Location: Houston

Weight lost: 35 pounds


Andrea started grocery shopping with her mom and reading nutrition labels to he more aware of the foods she was eating. Today she eats more fruits and vegetables, with treats now and then so she doesn’t feel deprived. For exercise, she runs, swims, and loves playing Dance Dance Revolution.


Andrea’s biggest challenge was overcoming the urge to snack. She admits it wasn’t always easy–but the adjustments she made have been worth it. Andrea’s best advice to others seeking to lose weight:

‘Fad diets don’t work long term. There are absolutely no shortcuts.’


Success Story #2

Name, age: Liz M., 16

Location: Jacksonville, Ra.

Weight lost: 35 pounds


Liz was active as a soccer player but was also an “avid snacker,” she says. She cut out sweets and junk foods and took up dancing. “I thought giving up soda would be the hardest thing;’ she says, but it turned out to be an easy way of cutting calories.


Liz says she couldn’t have done it without her family’s help. They agreed to keep junk foods out of the house. Now Liz goes out for an occasional milk shake but doesn’t snack on sweets every day. Her advice:

‘It was two to three weeks before I started seeing results. Stay motivated, and don’t give up.’


Success Story #3

Name, age: Trevor N., 17

Location: Pittsburgh

Weight lost: 40 pounds


Trevor got diet and exercise advice in a program at the Weight Management and Wellness Center at the Children’s Hospital of Pittsburgh. Before, Trevor spent a lot of time sitting in front of the TV, and he ate fast food three times a week. Now he runs, lifts weights, and plays basketball. He keeps his portion sizes in check, eats more vegetables, and avoids fast foods.



Start slow, Trevor says. He began by walking for the first two weeks and then upgraded to a jog. Now Trevor enjoys exercise. “It’s hard at the beginning. But when you lose weight, it’s a good feeling, and you want to keep losing more until you’re where you want to be,” he says. Trevor adds:

‘You’ve got to make it an everyday routine’

Small Changes,


Whether you want to lose a lot of weight or just a couple of pounds, these healthy common-sense tips are easy to fit into your everyday routine.

[check] Cut out sodas, juices, and sugary sports drinks, which are full of calories. Replacing one soft drink per day with low-fat milk or water can help you lose 15 pounds in a year!

[check] Watch food portions. When eating out, cut your food servings in half, and save the rest for another meal. For the 411 on portion sizes, visit

[check] Try to make healthy choices, such as fruits. vegetables, pretzels, and granola bars instead of ice cream, chips, and cookies.

[check] Stay on track with your family’s support. Ask them to stock the cupboards with healthy fare.

[check] A healthy, fiber-filled breakfast, such as whole-grain cereal with fruit, will fill you up and keep you satisfied until lunch.

[check] Spend less time sitting. Clean your room or walk the dog to burn more calories.

[check] You don’t have to hit the gym to get exercise. Dance, swim, run, hike, go rock climbing-find activities you enjoy.

[check] Team up with a friend to lose weight. You can help each other choose healthy foods and find fun ways of being active together.


* According to the National Weight Control Registry, what two practices help people maintain weight loss? (exercising daily and making permanent adjustments to eating habits)

* What strategies did Emily and other teens mentioned in the article use to lose weight healthily? (joining a weight-loss program, cutting back on junk food, getting more exercise, watching portion sizes, eating healthier foods, reading nutrition labels, allowing occasional treats)

* What other ideas do you have for teens who want to lose weight in healthy ways? (Answers will vary.)


What’s the difference between a weightloss diet and a healthy way of eating? Success, according to nutrition experts. Have students bring in advertisements for various diet plans and products. In a class discussion, show them how to dissect the ads’ claims. In addition, have them compare the diets’ methods with the tips and strategies mentioned in the article. Based on those comparisons, do the students believe that the diets will produce safe and lasting weight loss ?


Students can get tips and advice and chat with other teens about losing weight at

The National Weight Control Registry ( enrolls only people age 18 and older. It is, however, a good source of ideas and information for students.

The TeensHealth Web site has further advice for losing weight in a healthy way: fitness/dieting/lose_weight_safely.html.

A Village Romance Comes to Town [opinion]

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Byline: Sekai Nzenza

Jun 06, 2012 (The Herald/All Africa Global Media via COMTEX) — It’s a late afternoon in Mbare, and I am visiting my cousins Piri and Esina.

We are sitting on the small veranda of this two roomed house on a busy street.

Not too far away from here is the Rufaro Stadium where Bob Marley played the “Peace has come to Zimbabwe” song when he came to celebrate independence with us in 1980. Misheki, Piri’s husband has also just arrived to visit his wife. We gave him the only chair in the house because he is the man around here.

The chair has a broken back and it is missing half the stuffing from the seat. He has perched half his bottom on the cushioned part of the seat.


Since leaving the village three months ago, Misheki and Piri have not lived together due to lack of accommodation in Harare.

Piri is sharing this one bedroom house with Esina and another tenant, a young man who is hardly here because he imports dry fish, matemba, from Mozambique into Zimbabwe.

He pays US$50 rent for the room that is really meant to be a kitchen. Esina’s mother used to own this house but she has since relocated to the village because she said the city was no place for an old woman like her.

It’s a brick house, built sometime in the 1920’s when African men were coming to work in Salisbury. The house was built for a bachelor because the Rhodesian government said African women had no reason to come to town.

All the old houses along this street from the main bar to Rufaro stadium are one bedroomed bachelor flats with a kitchen.

Further down the street are communal bathrooms and toilets.

They are clean, because the City Council is very particular about the spread of diseases like cholera and typhoid.

Last time there was an outbreak of diarrhoea and vomiting here, many donors came in big trucks and gave the people clean water.

Since then, the City Council has employed more people to clean the toilets and communal showers daily. Because the population continues to increase, the City Council is building another communal washroom and toilets about twenty metres from Esina’s house. This means she will stop using the bucket as a toilet, kurasa mvura, at night because the new toilet will be a lot closer and also quite a distance away from the all night shebeen drinkers.

There is noisy everywhere; people talking, shouting, arguing, children crying or laughing and music blurring from several radios or music systems.

The music and radio noise will die out when the electricity goes but it will come back again soon as the power comes back. People walk past us all the time and some of them say “masikati” to us because they know Esina.

An argument has erupted between Piri and her husband Misheki.

After three months of unemployment and without a fixed place to stay Misheki has come to take Piri home. He plans to board the village bus and return to the village where he hopes their romance will be rekindled as husband and wife again.

The city has not worked for them.

What was the point of being married when Piri was living here without him, sharing a bed with Esina, a single woman?

Besides, it was not proper for two women to lie there together, on the double bed shielded away from the young male tenant’s room by just a wardrobe.

The temptation to do what was not proper could easily come from both sides.

Piri is all dressed up to go to her new job selling alcohol illegally. She is wearing a lacy white African outfit with another lacy wraparound cloth, accentuating her bottom very nicely. Her wig is just short enough and it sits so perfectly on her head.

It looks like real hair. Her face is light from the new skin lightening creams coming out of Zambia and the Democratic Republic of Congo.

There is no need to be dark skinned anymore, chekumirira hapana,” Piri had told me earlier when I commended on how light skinned she had become.

Piri sits impatiently on a bucket that is turned upside down. In front of her is a big basket covered with an African cloth.

Inside are twenty four bottles of punch, the illegal spirit smuggled from Mozambique. Each bottle has two hundred and seventy five millilitres of clear liquid which looks like gin.

On the label is a picture of a white blonde woman wearing a singlet and gloves posing like she is doing kick boxing.

The punch. Her picture is juxtaposed on top of the map of Africa. The bottle is labelled 47 percent alcohol and everything on it is written in Portuguese. In her handbag, Piri is also carrying twelve bottles of Zed, another illegal collection of alcohol, also imported from Mozambique.

Misheki says he no longer drinks Punch or Zed because just one bottle for a dollar can work on your brain so quickly.

The Mozambican stuff has different effects on people and that is why the Zimbabwean police have banned it here.

Within minutes, it changes your mood to dancing, talking nonsense, or you can become verbally or physically violent.

Some people have died from it because they drink more than two bottles without diluting and also without eating anything.

You are killing people and destroying families by selling this ‘get me drunk quick“, type of cheap illegal alcohol.

Stop it and let us go home,” Misheki begs Piri.

She calmly reminds him that it was village poverty and a very bad harvest that caused them to return to town and look for work in the first place.

Why would I go back to village misery and hunger when I can make ten dollars per day from selling these bottles?” she asks him.

They go on arguing for a while and Esina and I do not interfere.

We both know that when couples fight, outsiders should not be involved because the next day, the same couple will reconcile and you will be seen as the enemy.

Pleading his case, Misheki tells us that back in the village his uncle Josiya, the one who owned the fertile garden by the river was dead and since he did not have a son, the property now belonged to Misheki.

He would take Piri back to the village to work in the garden, grow vegetables, beans, tomatoes, onions and sweet potatoes for consumption or for sale.


They would never be hungry again and will no longer wait for the rains or stand in line for donor food handouts because all-year-round, the rich black soil was going to give them something back.

But Piri would not hear of it. “Look at me now. Nyatsonditarisa.

“Can you see these hands, this outfit, and this head, going back to the smoke of the village hut, going back to the mud in the garden and ferrying buckets to water the vegetables.

You are joking. Unotamba iwe! Not me. I have done that and that time is over.”

Since I am Piri’s older cousin, Misheki says it is just fortuitous that I happen to have come to Mbare to be his mediator.

Please Maiguru, tell your sister that her house in the village is still standing. Tell her that the city is no place for a good woman these days, especially a woman who sells illegal alcohol to men.”

The half sneer on Piri’s face tells me that I would be wasting my time to convince her to change her mind.

My cousin Piri fell in love with Misheki on the day they met on the village bus from Harare a few years ago.

They were both running away from the Operation Murambatsvina, the clean-up Harare campaign. It was love at first sight. Within a few weeks, they were living together as husband and wife.

Misheki was so happy to have found a good village wife. His mother did not accept a daughter-in-law who had been married before with children and worse still, who was older than her son.

Misheki ignored his mother’s disapproval and insisted that he loved Piri. His mother was furious, “What is love? You want to spend the whole day eating love? Look at our poverty. Leave this woman alone and go back to town to look for work.”

The village romance between Misheki and Piri continued to blossom.

Throughout the rainy season, they were seen in the field plowing, sowing, weeding and laughing together. They lived on very little and were nourished by love. Until they harvested very little in three consecutive seasons. Then they left the village and moved to the city three months ago.

Tell her that my love for her has not changed since the day we met on the village bus and I bought her Fanta and buns,” Misheki appealed to Esina for help.

Rather than sympathise with him, Esina and Piri laughed with sarcasm.

That is when I realised that Esina was happy to have a companion with an income in her house. Then Esina said, “Babamunini Misheki, keep on looking for a job. It is not a good thing for a man not to have money while his wife has money.

Without money, no compromise can be made in any marriage. Hapana dhiri.” Piri stands up, yawns and adjusts her wig and says to Esina, “Now you are talking.

Tell your Babamunini that he should make more money than I am making. When that happens, I will take him back. This is Harare.”

Piri shakes Misheki’s hand first then mine. She turns to me and says, “Sis, I have seen you.Ndakuonai. Let me go to work. Kundima kwangu.”

Piri grabs her basket, touches Misheki slightly on the shoulder and walks away. We watch her wiggle her backside and disappear through the Mbare crowd, the men playing pool at the shebeen turn their heads to look at her.

We used to live on love. But the city does not like love without money. Money first, then love,” Misheki says, shaking his head sadly.

Esina and I look at each other and say nothing. There is nothing to say.

Hopefully Piri will come back or perhaps, Misheki will find another village romance. One should never give up hope on love.

Dr Sekai Nzenza is a writer and cultural critic. She holds a PhD in International Relations and is a consultant and director of The Simukai Development Project.

Copyright The Herald. Distributed by AllAfrica Global Media (

Black Is Beautiful – Why Bleach?

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Byline: Peninah Asiimwe

Mar 12, 2013 (Rwanda Focus/All Africa Global Media via COMTEX) — Whoever said a light complexion was tantamount to beauty must be held accountable for the many bleached skins in the world. Most ladies – and quite a few men too – have gone crazy applying skin lightening creams and swallowing pills which have had negative effects on their health. This is all in the name of beauty!

Most ladies will confess to having thought of bleaching at one point or the other. Some want to as a way of curing acne which leaves behind among other things dark spots and blemishes but this is minimal. Most ladies bleach to change their skin complexion from dark to light so as to look prettier.


But some people blame women’s urge to bleach on racial stereotypes that used to elevate white skin above black. This created self-hate and low self-esteem because the blacks felt they couldn’t get the best treatment because of their color and so they tried by all means to change it. During Apartheid in South Africa, for instance, coloreds would receive better treatment like whites and yet they were actually not white.

However, some change their skin colour to seek attention. That is mainly the case with stars like models, musicians, actors and actresses in their bid to stand out from the crowd.

So should you bleach?

Dermatologists agree it is not advisable for one to bleach their skin regardless of the reasons. The major content in all cosmetic bleaching creams is hydroquinone and mercury, which are very dangerous and toxic to one’s health. According to question-and-answer website Askville, hydroquinone is an agent that bleaches the skin. It blocks enzyme reactions that occur in the skin cells and slows down the creation of melanin from which the colour of the skin is derived.


According to experts, these substances are capable of leading to kidney failure, high blood pressure, diabetes, cancer and even death. If something goes wrong in the process of lightening the skin, the side effects are dangerous. One’s skin could get permanent freckle-like dark spots for good. They could look burnt and dark usually after painfully turning red.

In fact some countries in Europe and the USA have banned the usage of hydroquinone. Uganda and Tanzania did likewise and have regularly confiscated products containing this dangerous substance that illegally make their way into the country through unscrupulous businessmen.

Copyright Rwanda Focus. Distributed by AllAfrica Global Media (

Quack alert: detecting phony health claims: become a savvy consumer and learn to protect yourself from quacks

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Lose weight while you sleep!” This same “health discovery” product also promises to build muscles quicker, heal wounds faster, reduce the amount of sleep needed, improve memory, tighten skin, strengthen bones, and even grow back hair. “The list truly goes on and on,” reads the ad.

Sound too good to be true? It is. Yet this real spam E-mail–and thousands of other ads through television, radio, magazines, and Web sites–push unproven and even unsafe health products.

To spot scams, you need a healthy dose of skepticism and the following information.

Buyer, Beware!

Quackery is the promotion of unproven health products and treatments without a scientifically sound basis. It can include deliberate lies, as well as “sincere” but misinformed and mistaken practices, notes Stephen Barrett, M.D. He operates the Quackwatch Web site, which catalogs dozens of examples of dubious “cures.”

Either way, quacks stand to make money from gullible consumers. And you can’t assume that something wouldn’t be sold if it didn’t work.

A lot of consumers think a product wouldn’t be on the market if it wasn’t safe,” says American Dietetic Association spokesperson Cynthia Sass at the University of Southern Florida. “That’s not necessarily true.”


Consider a drink or pill sold as a dietary supplement, for example. Because supplements generally don’t need Food and Drug Administration (FDA) approval, manufacturers don’t have to prove they’re safe and effective. To a large degree, what goes into the product is up to the manufacturer.

The Federal Trade Commission (FTC) forbids false and misleading advertising. State governments license health care providers and have their own laws against fraud too. Yet, no government agency screens ads for truthfulness before consumers see them. And the government simply doesn’t have the resources to review all published ads for tens of thousands of products.

As a result, consumers cannot assume that anyone has reviewed or approved any particular ad or product, warns FTC attorney Richard Cleland. “Consumers have to judge for themselves,” he says.

The legal term for that is caveat emptor. Or in plain English, “Buyer beware.”

Why Quackery Sells

Many people simply don’t question what they read, hear, or see in the media. They are too trusting. Some consumers also feel overconfident. They doubt anyone will dupe them, so they don’t question claims closely.

Other people want to be different. They like the idea of “natural” health products versus conventional medicines, even though “natural” products can also pose risks. Or people may rebel against the “medical establishment.”

Other people feel desperate. Bombarded by media images of rail-thin models and buff actors with rock-hard abs, many teens may already have a poor body image. Ads touting miracle weight loss or overnight muscle-building milk this vulnerability for all it’s worth.

People with certain diseases are especially vulnerable. Bogus treatments for sexually transmitted diseases, cancer, and other illnesses appeal to people desperate for relief. They want to believe there’s a magic fix out there. Unfortunately, many diseases have no known cures–just treatments to ease symptoms or slow their progress.

Fear fuels quackery too. After the September 11 attacks in 2001, companies promoted products such as home test kits for anthrax. After outbreaks of SARS (severe acute respiratory syndrome), scam artists promised protection against the deadly virus with masks, personal air purifiers, sprays, and supplements. None of the products was proven to work.

What’s the Harm?

The amount of health fraud is hard to estimate,” says the FTC’s Cleland. “But in all likelihood, it is in the tens of billions of dollars per year.” That includes everything from bogus arthritis and cancer cures to weight-loss gimmicks, bodybuilding promotions, and breast-enhancement cons. “The magnitude of the problem is pretty overwhelming at times,” says Cleland.

Quackery costs more than money. Real health is at stake. “You have a lot of products out there that no one has ever tested for safety,” notes Cleland. “No one knows for sure what’s in the products. And when we do know what’s in some of the products, we cringe.”

For example, various weight-loss products contain ephedra or other stimulants. “These can kill people,” says Cleland. Other products, like breast-enhancement creams, may contain chemicals that affect the body’s hormone balance. No one knows the long-term effects of such products on adults, let alone maturing teens.

Beyond this, quackery victims may delay getting the treatment they need for serious medical conditions. While cancer patients pursue bogus treatments, the disease can spread throughout their bodies. Likewise, HIV-positive people who rely on unapproved test kits or herbal treatments may delay getting accepted medicines to manage the disease. While the incurable virus progresses, they risk infecting other people too.

Get the Facts

Your first line of defense against quackery is reliable health information. Keep up with health news by reading articles from mainstream magazines and newspapers’ science reporters. Don’t rely on ads in back pages of magazines.

As seen on TV” isn’t reliable either. Nor can you trust infomercials. Both cable and broadcast channels want to sell airtime, and quacks are often willing to pay the ad rates. Legitimate news broadcast can provide useful information, but you should still check things out further.

The Internet contains both reliable and questionable health information. How can you tell the difference?

When you go on-line, make sure you go to a credible site,” says Sass. Some search engines let you limit results to .gov, .org, or .edu domains. Generally speaking, government Web sites, universities, major medical centers, and mainstream health organizations are credible. They’re not trying to bias or sway you. Rather, they give facts so you can make an informed decision.

If someone’s trying to sell you something, that’s where you open your eyes and your ears a little bit more,” says Sass. Be wary of Web sites that sell health care products. Be doubly suspicious of spam, or junk E-mail.

Talk to people in the know too. Your doctor, the local health clinic, or your school’s sports trainer can answer many questions. Talk with your parents too.

Be Critical

Learn to spot the red flags in quack come-ons. With practice, you can start to spot the scams.

* Bogus Breakthroughs. One Internet supplement ad promised “an entirely new way to rid yourself of those unwanted pounds!” With no diets, no exercise, and no dangerous side effects, the ad touts weight losses up to 8 pounds per week.

When you see such ads, do a reality check. If there were such a thing, wouldn’t it have made headlines in the mainstream media? “The only proven way to lose weight,” says the FDA, “is either to reduce the number of calories you eat or to increase the number of calories you burn off through exercise.” Crash diets or fad diets can be dangerous or lead to “rebound” weight gain.

* Quick Fixes. Quacks know you’d love to build muscles, increase breast size, eliminate acne, or make other changes overnight without effort. That’s why ads offer incredible results in just weeks or even days. But such promises mean nothing–the product doesn’t work. Real life doesn’t offer quick fixes.

* Jumbled Jargon. Quacks often use meaningless medical jargon to lure customers. But techno-babble like “thermogenesis” doesn’t really mean anything.

Other terms disguise a product’s real nature. One “scientifically formulated” weight-loss supplement would also “cleanse your body” of “unhealthy toxins and fat.” Translation: The product could cause severe diarrhea. That’s not only painful, but also potentially dangerous.

* Tacky Testimonials. “My strength is surreal! This must be a dream.” Some quacks make up phony testimonials from “satisfied customers.” But even if this praise came from a real person, you can’t trust it. (Indeed, if fine print says results are “not typical,” does that mean most customers are not satisfied?)

Isolated anecdotes don’t prove anything. Because teen boys naturally gain weight and muscle, any growth while taking a supplement may be just a coincidence. Likewise, a girl’s breasts may get bigger because she’s maturing, not because of any enlargement product.

Wishful thinking plays a role too. In many studies, as many as one-third of the patients report feeling better, even if they only took sugar pills, or placebos. That’s why scientifically accepted treatments rely on controlled, double-blind tests done with sufficiently large population samples. Researchers need to know if a medicine performs significantly better than a placebo.

* Laundry Lists. Can one product really relieve low-back pain, soothe dry skin, awaken sleeping hair follicles, ease arthritis, and reduce the risk of heart attack? Emu oil, colloidal silver, DHEA (a hormone supplement), and Cat’s Claw (an herbal product) are just a few products promoted as miracle cure-ails. In the real world, however, no one product treats everything.


* Guaranteed! Quacks figure most customers will be too embarrassed to admit they were duped and demand their money back. Other customers may realize only too late that the Internet ad provided no real-world address or that a post office box is no longer used. What good is a money-back guarantee if no one can ever collect?

Fine Print. Some ads’ disclaimers say proper diet and exercise are needed either to lose weight or build muscle. Of course, if someone were already doing that, they probably wouldn’t need the product.

Many ads also note that their statements have not been evaluated by the FDA, and that the product is not intended to treat any disease or condition. If no one has proven that the product works or is even safe, why should you rely on an ad’s puffed-up promises?

* “All-Natural.” “Natural” doesn’t necessarily mean safe. Some herbs can have serious side effects. Others trigger allergies or interact with prescription medicines. Indeed, natural supplements often carry no warnings and have not been tested in controlled laboratory settings. Their manufacturing has been subject to less rigorous standards than those for FDA-approved drugs.

Also watch out for products with added vitamins or minerals. Too much of some elements may be toxic or cause unfortunate side effects.

* Time-tested. Folk remedies may have been around a long time, but that doesn’t mean they necessarily work. They may just reflect old superstitions.

* Goofy Gadgets and Gimmicks. One breast-enlargement “system” features a “unique patented vacuum pump” that resembles a torture chamber device. Another Web site touts hypnosis to bolster breast size.

What You Can Do

What if you’ve been burned by a bogus health care claim? Your safety comes first.

“If a teen has any kind of adverse event after taking a product, he or she should immediately contact a physician or the poison control center in the area,” says Cleland. “It’s only by collecting these adverse events that we can get a good picture of the safety profile of some of these products.” Such reporting can help the government get dangerous products off the market.

Beyond that, report the incident to your state attorney general’s office or the FTC. “To file an on-line complaint, all you need to do is go to,” says Cleland.

With quackery, as with other health issues, prevention is the best medicine. Remember that anything that sounds too good to be true can’t be for real.

Keep asking questions and become a savvy health care consumer. After all, a healthy dose of skepticism is exactly what you need to protect yourself from quacks’ hyped-up claims.

No Prescription?

“Prescription Drugs Prescribed On-line and Shipped Overnight to Your Door! No Prior Prescription Necessary!” Just fill in the on-line form, and–presto–an unknown doctor will write the prescription without any physical exam.

Some on-line pharmacies offer weight-loss drugs, antidepressants, and even addictive tranquilizers with no physical exam. Some Web sites even offer drugs that haven’t been approved for use in the United States.

If a company doesn’t care whether a real doctor has examined you, why should it care if you suffer serious side effects from a medicine? Why should it care whether products are genuine, sanitary, or even legal?

Legitimate pharmacies require a real prescription from a licensed doctor who has actually examined you. Any pharmacy that tries to sell you a different story is a prescription for trouble.

Quack Contraptions

Goofy gadgets and gimmicks have been around for ages. That’s why Bob McCoy began The Questionable Medical Device Collection, which is now at the Science Museum of Minnesota. The McGregor Rejuvenator promised to make people younger. The Phrenology Machine supposedly diagnosed personality from bumps on the head. The Normalizer shook people’s backsides to make them lose weight. The Stimulator’s electric shock supposedly made hair grow. Yes, these sound silly. Yet people still let themselves get conned by quacks.


Students will be able to recognize common techniques used to manipulate consumer thinking regarding health care products. Students will be able to make comparisons of products by examining ads.


* What is meant by the term quackery? (Quackery is the promotion of unproven products and treatments without a scientifically accepted basis. It can include outright lies or sincere but misinformed and mistaken practices.)

* How can nutritional supplements be especially easy for a company to promote–whether they work or not? (Dietary supplements are not regulated by the Food and Drug Administration, and therefore manufacturers do not have to prove that they are safe and effective.)

* Is it reasonable for the consumer to feel assured that products are effective as advertised? (Government agencies scrutinize advertisements for false and misleading marketing of products. However, freedom of the press actually protects many advertisements for questionable products from censorship. Not all products can be screened, so the consumer must always beware.)

* Explain why quackery sells as well as it does. (Naive consumers may accept what they read, hear, or see in the media without questioning it. They may feel that they are so intelligent or well-informed that they cannot be duped by an ad. Some consumers may choose a product because it is outside the mainstream of medical therapies, fashionable, or simply unconventional. People with self-image problems and/or certain diseases may be more vulnerable to advertising claims.)

* How can a person’s decision to use quack products and services cause harm? (Quackery wastes consumers’ money, delays pursuit of more reliable approaches to their disease or problem, and/or may cause harmful side effects.)


1. Discuss and list with your class examples of mind-sets of consumers (“If it’s ‘natural,’ it must be safe.”) and individual health or psychological situations in which they might be easily convinced by fraudulent ads. The article will provide some answers, but students may offer examples from their own experience.

2. Have students complete a detailed critique of an ad for a nutritional supplement, weight-loss product, or other “questionable” product, and compare the ad to one for an FDA-approved drug such as Advil or Tylenol.


* The National Council Against Health Fraud is a nonprofit, tax-exempt voluntary health agency that focuses its attention upon health fraud, misinformation, and quackery as public health problems. Read about it at

* An excellent article was published in the November-December 1999 issue of the FDA Consumer magazine (Vol. 33, No. 6). It is titled “How to Spot Health Fraud” by Paula Kurtzweil. This and other quality, reader-friendly materials can be found on-line at or by subscribing at the same Web site.

* The Federal Trade Commission Web site offers many avenues for researching consumer fraud, at Readers can click on For Consumers for tips on a variety of topics. The “Do Not Call” registry is featured, as well as spam E-mail. The following Web page brings you a list of articles under Operation Cure-All ( conline/edcams/cureall/coninfo.htm).


Federal Trade Commission

Food and Drug Administration


www.Quackwatch. org