Common sense or overreach? California moves forward with ban on underage access to diet products

28 Jan 2022 --- California State Assembly has voted in favor of passing a bill banning the sale of dietary supplements for weight loss and over-the-counter (OTC) diet pills to people under the age of 18 without a prescription.

Bill AB1341 was passed with 53 votes in favor to 13 against and is slated to be heard by the State Senate this June. Provisions include a fine of up to US$1,000 per violation. The move has been met with powerful opposition from supplement associations who are mobilizing grassroots movements to urge officials to reject the proposal. 

The Council for Responsible Nutrition (CRN), the American Herbal Products Association, the Natural Products Association (NPA) and the National Association of Chain Drug Stores, all stated their opposition during proceedings. They cite issues such as the law being too broad and eventually leading youths to illegal means to obtain the supplements.

At the same time, the bill is heralded by supporters as a means to protect minors who are more vulnerable to developing eating disorders. It has the backing of the Strategic Training Initiative for the Prevention of Eating Disorders (Striped).

“This legislation offers a commonsense solution to protect our children by prohibiting the sale of supplements sold for weight loss to minors, just as we have done with other risky products like tobacco,” Bryn Austin, Striped director and professor specializing in social sciences and pediatrics at Harvard University and Boston Children’s Hospital, tells NutritionInsight. 

On the other hand, Daniel Fabricant, president and CEO of NPA, tells NutritionInsight: “This legislation targets legitimate businesses, especially small brick and mortar retailers, who would have to retrofit their stores and put popular products under lock and key.”Women are two times more likely to use weight loss supplements and OTC diet pills than men, legislators heard.

“Profits over people”
The bill was authored by Assemblymembers Cristina Garcia, Cecilia Aguiar-Curry and co-authored by Wendy Carrillo.

“We need to do more to protect our youth from the harmful effects that weight loss supplements and OTC diet pills have on our youth. With easy access, our youth are subject to eating disorders and many other health implications. We need to stand up to an industry that puts profit over people,” Garcia highlights.

Striped outlines that weight-loss supplements are three times more likely to cause severe medical injury than vitamins. Youth who use OTC pills are six times more likely to be diagnosed with an eating disorder within three years compared to non-users. 

“State lawmakers have the right and responsibility to protect consumers, especially children, from dangerous consumer products. This is a simple case of consumer protection 101,” Austin underscores.

Lax regulation?
The NPA, however, states it filed a Freedom of Information Act request with the US Food and Drug Administration (FDA) to determine if any association existed between dietary supplements and eating disorders. “There are no adverse events or reporting associated with dietary supplements and eating disorders,” the association says.

“We support vigorous enforcement of the law to protect consumers, but this proposal is unnecessary and will do nothing to protect public health,” Fabricant adds.

During readings of the bill, legislators heard that dietary supplements are not subject to approval or rigorous regulation by the FDA because they are treated more like food. A position paper recently called for more oversight powers to the FDA, claiming the US “flooded” with questionable quality supplements.

“The FDA has repeatedly exposed dietary supplement companies that deliberately break the law and intentionally deceive and endanger the lives of children by selling weight-loss supplements products that are illegally laced with banned and dangerous ingredients,” Austin states. 

Despite the FDA’s effort, this type of manufacturer behavior continues, she adds. 

“The FDA has linked weight-loss supplements with stroke, heart attack, liver damage, and even death. The CDC estimates that 23,000 Americans are sent to emergency rooms every year due to supplements, with fully a quarter due to the weight-loss category alone,” Austin says.The bill targets weight loss supplements and OTC pills.

‘Broad wording’
According to the bill, dietary supplements for weight loss and OTC pills are described as items which may include, but are not limited to, thermogens, lipotropics, hormones (including hormone modulators and hormone mimetics), appetite suppressants and ingredients deemed adulterated under Section 342 of Title 21 of the United States Code.

Depending on the outcome of the State Senate, the bill could come into force on July 1. The state public health department will ultimately be responsible for determining which products are subject to the bill’s restrictions.

“It leaves the process of identifying products up to stakeholders who have a limited background on dietary supplement law and regulation. As written, these stakeholders would have the authority to include many popular products that millions of Americans use safely every day,” Fabricant notes.

The bill also requires stores to keep the products behind the counter or in a locked case, requiring consumers to request them directly from a pharmacist, manager, or other supervisory personnel.

Fabricant states that the wording of the bill is too broad. “We share the concern for teenagers with eating disorders, but banning ingredients found in vitamin water, fruit smoothies and other common products in the grocery store is an overreach.” 

Prior to the assembly’s decision, Julia Gustafson, CRN’s vice president, government relations, told NutritionInsight that it “has voiced its concerns about the current legislative text to the bill sponsor, as well as offering testimony publicly at last year’s Assembly Health hearing.”

“We truly appreciate the sponsor’s willingness to discuss our concerns and look forward to further dialogue with Assemblymember Garcia as the bill works through the legislative process.”NPA’s campaign has generated 4,000 letters and 3,000 calls to elected officials in California.

Mobilizing opposition
Fabricant argues that the bill is an overreach. “This isn’t about market share, it is about stopping a bill that would limit access to popular products sold by responsible retailers while driving young people toward retailers on the dark web.”

“Obesity and poor nutrition are a significant problem in the US. These products have kept Californians healthy during these challenging times.” 

The NPA has been fighting against this proposal for several years in California and other states. Similar legislation is being considered in New York, New Jersey, Missouri, and Massachusetts, the association says.

“We need people to make their voices heard and tell elected officials to reject this misguided proposal.”

By Andria Kades