Legislation in the state of New York that would have restricted minors’ access to dietary supplements for weight loss and muscle building died this week.
While the New York state Senate recently passed S16D, the legislature adjourned Thursday morning before the state assembly debated or voted on the companion bill: A431.
A similar state bill in the California Legislature recently floundered as well, becoming a two-year bill that cannot move forward until 2022.
However, bills introduced in Massachusetts remain alive that would impose restrictions on energy drinks and supplements for weight loss and muscle building.
In New York, S16D would have prohibited the sale of an over-the-counter (OTC) diet pill or supplement for weight loss or muscle building to minors unless a health care provider prescribes or authorizes such pills or supplements. The state health department—in consultation with state and federal agencies and relevant stakeholders including the “eating disorders community”—would be responsible for determining which OTC diet pills or supplements for weight loss or muscle building should be subject to the prohibition.
Grassroots campaigns opposing legislation
Thanks to a grassroots campaign spearheaded by the Natural Products Association (NPA), close to 3,000 emails were sent to lawmakers in opposition to the bill, including 1,000 this week, according to Kyle Turk, director of government affairs with NPA.
“They’re not used to getting thousands of emails on an issue, especially when it’s supposed to be non-objectionable,” said Dan Fabricant, Ph.D., president and CEO of NPA, in an interview. “That’s what turned the tides on this.”
In California, state lawmakers also received a mountain of calls in opposition to legislation that would prohibit retail establishments from selling dietary supplements marketed for weight loss or OTC diet pills to anyone under the age of 18.
In an April 26 email to Turk, a staff member for California state Assemblywoman Lorena Gonzalez asked whether he knew who was organizing phone calls to the lawmaker’s office in opposition to the weight loss bill, AB 1341.
“We really can’t handle the volume of calls given our work-from-home situation (Google Voice can only do one call at a time), and it means we can’t pick up calls from constituents with issues like EDD [Employment Development Department] problems that are really dire,” Laurel Brodzinsky, legislative director for Gonzalez, wrote to Turk. “I understand the desire to lobby, but if there’s anything we can do to decrease the volume, it would really be appreciated!”
NPA’s grassroots campaign in California, Turk said, resulted in 5,388 emails and 5,500 phone calls to the state legislature in opposition to the bill.
AB 1341 recently became a “two-year bill,” meaning it cannot move forward until 2022, according to the American Herbal Products Association (AHPA). In a newsletter last month, AHPA explained the bill “must move forward with a vote of the full state assembly early in 2022, or its passage will fail.”
Reasons for opposition to bills
Industry representatives have vigorously opposed bills introduced in state legislatures on opposite coasts of the U.S. to restrict access to weight loss and muscle building supplements.
New York’s legislation “only punishes brick and mortar,” Fabricant said. “We asked everybody, ‘Is there a specific ingredient that’s a problem? Is there a specific product that’s a problem?’ And to have a bill where basically everything’s on double secret probation and … the eating disorder people are going to decide the fate of what stays on the market, what doesn’t, is crazy. Where else can that happen?”
The Council for Responsible Nutrition (CRN) said it opposed the bills in New York since their introduction, participated in grassroots activities, reached out to state lawmakers and worked with on-the-ground lobbyists to convey its concerns regarding the proposal.
New York’s “proposal would have needlessly restricted access to safe and beneficial products that may help consumers meet their fitness and weight goals without any scientific or legal basis to do so,” Julia Gustafson, vice president of government relations with CRN, maintained.
“Simultaneously, the bill would also place unreasonable compliance and economic burdens on retailers that may dissuade them from selling these products/ingredients at all,” she said in a statement.
Concerns related to eating disorders, illegal ingredients
New York state Sen. Shelley Mayer, who introduced the bill to restrict access to weight loss supplements, hasn't given up on the legislation.
“Important consumer protection bills often take time to be enacted," she said in a statement. "As chair of the Education Committee, I feel a strong commitment to ensuring our children’s health and well-being in and out of the classroom. We are confident our bill is smart, well drafted and will address unhealthy weight control behaviors and eating disorders affecting teens. We look forward to continuing to press ahead for passage in both houses next year.”
Mayer also explained her support for the bill in a recent interview with Natural Products Insider.
Young people face pressure to be thin and fit—pressures that have only grown thanks to social media, she said. But Mayer said the impact of diet pills on young people is unknown, and “the state has a public health interest in ensuring they’re not sold to children under 18.”
Mayer said she has an open-door policy and heard from industry groups opposed to the bill.
“I have a fundamental disagreement with them, and I think they’re out of touch with what’s happening on social media,” she said, distinguishing traditional advertising when she was a kid from promotions in the modern age via social media platforms like TikTok.
A memo from Mayer on the bill characterizes eating disorders as "a serious public health problem affecting youth and adults of all races, ages and genders."
"Eating disorders are diagnosed based on a number of criteria, including the presence of what clinicians call unhealthy weight control behaviors (UWCBs)," the memo stated. "One UWCB of particular concern is the use of pills or powders to lose weight or build muscle, which are often sold as dietary supplements. Although they are sold alongside multivitamins and other supplements largely regarded as safe, these products often contain unlisted, illegal pharmaceutical ingredients that pose serious risks."
Critics and advocates of the weight loss supplements bills have argued whether research demonstrates an association between diet products and people suffering from an eating disorder. But advocates also have pointed to research showing the presence of harmful ingredients in products marketed for weight loss or muscle building.
Industry trade groups have responded dietary supplements are subject to comprehensive federal regulations, as well as enforcement by FDA and FTC. The state bills, however, underscore concerns by some state lawmakers and others that federal oversight isn’t sufficient to protect minors from products marketed for weight loss or muscle building.
S. Bryn Austin is director of the Strategic Training Initiative for the Prevention of Eating Disorders, or STRIPED, a graduate-level training initiative based at the Harvard T.H. Chan School of Public Health and Boston Children’s Hospital. She has supported state bills to impose age restrictions on supplements marketed for weight loss and muscle building.
These supplements “have come up again and again in rigorous research showing that regulation at the federal level just is not getting the job done in terms of protecting consumers and protecting child health,” Austin said in an interview. “[Coming] from the perspective of public health and child health, we’re very concerned about children using products like this knowing that … they can be so harmful.”
In testimony last month in favor of California’s AB 1341, Jason Nagata, M.D., assistant professor of pediatrics at University of California, San Francisco (UCSF), said research has found many weight loss supplements are tainted with such substances as stimulants, steroids and prescription drugs. “Rigorous” studies, he added, have shown such weight loss products “pose serious health risks to consumers.”
Weight loss supplements, Mayer suggested in the interview, pose “direct health risks” and have exacerbated a “fixation on weight.”