Imported Compounded Diet Pill Use Among Brazilian Women Immigrants in the United States

Abstract

In Brazil, compounded diet pills that combine amphetamines, benzodiazepines, antidepressants, diuretics and laxatives are often prescribed. In 2006, the Food and Drug Administration banned their sale in the United States (US) citing substantial safety concerns. This study evaluates the prevalence of, and factors associated with, use of these pills among Brazilian immigrant women aged 18-50. Pill use was assessed at one clinic and two churches using an anonymous survey (n = 307). While living in the US, 18% of clinic respondents and 9% of church respondents reported using these diet pills. Nearly two thirds of pill users reported adverse effects. In multivariate logistic regression analysis, being unmarried, college educated, dissatisfied with current weight, and advised by a US physician to lose weight were associated with greater odds of imported diet pill use. To enhance care of Brazilian immigrants, US physicians should become familiar with the health consequences of imported diet pills from Brazil.

Imported Fenproporex-based Diet Pills from Brazil: A Report of Two Cases

“…23, 24 In one study, two-thirds of diet pill users experienced side effects, most commonly insomnia, anxiety, palpitations, fatigue and nausea/vomiting. 7 In addition to a case report of severe abdominal pain in the US, 8 case reports from Spain have described the association of these compounded diet pills with hyperthyroidism, 25 hypokalemia, 26 and syncope. 26 An additional concern is that compounded diet pills might not include the medications that they are reported to contain.…”

“…2 In fact, the international availability of fenproporex, combined with Internet sales and other illicit markets, has led to its distribution within the US. [6][7][8] In Europe and South America untested amphetamines have been combined with multiple prescription medications to create potentially hazardous diet pills. 9,10 Physicians prescribe these diet pills which often combine fenproporex with benzodiazepines, selective serotonin reuptake inhibitors, diuretics, laxatives, thyroid hormones and other substances.…”

“…9,10 One study documented that 18% of young immigrant Brazilian women visiting a primary care practice had used these compounded diet pills while they were living in the US. 7 Given their availability in the US, the FDA has issued a warning regarding the use of fenproporex-based compounded diet pills. 6 Despite the FDA warning, little is known regarding the harm these diet pills cause individuals in the US.…”

Bariatric Endoscopy

“…Of signi fi cance, physicians should be aware that two compounded supplements with reported weight-loss effects are being imported from Brazil. These supplements, Emagrece Sim (also known as the Brazilian diet pill) and Herbathin dietary supplement, have been shown to contain prescription drugs, including amphetamines, benzodiazepines, and fl uoxetine [ 116 ] . There is an FDA warning against their use in the United States [ 117 ] .…”

Screening for Schistosoma mansoni and Strongyloides stercoralis Infection Among Brazilian Immigrants in the United States

“…We conducted a retrospective chart review of a quality improvement initiative implemented at a community health center clinic located in Somerville, Massachusetts that is part of an integrated academic, public healthcare system. Over half of the clinic's patients are Brazilian immigrants [ 4 , 5 ]. The primary objective was to determine the prevalence of, and factors associated with, Schistosoma and S. stercoralis seropositivity in this population.…”