The health community is spinning with worry about the fate of science and evidence-based medicine if Trump makes good on his promise to let Robert F. Kennedy Jr. “go wild” on the nation’s leading health agencies. Kennedy has rightly received widespread condemnation for his contradictory anti-vax and pro-ivermectin views. Many businesses operating in the health space are leery of Kennedy’s potential influence in a Trump administration, but there’s one that is likely gleeful about the prospects of a free pass from the feds: dietary supplements.
This concerns us because the dangers of dietary supplements, particularly those sold with false claims for weight loss and muscle building, are clear. This summer, yet another damning study came out warning the public about two liver toxins: green tea extract, a common ingredient in weight loss supplements, and ashwagandha, a common ingredient in muscle building supplements. Girls and young women using these products have nearly six times the risk of being diagnosed with an eating disorder within just a few years. Whether young people are using these products because they already have an undiagnosed eating disorder or are using them as part of a pattern of worsening symptoms that lead to an eating disorder, either way, sellers are profiting from the mental health struggles of children.
Just before the election, RFK Jr., who has no public health or medical training, posted on Elon Musk’s X platform his declaration of war against the Food and Drug Administration. He threatened: “FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma. If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags.”
We are particularly concerned that he highlighted nutraceuticals, a subtype of dietary supplement, and peptide hormones, a common adulterant in the dietary supplements sold for weight loss and muscle building, as advancing human health. Peptides can be extremely dangerous, are widely promoted on social media to young people, and are prohibited by both the U.S. Department of Defense for use by service members and by the World Anti-Doping Agency for use by competitive athletes.
In the absence of meaningful regulation from the FDA, the supplement industry will no doubt take Kennedy’s stance as a free pass to relentlessly promote its deceptive and predatory products. We recently published a study of TikTok videos promoting weight loss and muscle building supplements to young people, finding virtually none of the videos provided any scientific evidence that the products work — and almost none disclosed commercial sponsors.
This spring, New York became the first state in the U.S. to ban the sale of these supplements to children. This was a great victory for public health, led in part by a courageous group of teen advocates we work with.
We have high hopes that other states will follow suit, and in fact the New Jersey state Assembly recently passed similar legislation by a wide margin, sending the bill along to be taken up by the state Senate. Teams of teenagers and young adults in a half-dozen states are gearing up for the fight, and we’ll be right there with them, sharing the scientific data that these products are dangerous, ineffective, and exploitative. It should be a slam-dunk for policymakers.
But the supplements industry is wealthy and ruthless. Not only do they market their products with a menagerie of deceptive claims, but they are also flooding statehouses with disinformation and waging a full-out attack on scientific research and researchers like us. It’s the same playbook used by Big Tobacco and Big Sugar.
And it’s incumbent on all of us to recognize the tactics and be prepared to push back to protect our children’s health.
The weight loss supplement lobbyists are working to undermine sound science in three ways that might be particularly persuasive to a new Trump-era FDA.
1. Pushing pseudoscience
To give themselves a veneer of credibility, industry lobbying groups fund pseudoscience and financially conflicted studies without fully disclosing the studies’ ties with industry.
For instance, just as the science linking weight loss supplements to eating disorders in young people was gaining resonance with state lawmakers, the leading trade association for the industry — the inaptly named Council for Responsible Nutrition (CRN) — funded the writing of an article published in Nutrients by an author who is a business consultant to the supplements industry.
In defending the industry, this article makes the misleading claim that “dietary supplements are routinely used in the treatment of eating disorders.” It even refers to the use of dietary supplements as “standard of care” for eating disorders. In fact, the type of supplemental, calorie-dense nutritional supports used to help malnourished people gain weight are worlds apart from the weight loss and muscle building supplements that have raised so much concern with physicians and health scientists. Yet this article, published in a respectable-sounding journal, deliberately blurs the line.
And that’s not the only deception: The author of the Nutrients article declared no conflicts of interest. Yet in their own trade publication, HBW Insight, CRN let it slip that they funded the article, referring to it as a “third-party analysis of the literature funded by the CRN.”
In another example of pseudoscience proliferating, over 90% of the 72 randomized controlled trials evaluating the effects of dietary supplements on weight loss in the past five years had commercial funders, according to a study that our research group recently completed. It might not surprise you that 93% of those commercial funders either sold supplements themselves or their parent or subsidiary company did.
2. Deliberately blurring the facts
A seasoned Capitol Hill public health lobbyist once told one of us that when the opposition wants to keep the status quo, which usually means blocking new regulations on their industry, all they need to do is confuse lawmakers. When an industry can inject uncertainty in the minds of policymakers and the public about the harms linked with their products and make the science appear uncertain, the typical lawmaker response is inaction.
Well over a decade ago, “Merchants of Doubt” authors Naomi Oreskes and Erik Conway published a searing expose on exactly this strategy used by tobacco, fossil fuel, and other industries.
Toward this end, supplements industry mouthpieces persistently blur the line between dangerous dietary supplements sold with claims to lead to weight loss or muscle building and medically necessary nutritional supplementation for malnutrition due to eating disorders. That is exactly the tack taken by CRN’s article in Nutrients. The author seeks to conflate the two to make weight loss and muscle building supplements seem like important medical interventions. In fact, the American Academy of Pediatrics warns against young people using these products at all.
3. Undermining scientists who challenge industry
A prime example can be found in PricePlow, a self-identified media partner of Natural Products Association, which is another major lobbying association for the supplements industry.
The publication posted a fever dream of a piece, replete with dissembling claims that the industry is made up of “scientific, truth-seeking individuals … [who] strive to base our decisions around as much scientific rigor a possible” while lodging bizarre accusations against our research organization, the Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED). They insist we “have money-printer-level funding, with which they can run obscenely ridiculous studies, torturing the data until it confesses statistical lies, then have it published in basically any major journal.”
To be clear, STRIPED is a small academic research center with just a few part-time employees that relies primarily on grants totaling low six digits to stay afloat. PricePlow warned its readers, “The industry needs to take note, because this group is well-funded and they are seizing power over numerous regulatory affairs, removing consumer access to nutritional supplements in the process. The industry hasn’t seen anything quite like this, and frankly, it’s grossly unprepared for this level of warfare.”
This rhetoric may seem ludicrous, but it’s part of a pattern, and this industry is no stranger to conspiracy theorists. One of the most notorious: Alex Jones, who generated millions through dietary supplements sales to help bankroll his disinformation campaign against the parents of children murdered in the mass shooting at Sandy Hook Elementary School.
This industry has a lot of money to push its agenda. In 2019, American households spent over $2.5 billion on weight loss supplements, and industry forecasters estimate that by 2027 the sector will pull in $4 billion in annual revenue.
With the presidential election outcome, we could be looking at further erosion of any semblance of oversight of supplements on the federal level.
S. Bryn Austin, Sc.D., S.M., is a professor at Harvard T.H. Chan School of Public Health, Harvard Medical School, and Boston Children’s Hospital. She is the director of the Strategic Training Initiative for the Prevention of Eating Disorders: A Public Health Incubator (STRIPED). Amanda Raffoul, Ph.D., M.Sc., is assistant professor of nutritional sciences at University of Toronto and affiliated faculty with STRIPED.