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Nearly one in 10 adolescents across the globe have used a nonprescription weight-loss product, according to a systematic review and meta-analysis.

Across 90 studies, 8.9% of children and adolescents reported using a nonprescription drug or dietary supplement for weight loss at least once in their lifetime, while 4.4% used a product in the past month and 2% used one in the past week, found Natasha Yvonne Hall, PharmB, MHE, of the School of Public and Preventive Health in Melbourne, Australia, and colleagues in .

Use of these "ineffective and potentially harmful nonprescribed weight-loss products" increased in recent years, the researchers wrote. When they restricted studies to only those published prior to the year 2000, the lifetime prevalence was 5.1%, but that increased to 10.3% for studies conducted after 2000 and to 13% after 2010.

"Nonprescribed weight-loss products in children are not medically recommended for healthy weight maintenance as they do not work, are dangerous, are associated with unhealthful weight gain in adulthood, and increase the risk of being diagnosed with an eating disorder within several years of onset of use," Hall and co-authors underscored. Prior research has linked childhood use of nonprescribed weight-loss products with a slew of harmful outcomes like low , , and .

In the current analysis, lifetime prevalence of diet pill use was the highest at 6.0%, followed by use of laxatives (4.0%) and diuretics (2.0%) -- which Hall's group said was "concerning because of the mental and physical health risks associated with the use of these medical products that are not indicated for weight loss but are often used as weight-loss products."

Across the board, nonprescription weight-loss product use was significantly higher among girls than boys (lifetime prevalence of 9.5% vs 3.2%). Calling this a "public health concern," Hall's group referenced the link between use of weight-loss products with girls who have "low self-esteem, parental influence to lose weight or parental dissatisfaction with weight, self-body dissatisfaction, peer groups who value thinness, and media or social media influences promoting unrealistic beauty standards."

The meta-analysis, which included studies from North America, Asia, and Europe, also found use of these products was significantly higher among North American adolescents. " replicated this result and reported that unhealthy weight control behaviors were more common in North American adolescents compared with European adolescents," they noted.

Hall's group called it "alarming" just how easily children and adolescents can get their hands on these nonprescription weight-loss products -- all without a healthcare provider's orders and without restrictions or regulations. They said this "emphasizes the need for increased regulation and restriction to be placed on nonprescription weight-loss products, especially for individuals 18 years or younger."

For the meta-analysis, Hall's group pulled 90 articles with data on 604,552 unique participants from 25 different countries and six different continents. A little over half of the studies were from North America. All studies were restricted to those that reported prevalence data on use of nonprescription weight-loss products, included individuals 18 years or younger, and were published in English. Study publication dates ranged from 1985 to 2023.

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