The report notes that in research investigating supplement use within adolescents, the key motivations involved maintaining or improving overall health, as well as to improving performance, rather than for weight loss purposes.
The authors additionally note the importance of supplements within treatment and recovery plans for patient’s suffering from eating disorders.
“Organizations advocating for policies to limit the ability of young people to purchase dietary supplements have stated that dietary supplements independently increase the risk of developing an eating disorder. This conjecture contradicts the evidence base and undermines the critical need for prevention and treatment strategies driven by evidence-based guidelines,” the report states.
The author of the review, Dr Susan Hewlings emphasised in a recent interview with the Council for Responsible Nutrition: “In order to truly address eating disorders, we need to address the fact that it is a multidimensional, complex issue. You have to look at the literature on the risk factors, which again is connected to the prevention. Because in order to prevent something you have understand risk factors.”
Causes of eating disorders
Eating disorders are a complex and highly prevalent (exist in 1-3% of adolescents) group of conditions, with multifactorial causes.
It has been noted these often occur in combination with psychological conditions including mood and anxiety disorders. In addition, genetic and environmental risk factors have an impact.
Focussing on one causal behaviour has been a common approach previously, yet the multidimensional nature of the condition makes this an inevitably poor method, the report states.
The review sought to investigate the literature for evidence-backed risk factors associated with eating disorders, including the apparent link between dietary supplements and their occurrence.
Supplementation vs. medication
The review discusses the blurring line between supplements and “diet pills”, which may have led to the controversies surrounding the supposed link between supplements and eating disorders.
The epidemiological Monitoring the Future (MTF) study included the analysis of the use of “diet pills” within high school students. It discussed that their use is at the lowest ever levels reported; a finding described as a “positive development” due to their inclusion of phenylpropanolamine (PPA) which is now a banned over-the-counter medication.
The MTF study also specifically discussed dietary supplements, highlighting an increased use of creatine in 10th and 12th graders, attributed to an increased interest in weight training during the pandemic as opposed to weight loss purposes.
Further data obtained from the National Health and Nutrition Examination Survey (NHANES), published in 2020, found that one third of the children and teenagers took a dietary supplement in the 30 days leading up to the survey. Of these, 17.3% had taken a multivitamin, 5.4% had taken vitamin D, and 4.2% had taken vitamin C, with weight loss supplements not appearing the most frequently consumed category.
The authors conclude the collated evidence highlights the lack of clear evidence to support the advocated policies to limit supplement use in young people, with the report stressing: “Basing policy recommendations on poorly designed research, which includes non-validated surveys that do not accurately classify dietary supplements, is problematic and irresponsible.”
The team emphasise that such suggested restrictions to dietary supplement access would actively contradict advice provided by professional health organisations, which specialise in the treatment of such disorders.
Hewlings tells Nutraingredients: “To focus on any one thing stands in the way of the multidimensional comprehensive efforts that research suggests are required to appropriately address this global public health concern.
“We need to continue to communicate the science and research regarding eating disorder risk factors and etiology and evaluate effective prevention efforts. Eating disorders are complex and multidimensional and therefore require education and awareness from multiple disciplines.”
“Eating Disorders and Dietary Supplements: A Review of the Science”
by Susan J. Hewlings