BOSTON — No one picked up on her struggle with her eating disorder, not even after she was hospitalized for the first time weighing 92 pounds.
“My mom didn’t know,” Kristy McMillan said. “My mom would give me money to grab stuff at the pharmacy and I would use the money for diet pills. My eating disorder was my secret for a long time.”
The Belmont resident, now a nurse at Boston Children’s Hospital, struggled for 21 years with an eating disorder that she believes started when she was 15 and in high school. Her life came to revolve around the numbers on the scale, the size of her clothing, the diet pills, the diet drinks and the need to restrict when she did eat. “I was obsessed. I didn’t care what it took to lose weight,” she said.
Not even when she suffered from irregular heartbeats, fainting spells, abnormal EKGs and cardiac episodes that were so frequent she routinely collapsed into unconsciousness while working, not the repeated hospitalizations and not when she miscarried because her heart could not sustain a pregnancy.
“My eating disorder robbed me of my ability to carry my own child, robbed me of that experience,” McMillan said.
As an adolescent and young adult, McMillan had easy access to diet pills, diet drinks and supplements that proport to burn calories, burn fat, promote weight loss and promise miraculous results in days. She used them all, restricted when she needed to, purged when she couldn’t and exercised obsessively.
That easy access in Massachusetts could end with a bill filed by Rep. Kay Khan, D-Newton. The state legislator has been championing children’s issues throughout her political career and turned her attention to the multibillion-dollar weight-loss supplement industry nine years ago.
Pre-teens, adolescents targeted through social media
Khan found children are more and more frequently targeted by the industry. The substances are often touted and sold on social media platforms. They are endorsed by influencers, with the unrealistic images posted on sites linked with the products.
Khan’s bill would make it more difficult for young people to access the weight-control substances and supplements that promise to build muscle or increase strength by restricting sales to people over 18. The lawmaker’s proposal would take the supplements off the open shelves of grocery stores, big box outlets and pharmacies, and put them behind the counter.
Calls to CVS, Walgreens and GNC for comment on the proposed legislation were not immediately returned.
Other substances, such as tobacco products and pseudoephedrine, the active ingredient in decongestants and allergy medications, have already been relegated to controlled sales.
“I have been filing this legislation since 2015,” Khan said of the proposal; however, she has changed her tactics since she first filed the bill. Realizing that she could not purge the substances from Massachusetts, she instead sought to control their sale and protect youngsters under 18.
“I got a lot of pushback from the producers of these substances,” Khan said, adding that when she modified the proposal to restrict sales rather than ban them outright in Massachusetts, the opposition calmed. “It’s a billion-dollar industry.”
The legislator, who plans to retire at the end of the session, organized a special legislative briefing Tuesday to encourage her colleagues to pass the measure and get it to the governor’s desk.
New York legislators enacted a similar legislation that went into effect in April and affects both brick-and-mortar stores and online sales. If passed in Massachusetts, enforcing the sales restrictions would fall under the auspices of Attorney General Andrea Campbell. A Brandeis University study pegged the implementation costs of moving the products behind the counter at $47,536.
According to the Fact.MR, a market research company, Americans spend $33 billion a year on weight loss products including diet pills.
Prescription meds not affected by legislation
The proposed legislation does not affect the prescription weight-loss products designed to treat adults with type 2 diabetes but are often prescribed off-label for weight loss. It pertains to items labeled as supplements that claim weight loss or fat-burning properties. or muscle and strength-building properties.
The jury is still out on whether the supplement products are effective, according to a report compiled by the U.S. Government Accountability Office. According to the report, “little is known whether they are effective, but some supplements have been associated with the potential for physical harm.” The report found myriad products available as caplets, tablets, liquids, powders and bars.
The report, referenced by the National Institutes of Health with the U.S. Department of Health & Human Services, found the products to be expensive and that ingredients can interact and interfere with medications taken for health reasons.
Even without unintended interactions between the supplements and medications, the substances can be harmful. On the list of supplements published by the National Institutes of Health, several that contain caffeine or other amphetamine-like substances such as bitter orange, guarana, kola nut and yerba mate were found to contribute to heart palpitations, elevated blood pressure and tachycardia.
The Food and Drug Administration does not regulate supplements in the same way it regulates medications; there is no vetting of products or clinical trials. “In almost all cases,” according to the government website, “additional research is needed to fully understand the safety and/or efficacy of a particular ingredient.”
Bryn Austin, a professor at Chan School of Public Health at Harvard and Harvard Medical School, said the use of the substances has been linked to heart attacks, strokes, kidney and liver damage, and even death.
“Many of the supplements were found laced with banned substances, found to contain anabolic steroids and stimulants not intended for human consumption,” Austin said. The professor told the legislators that the Department of Defense has banned both diet and protein supplements in the armed services because their use has been linked to noncombat deaths of deployed soldiers.
“Any 12-year-old can go into the supermarket, can go into a pharmacy and buy the same supplements the Department of Defense said were too dangerous for its recruits to use,” Austin said.
Dr. Greg Hagan, a pediatric specialist with the Cambridge Health Alliance, likened the supplements to tobacco “except no one thought that tobacco was safe.”
Not just girls
Boston University sophomore Stanley Huang told his story at the briefing, informing the legislators that his eating disorder started when he was in high school and was fueled by social media.
“I started noticing my body, my appearance,” Huang said, adding he compared what he saw in the mirror to what he saw on social media and found he failed to measure up. He started running cross-country, logging 40 miles a week, stopped eating and started using diet pills and protein supplements to approximate what he saw on social media.
“The pain of hunger did not compare to my feelings of inadequacy,” Huang said.
McMillan has been in recovery for seven years.
“I didn’t realize how much my life revolved around pills, diet products and being thin,” she said. It was the total exhaustion she felt every night after a day at work and studying for an advanced degree that had her questioning her life as she sat in her pajamas in bed every night. That’s when the change came and she sought help.
“My daughter would come in and sit on the bed to do her homework,” McMillan said, explaining she and her husband adopted the youngster. “I realized I was not the mother I wanted to be, not living the life I wanted to have. The eating disorder was draining energy from me; it was impacting me and my family. It was not the way I wanted to raise my daughter.”
