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. 2025 Jan 22;3(1):qxaf002.
doi: 10.1093/haschl/qxaf002. eCollection 2025 Jan.

Economic and equity evaluation of age restrictions on over-the-counter diet pills and muscle-building supplements

Cynthia A Tschampl  1 , Masami Tabata-Kelly  1 , Mary R Lee  2   3 , Elena Soranno  1 , Upanita Barman  4 , Amanda Raffoul  5 , S Bryn Austin  6   7   8
Affiliations

Economic and equity evaluation of age restrictions on over-the-counter diet pills and muscle-building supplements

Cynthia A Tschampl et al. Health Aff Sch. .

Abstract

Over-the-counter diet pills and muscle-building supplements are linked to increased eating disorder diagnoses, especially among youth. With limited regulatory oversight, minors may unknowingly consume harmful substances leading to other adverse effects. Massachusetts has proposed restricting sales to individuals under 18 years. However, concerns about health equity and unintended consequences arise when proposing new policies. We conducted a cost-effectiveness analysis of the proposed age-restriction policy compared to the status quo, focusing on 2 closed cohorts of males and females aged 0-17 years in Massachusetts over a 30-year time horizon. We evaluated the impact from both societal and health systems' perspectives and further assessed equity implications by modeling 3 racial/ethnic subgroups. The policy is projected to prevent 57 034 eating disorder cases and over 46 000 additional adverse medical events (eg, liver injuries). It would yield 51 749 quality-adjusted life years and generate healthcare savings of $14 million and societal savings of $30 million annually. The Latine subpopulation would see the highest per capita health benefits followed by Black and White residents, respectively. Restricting the sale of these supplements to minors offers both health and economic benefits. These findings underscore the policy's effectiveness, fiscal responsibility, and positive equity impacts, providing confidence for policymakers and the public.

Keywords: adolescent health; adverse medical events; cost-effectiveness analysis; diet pills; distributional cost-effectiveness analysis; eating disorders; economic evaluation; health equity; health policy; muscle-building supplements; prevention; public health policy.

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Conflict of interest statement

Conflicts of interest: Please see ICMJE form(s) for author conflicts of interest. These have been provided as supplementary materials.

Figures

Figure 1.
Figure 1.
Logic model for the current study. Source: Authors’ summary.
Figure 2.
Figure 2.
Health and economic gains related to the age-restriction policy on 3 racial/ethnic subgroups. Source: Authors’ analysis.
See this image and copyright information in PMC

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