Drug abuse for weight loss

Abuse is the persistent or sporadic intentional overuse of a drug, resulting in harmful physical or psychological effects. Like drug and alcohol addiction, abuse is not uncommon. Abuse applies not only to prescription drugs but also to over-the-counter drugs. For example, diuretics and laxatives are available at every pharmacy and are often used for weight loss. Such irrational use of drugs, especially by women, often leads to negative physical health consequences and may contribute to eating patterns disorders and mental disorders. Today, we want to talk about several cases of drug abuse for weight loss based on research. Case reports were found by the DrugCard platform during local medical literature monitoring.

Take a look at how literature monitoring works in DrugCard.

A case of secondary gout after diuretic abuse

The DrugCard platform found an article in the «Ukrainian Journal of Rheumatology» describing a case of secondary gout due to chronic diuretic abuse. To reduce weight, the woman took furosemide every day at a dose of 40-80 mg/day for 6 years. For the first year, she lost 5-7 kg. She tried to lose weight using diuretics without medical supervision and continued to take 1-2 furosemide tablets daily to maintain her normal weight. The patient had no approved indication for such use and was not prescribed these medications. She used drugs in an off-label manner, relying on the active ingredients’ effects rather than clinical guidance. As a result of such irrational intake of diuretics, persistent hyperuricemia developed, affecting organ function. Later, tofus gout with a pronounced articular syndrome debuted. Tofus arthritis developed 2 years after the start of diuretics, progressed rapidly and led to the development of the severe articular syndrome.

Abuse of the diuretic hydrochlorothiazide for weight loss

In the “The Ukrainian Scientific Medical Youth Journal” the DrugCard platform found an article about a case of hypokalemia due to chronic abuse of hydrochlorothiazide. The woman came to the hospital with complaints of general weakness, lack of movement in the limbs, and hoarseness. According to relatives, she fell 2 days ago and injured her left arm and left half of her body. She took dexketoprofen and tolperisone to reduce pain. Also, she experienced an acute respiratory viral infection last week. Acute cerebrovascular accident was excluded after the CT scan. In the blood test – leukocytosis, hypokalemia. The ECG showed flattened T waves. Differential diagnosis was made between Guillain-Barré syndrome, myasthenic crisis and adverse effects of tolperisone. When the patient became contact, she reported an additional anamnesis. It turned out that during the last year the patient systematically took hydrochlorothiazide 25 mg once a day to reduce body weight.

Pharmacovigilance assessment of hydrochlorothiazide abuse case

The prevalence of information about various weight-loss methods hurts the general population’s health. One of these “folk” methods is to use hydrochlorothiazide, a thiazide diuretic. The pharmacodynamics of the drug explains the development of one of its side effects – hypokalemia, which may affect blood sugar and overall body processes. Hypokalemia is manifested by muscle weakness, paresis and paralysis in severe cases. Taking diuretic drugs for a long time without consulting a doctor can lead to serious complications and threatening conditions. Also, the woman took tolperisone to treat the injury in the previously mentioned case. This is considered off-label use because tolperisone, a centrally acting muscle relaxant, is indicated for the symptomatic treatment of muscle spasms associated with neurological diseases in adults.

Health Risks of Using Diuretics for Weight Loss

Diuretics, often referred to as “water pills,” are medications that help the body remove excess fluid and maintain fluid balance. They are commonly prescribed worldwide as part of treatment for high blood pressure. However, like all medications, diuretics must be used appropriately. Misuse or overuse can lead to serious health problems.

Excessive use may cause dehydration, disrupting organ function, body processes, and leading to cravings, muscle cramps, abnormal heart rhythms, and risk for complications. It can also affect fat intake, dietary fat, and normal metabolism where the body may store fat differently.

Long-term or inappropriate use disorders may place strain on the kidneys, increasing the risk of kidney dysfunction or even failure. In some cases, overreliance on diuretics can also cause fluctuations in blood pressure, including rebound hypertension, as the body attempts to compensate for fluid loss.

Multiple drug abuse for weight loss

In the journal “Reports of Vinnytsia National Medical University” the DrugCard platform identified a case report describing chronic laxative abuse for weight loss, leading to dependence and worsening eating habits and food behaviours. A young woman used stimulant laxatives (senna and bisacodyl) and later increased use of diuretics and enemas.

Over six months, she lost 26 kg but subsequently developed dependence, with severe constipation lasting up to two weeks when attempting discontinuation.

After several years, she developed facial and peripheral oedema and began self-medicating with furosemide. As its effect diminished, she increased the dose to achieve further weight loss. When oral laxatives became ineffective, she also used laxative enemas multiple times per week. Clinical improvement was achieved only after specialised proctological treatment.

Evaluation of a case of abuse of mixed drugs by pharmacovigilance

Very often, contact laxatives of natural or synthetic origin are used for weight loss. They are affordable, fast-acting, and available in a variety of dosage forms. Long-term, daily use can cause a gradual decrease in the effect. And this, in turn, leads to a specific lesion of the gastrointestinal tract, other organs and systems known as “laxative disease”. The described clinical case is interesting in that a young woman, against the background of prolonged abuse of laxatives, tried to refuse to take drugs. But due to the appearance of peripheral oedema, she began to use diuretic drugs on her own. During the examination, the daily furosemide dose reached 15 tablets (600 mg/day).

Long-term use led to “laxative disease” and increased dependence on drugs, including diuretics. The patient increased furosemide intake to high doses, demonstrating substance use, substance use disorders, and use disorder patterns.

Warning Signs and Clinical Indicators of Drug Misuse for Weight Loss

Signs of weight loss drugs abuse include misuse of prescription drugs, increasing dosage, and use without supervision. It may also include changes in appetite, abnormal calories intake, and reliance on suppressing appetite strategies. What may raise alarms:

• Taking prescription medications (such as diuretics or laxatives) without a doctor’s prescription
• Long-term medication use or increasing the dosage without supervision
• Constant fatigue, weakness, dizziness
• Stomach and digestive problems

More serious signs:

• Dehydration
• Decreased potassium levels in the blood
• Drop in blood pressure when standing
• Kidney problems (based on blood tests)
• Increased uric acid levels

In severe cases, the following may occur:

• Heart rhythm disturbances
• Muscle and nervous system problems
• Gout

It’s also important to pay attention to a person’s behaviour, as they may be very afraid of gaining weight. Or they may have a negative perception of their body and continue taking medications even if they are already causing side effects.

GVP requirements in case of drug abuse

Pharmacovigilance activities include identifying the off-label use of drugs, such as abuse and overdose. These cases highlight the importance of monitoring approved and non-approved uses, including oral Wegovy, GLP-1 receptor agonists, and other weight loss medications and obesity drugs. This, in particular, can be done during medical literature monitoring. After all, such use of drugs can lead to the development of adverse reactions. These clinical cases demonstrate the serious health consequences of self-medication and uncontrolled drug use for the purpose of losing weight. The abuse of drugs to reduce body weight requires the close attention of physicians, as well as pharmacovigilance specialists. PV documentation describes such cases (e.g., PSURs and ICSRs). In turn, we remind you that the pharmacovigilance platform DrugCard will always help you with literature searches for such cases. Using deep learning technologies, the platform continuously screens scientific medical literature and regulatory agency websites to deliver just-published articles.

Conclusion

Drug abuse for weight loss is becoming an increasingly common problem in medicine, especially when it comes to readily available medications such as diuretics and laxatives. People often mistakenly believe they can help them lose weight quickly and easily. For example, interest in “how much weight can you lose with furosemide” or “furosemide dose for weight loss” is based on a misunderstanding of how these medications work and widespread misinformation.

In fact, using such medications without medical supervision can lead to serious health problems. Sometimes these conditions can mimic other illnesses, leading to a delay in proper diagnosis. Proper nutrition, balanced meals, and structured addiction treatment are essential for people struggling with these issues.

Therefore, it is important to constantly monitor such cases and study them in medical practice and scientific literature. This helps to identify the problem of abuse early. It is also very important that doctors be attentive to such situations and that people receive more information about the risks of improper weight management.