Are laxatives the 'budget Ozempic'? Doctors warn about weight-loss trend

Laxatives are not a weight-loss aid, but doctors worry some people are still not getting the message — especially as they look for cheaper, more accessible alternatives to weight-loss drugs like Wegovy and Zepbound.

Almost 1 in 10 adolescents have used "ineffective and potentially harmful" nonprescribed weight-loss products such as laxatives, diuretics and diet pills, researchers reported in JAMA Network Open in January 2024.

The use of weight-loss products happens "at high levels in adolescents, especially girls," and can have long-term health consequences, they conclude.

The meta-analysis included 90 studies with more than 604,000 participants around the world.

Some people have been treating laxatives like a “budget Ozempic,” The Wall Street Journal reported in September 2023, a reference to the blockbuster Type 2 diabetes drug many Americans are using off-label for weight loss.

That may be one reason there’s been a high demand for over-the-counter laxatives. Other possible reasons include an aging population, sedentary lifestyles, less healthy diets and people taking more medications, which can contribute to constipation, NBC News reported.

In September 2023, a spokesperson for the pharmaceutical company Sanofi told NBC News that the company was seeing “unprecedented demand” for its Dulcolax products to the point “some retailers temporarily may not have certain Dulcolax products on their shelves.”

Using laxatives to try to lose weight is not a new phenomenon — doctors say people, often young women, have been doing it for a long time — but it may be gaining new attention on social media platforms.

Experts from the American College of Gastroenterology strongly warn against the practice.

“You should never conflate laxatives with weight loss. Laxatives are not intended for weight loss. Don’t even go there,” Dr. William Chey, chief of the division of gastroenterology and hepatology at the University of Michigan, tells TODAY.com.

“It’s not a safe way to lose weight, and it’s also not a long-lasting way to lose weight,” adds Dr. Lin Chang, vice-chief of the division of digestive diseases at UCLA.

The National Eating Disorders Association calls laxative abuse — defined as frequent use of the products to lose weight — “serious and dangerous.”

Can laxatives help with weight loss?

Laxatives can cause you to lose a little weight — a few pounds at most — in the short term by causing you to pass the stool that’s in your body, Chey says. Taking excessive amounts of laxatives leads to diarrhea and the loss of fluids.

“So really what you’re losing is stool and water weight, which is not real weight loss,” he notes.

“Maybe their belly will feel flatter,” but it’s temporary and the weight will come back in a few days as the person rehydrates, Chang says.

It might feel like you've had a very satisfying bowel movement, but you're not losing weight, said Dr. Roshini Raj, a gastroenterologist and clinical associate professor at the NYU Grossman School of Medicine, in a TODAY segment that aired Jan. 17, 2024.

"The only thing you're losing is water and electrolytes, and those are both very important things," Raj warned. "Abusing laxatives in this way is potentially quite harmful and doesn't give you any benefit of true weight loss."

At standard doses, laxatives don’t stop the body from absorbing of food, fat and calories. To get that effect, you’d have to take such a big dose that it induces diarrhea, which is potentially dangerous, the experts warn.

What are the dangers of using laxatives for weight loss?

Taking laxatives to the point where you’re having significant diarrhea can cause dehydration and throw off the electrolytes in your body, the doctors say. Symptoms include dizziness, lightheadedness, blurred vision and tingling in the feet or hands.

“It’s not safe to have electrolyte disturbances, particularly for people who have heart disease, for example,” Chang says. “That’s (from) more excessive use. But I know people will do that — they’ll do excessive use of things to lose weight.”

A person who takes so many laxatives that they’re no longer absorbing nutrients could potentially become malnourished, Chey says. An early sign of that would be a deficiency in fat-soluble vitamins such as A, D and K.

“When you induce a lot of diarrhea, you basically just flush those through and you don’t give the body a chance to absorb them,” he notes.

There’s also the potential of laxative dependency with some products. People can build a tolerance and have to keep raising the dose. Chang has had patients who had to take 17 or 30 tablets to have a bowel movement.

She’s also observed that people who take laxatives because they want to lose weight can develop constipation symptoms.

Will laxatives help with belly fat?

No, laxatives will not help with belly fat, Chang says.

What are the best natural laxatives?

Eating two kiwifruits a day improves constipation and abdominal comfort, a study published in The American Journal of Gastroenterology 2023 found.

Other fruits, such as peaches, plums, cherries and apples, can have a laxative effect, Chey noted. Chang also advised eating five prunes a day.

Bottom line: Fiber in the diet, exercise and hydration are important for regularity.

But you don’t have to have a bowel movement every day. Normal bowel frequency is anywhere between three times per week and three times per day, both experts say.

When is it appropriate to take a laxative?

Take it if you have constipation, which can mean different things to different people, Chang says. A simple definition is having fewer than three bowel movements per week or having difficulty evacuating stool, she notes.

If adding fiber to your diet, exercise and hydration don't relieve constipation, try osmotic laxatives, such as MiraLax, she advises. They cause water to be retained with the stool, softening it so it's easier to pass.

Stimulant laxatives, another type, stimulate the smooth muscle of the bowel to contract, but they often have more side effects, Chang notes.

Use a laxative just on occasion when you need it.

“Using the laxative now and again, it’s totally fine,” Chey says. “If you start to notice that you’re persistently being constipated and having to use laxatives on a regular basis, it’s time to see your doctor.”

This article was originally published on TODAY.com