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COPYRIGHT 2004 All rights reserved. Reproduced by permission of The Condé Nast Publications Inc.
One day last September, as Britney Spears was about to board a flight to Los Angeles from London, a rectangular blue bottle fell out of her purse. She quickly stuffed it back in, but not before the paparazzi recorded the event. Neither Spears nor her spokesman was willing to comment on the contents of the bottle, but the next morning London's Daily Express published a page of pictures under the headline "exclusive: pop princess spotted at airport with pot of slimming tablets." Spears was apparently carrying Zantrex-3, one of the most popular weight-loss supplements currently sold in the United States. The pill, which retails at about fifty dollars for a month's supply, contains a huge dose of caffeine, some green tea, and three common South American herbs that also act as stimulants. It hit the U.S. market last March and has had a success that would be hard to overstate. Millions of bottles have been sold, and during the Christmas season it was displayed in the windows of the nation's largest chain of vitamin shops, G.N.C. (It is so highly sought after that many of the stores keep it in locked cabinets.) Zantrex-3 is also sold at CVS, Rite Aid, Wal-Mart, and other chains, and over the telephone and on the Internet. If you type "Zantrex" into Google, more than a hundred thousand citations will appear. At any moment, there are scores of people auctioning the stuff on eBay.
Perhaps the most interesting element of Zantrex-3's success story, however, is that it is far from unique. There are hundreds of similar products on the market today, and they are bought by millions of Americans. And though Zantrex's manufacturer makes some heady claims ("the most advanced weight control compound period"), so do the people who sell Stacker 2 and Anorex (whose publicity assures us that the "genetic link" to obesity means that repeated diet failure is "not your fault"), along with those who sell Carb Eliminator and Fat Eliminator. Almost all of these compounds suggest that they can help people lose weight and regain lost vigor, and often without diet, exercise, or any other effort.
The diet-pill business may be the most visible segment of the vitamin-, mineral-, and herbal-supplement industry, but it is by no means the largest. Thousands of different tablets, elixirs, potions, and pills are sold in the United States, and remarkably little is known about most of them. That doesn't deter consumers. Since 1994, when Congress passed a law that deregulated the supplement industry and opened it to a flood of new products, the use of largely unproved herbal remedies--from blueberry extract for impaired vision to saw palmetto for the treatment of enlarged prostates and echinacea to prevent colds--has increased as rapidly as the use of any commonly prescribed drug.
Since that legislation, the Dietary Supplement Health and Education Act, became law, companies have been able to say nearly anything they want about the potential health benefits of what they sell. As long as they don't blatantly lie or claim to have a cure for a specific disease, such as cancer, diabetes, or aids, they can assert--without providing evidence--that a product is designed to support a healthy heart (CardiAll, for example), protect cells from damage (Liverite), or improve the function of a compromised immune system (Resist). There are almost no standards that regulate how the pills are made, and they receive almost no scrutiny once they are, so consumers never truly know what they are getting. Companies are not required to prove that products are effective, or even safe, before they are put on the market.
Still, there is more to the growing reliance on supplements than the lapses of a single law: Americans long ago wearied of taking doctors' orders, and, increasingly, they are skeptical about the motives of big pharmaceutical companies. People want to feel in control of their own health. Supplements, with their "natural" connotations and cultivated image of self-reliance, let them do that. There is even a word to describe all the things--other than plain food--that people consume in the pursuit of health: nutraceutical.
Nutraceuticals are found everywhere today, in foods fortified with "extra" vitamins, in sports drinks, in "enriched" water, and now even in candy. Six out of ten adults in the United States take one or more supplements each day. Often, these include multivitamins, which are frequently recommended by physicians, but a staggering number of amino acids, weight-loss cures, and herbal tonics are also swallowed every day, all in the belief that they will improve health, fend off disease, or make up for dietary and behavioral habits that have placed obesity and indolence among the leading health problems facing the United States. Last year, Americans spent nineteen billion dollars on dietary supplements--nearly five times as much as they did just a decade ago. And they spent that money on everything from Vitamin C to garlic (the uses of which vary, with benefits that are never clear), from kava (which the F.D.A. says may cause severe liver damage but which is still widely available in health-food stores as a remedy for stress) to comfrey (an herb of dubious value commonly used to quell irritated stomachs), and even ephedra, which the federal government only recently decided to ban, despite reports over the last eight years implicating it in scores of deaths and hundreds of strokes, seizures, and other severe maladies.
"For many people, this whole thing is about much more than taking their vitamins," Loren D. Israelsen, the executive director of the Utah Natural Products Alliance, and a principal architect of the 1994 legislation, told me not long ago. "This is really a belief system, almost a religion. Americans believe they have the right to address their health problems in the way that seems most useful to them. Often, that means supplements. When the public senses that the government is trying to limit its access to this kind of thing, it always reacts with remarkable anger--people are even willing to shoulder a rifle over it. They are ready to believe anything if it brings them a little hope." Frequently, such products come veiled in a cloak of science. Ads for Zantrex-3, for example, claim that its "superior power is validated by a direct comparison of published medical studies . . . scientific fact . . . irrefutable clinical data." The people who sell the pills on the telephone don't rely on science at all, however, when they tell callers that the capsules in those blue bottles could change their lives.
"When I train salespeople, I say to them, 'Do you know what people are calling you for? It isn't the pill. They are calling you for hope. That is really what they want from you,' " Don Atkinson, who is the vice-president of sales for Basic Research, the privately held conglomerate that distributes Zantrex-3, told me recently. I spoke with him in his office in Salt Lake City, which regards itself as the Silicon Valley of the dietary-supplement industry. Atkinson, a hearty and engaging man with a graying buzz cut and a firm handshake, slowly wrote the word "hope" on a lined piece of paper soon after I came in. "The customer has been overweight for years. And they have tried everything. And they have been on Atkins and everything else and nothing has worked. And some of these people are so incapacitated by their weight and their problems associated with it that they would like to die. Just wish they could just die. And they dial up and they are unhappy people. And they think, O.K., if I take this and it doesn't work it's further evidence that I am a failure. Our job is to give them hope. To say, 'You know what? You can do this.' " Atkinson...
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