Introduction The use of weight loss supplements is increasing, often driven by online marketing. However, many of these supplements are adulterated with undeclared pharmaceutical substances, potentially posing significant health risks. We investigated the presence of sibutramine and sildenafil in weight loss supplements and assessed the associated clinical outcomes. Materials and methods A total of 12 weight loss supplement samples (capsules, tea, and coffee bags) were analyzed using liquid chromatography-high resolution mass spectrometry. Demographic and clinical data were collected by the Marseille Regional Pharmacovigilance Centre from 29 patients who reported using these products. Results All samples were found to contain sibutramine, with concentrations ranging from 7.5 mg to 15.4 mg per unit. Sildenafil was detected in all samples, with concentrations ranging from 1.7 mg to 4.8 mg per unit. Clinical data from 29 users showed significant weight loss, with an average of 7.5 kg after 37 days of use. Adverse effects included anorexia (n = 15), tachycardia (n = 13), insomnia (n = 2) and chest pain (n = 4). In some cases, more serious effects such as seizures and dependence were observed. Discussion Both sibutramine and sildenafil were withdrawn from the market due to cardiovascular risks. As such, the unregulated use of these products pose a serious risk to public health, particularly in individuals with underlying cardiovascular disease. Conclusion We detected sibutramine and sildenafil in all 12 weight loss supplements tested, which highlights the need for stricter regulation and monitoring.
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