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What is Apetamin? The dangerous ‘slim thick’ drug all over social media


TextAlex PetersIllustrationCallum Abbott

The unlicensed supplement promoted by social media influencers as a quick way to achieve an hourglass figure has been causing serious health consequences

Beauty ideals change with the times. The pressure on women to fit them never does. After decades of waif-thin bodies being held up as the pinnacle of beauty, Kardashian-esque curves are now the look to strive for, and women are going to extreme lengths to achieve it from undergoing the fat-grafting procedure Brazilian butt lift to buying illegal appetite stimulants off the internet.

One appetite stimulant currently making headlines is Apetamin. Despite being an unlicensed drug in America and the UK, Apetamin is widely available online and has become popular with social media influencers who promote it as a quick, non-surgical way of achieving a “slim thick” hourglass figure. As of writing, there are 11 million views on the Apetamin hashtag on TikTok and countless Instagram accounts dedicated to the drug. The problem, however, is that increasingly people using Apetamin are reporting negative side-effects ranging from extreme fatigue and nausea to liver failure and even comas. In 2019, YouTuber AshaGrand posted a video describing how she almost died after crashing her car when she blacked out on Apetamin, while in the recent BBC Three documentary Dangerous Curves: Get Thicc, Get Sick? presenter Altou Mvuama shared how her mother fell into a coma after taking the drug. 

But what actually is Apetamin? How does it work and is it really dangerous? Dr Azza Halim, a board-certified anesthesiologist, aesthetics, and functional medicine physician based in Florida, helps explain. 

WHAT IS IT?

Marketed as a vitamin supplement and “appetite stimulant,” Apetamin is a weight-gain syrup manufactured by Indian pharmaceutical company TIL Healthcare. While the product is sold widely across Africa, Asia, Russia, and Central and Latin America, it has not been sanctioned for safe consumption by the FDA or the UK equivalent, Medicines and Healthcare Products Regulatory Agency. 

One of the key ingredients in Apetamin is cyproheptadine hydrochloride, a sedative antihistamine used for allergies available in the US and the UK by prescription only. It is the cyproheptadine hydrochloride that is responsible for the effect of Apetamin, Dr Halim says. “The claim is that the cyproheptadine hydrochloride will increase appetite by increasing IGF-1 levels, which is a hormone we all have,” she explains. “It also influences the hypothalamus which is responsible for appetite.” 

“Unfortunately many people are getting access to this medication online without any guarantee of safety, purity, or dosage” – Dr Azza Halim 

In the past, cyproheptadine hydrochloride has mostly been used to relieve allergy symptoms and as an aid to help overcome decreased appetite and malnutrition in children and adults with various chronic illnesses including anorexia nervosa, cancer, cystic fibrosis, and Aids. Alongside cyproheptadine hydrochloride, Apetamin contains L-lysine HCL (an amino acid commonly found in food and supplements), and vitamins B6, B1, B3, and B5. It’s these vitamins that allow Apetamin to be marketed as a vitamin supplement and, Dr Halim says, gives a false sense of safety to consumers. “Unfortunately many people are getting access to this medication online without any guarantee of safety, purity, or dosage,” she explains.

HOW DOES IT WORK?

Cyproheptadine hydrochloride has an appetite-stimulating effect which increases the desire to eat constantly. It also stimulates growth hormone secretion through deep sleep induction (hence the extreme fatigue). According to a report by BuzzFeed News, one user of Apetamin saw her weight increase from 109 pounds to around 125–130 pounds after drinking just one bottle over the course of a week. Another woman consumed six bottles over an eight-week period and gained 60 pounds. However, as she told Buzzfeed, she experienced extreme drowsiness during that time. “It’s not fatigue as in you’re just tired – it literally puts you to sleep,” she said. 

WHAT ARE THE SIDE-EFFECTS?

According to Dr Halim the side effects of Apetamin include: drowsiness, tremors, irritability, blurred vision, nausea, diarrhea, joint pain, joint swelling, liver toxicity, and liver failure. “There are reports of drug-induced autoimmune hepatitis when used with alcohol and even has been case reports of coma induced by Apetamin through liver toxicity,” she says. “The FDA has also issued warnings regarding seizures associated with Apetamin.”

The fatigue side-effect can be so strong that it causes black-outs, including the one that caused AshaGrand’s near-fatal car crash. A woman who spoke to BBC Three said she was sleeping all the time, would fall over constantly, and couldn't even write her name on a piece of paper because her hands were shaking so much. “I collapsed in the street and they brought me into hospital,” she says. On top of that, the Apetamin didn’t deliver the results she was looking for. “The whole of me just sort of increased,” she says. “It was like you put me in water and I just expanded.”

“There are reports of drug-induced autoimmune hepatitis when used with alcohol and even has been case reports of coma induced by Apetamin through liver toxicity,” she says. “The FDA has also issued warnings regarding seizures associated with Apetamin.”

While much of the evidence at the moment is anecdotal, a 2020 case study by doctors at the George Washington University School of Medicine and Health Sciences presented the symptoms of a 40-year-old female Apetamin user which included fatigue, right-side abdominal discomfort, and jaundice. “The FDA has not approved its use therefore it is not advised for people to seek out medications that are deemed questionable,” says Dr Halim. “Being non-regulated means that there is no guarantee as to actual ingredients or dose in the supplement which is concerning as well from a safety profile.”

She also stresses that for young teens taking Apetamin the consequences could be particularly bad. “It is not wise to manipulate hormones during youth growth/development as the long-term untoward effects can be permanent and damaging during teen development both physically and mentally,” she explains. “What one does, eats, and takes early in life during growth and development always has lasting effects later with life-long consequences. Development, hunger hormones, and growth are all important factors that may cause long term obesity and metabolic syndrome potentially developing later in life.” 

WHAT TO DO INSTEAD?

With the pressures put on us by social media to achieve impossible beauty standards, it’s no wonder that so many people are looking for a miracle solution or quick fix. But, as Dr Halim says, you have to ask yourself whether the benefits outweigh the risks. “Here, we see that the risks are much greater than any possible benefit claimed,” she says. 

Her recommendation is always to focus on nutrition and exercise to achieve a healthy physique without risking one’s health or life, and she also supports cosmetic enhancements when done in a healthy manner. “I emphasise to my patients that the goal is to focus on one’s own beauty as opposed to the photoshopped images on social media,” she says. “Hopefully by educating our patients about these trends and through positive reinforcement of body image reality vs social media, we can mitigate any dire consequences associated with unsafe practices, medications, supplements, and even some risky procedures.”

According to the BBC, multiple retail and social media platforms have promised to take action to remove Apetamin from their sites. A spokesperson for Depop told BBC Three, “Medical products, including unlicensed products such as Apetamin, are not permitted on Depop and will be removed”, while a YouTube spokesperson said: “YouTube’s Community Guidelines prohibit any content encouraging dangerous or illicit activities. We routinely remove content flagged by our community that violates these policies.”

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