To the Editor: Rising obesity rates in high income countries have resulted in a growing demand for weight‐loss products.1 Unfortunately, drugs that increase energy expenditure often have severe adverse effects. 2,4‐Dinitrophenol (DNP) uncouples oxidative phosphorylation, inducing a hyper‐metabolic state. It was first used for weight loss in the 1930s but was banned due to deaths.2 It has recently had a resurgence in popularity in the body building/body sculpting arena as a “fat burner” and “pre‐event shredder”, and is available online and as an undeclared ingredient in supplements.1
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- 1. Petróczi A, Ocampo JAV, Shah I, et al. Russian roulette with unlicensed fat‐burner drug 2,4‐dinitrophenol (DNP): evidence from a multidisciplinary study of the internet, bodybuilding supplements and DNP users. Subst Abus Treat Prev Policy 2015; 10: 1–21.
- 2. Grundlingh J, Dargan PI, El‐Zanfaly M, Wood DM. 2,4‐Dinitrophenol (DNP): a weight loss agent with significant acute toxicity and risk of death. J Med Toxicol 2011; 7: 205–212.
- 3. Therapeutic Goods Administration. Scheduling delegate's interim decisions and invitation for further comment: ACCS/ACMS, July 2016 — scheduling medicines and poisons: 2,4‐dinitrophenol [website]. TGA, 2016. https://www.tga.gov.au/book-page/13-24-dinitrophenol (viewed July 2019).
- 4. Kamour A, George N, Gwynnette D, et al. Increasing frequency of severe clinical toxicity after use of 2,4‐dinitrophenol in the UK: a report from the National Poisons Information Service. Emerg Med J 2015; 32: 383–386.
- 5. Mowry JB, Spyker DA, Brooks DE, et al. 2015 Annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 33rd annual report. Clin Toxicol 2016; 54: 924–1109.
This work was supported by a National Health and Medical Research Council Program Grant (ID: 1055176). Jared Brown is a recipient of a UNSW Scientia PhD scholarship. The funders had no role in planning, design, data collection, analysis or interpretation, reporting or publication. We thank staff at the NSWPIC and the NCIS for providing data. The NCIS is managed by the Victorian Department of Justice and Community Safety.
No relevant disclosures.