Inappropriate prescribing of compounded antiobesity formulas in Brazil

Volunteers posing as patients underwent paid medical consultations at the offices of 107 Brazilian doctors (in two Brazilian cities) with the purpose of obtaining an antiobesity prescription. In 80.3% of 71 São Paulo visits, as well as in 47.2% of 36 Recife visits, compounded preparations were prescribed. Four to six active components predominated, but there were prescriptions listing as many as 17 components. All contained anorectic substances and benzodiazepines. Diuretics, thyroid agents, laxatives, medicinal plants, and a variety of other substances were often included. The prescribed doses were frequently above recommended limits, reaching amounts as much as five times the internationally defined standard doses. In some instances two anorectic substances were prescribed simultaneously. Most doctors failed to warn volunteers of the possible occurrence of adverse reactions to the prescribed substances. Furthermore, in the case of all volunteers involved, antiobesity prescriptions would be completely unnecessary, a fact that points to improper medical conduct on the part of doctors. It is concluded that the practice by some Brazilian medical doctors of prescribing manipulation formulas based on anorectic and benzodiazepine drugs is a greater hazard than a benefit to patients.