Patterns of 2,4-Dinitrophenol Use as Discussed on Social Media

Abstract

ABSTRACTImportanceThe usage of social media is associated with worsening perceptions of body image and increasing access to, and use of, toxic weight loss supplements. Little is known about the effect of nonlethal doses of one mechanistically unique supplement, 2,4-dinitrophenol (DNP). DNP has been banned by the FDA making human studies difficult, but the public still consumes DNP leading to a gap in our knowledge on the effects of DNP. Here we use social media to investigate the use of DNP, providing the largest characterization of its usage to date.ObjectiveDetermine the doses of DNP generally consumed, adverse effects at those doses, and coingestants.DesignCross-sectional analysis of Internet posts.SettingOur study collected publicly available data from 2017–2018 from Internet discussion forums (also called bulletin boards) dedicated to the discussion of weight loss and body building.ParticipantsParticipants are anonymous posters on these Internet forums.Main MeasuresOur main measure was the distribution of reported doses of DNP consumed. Our secondary measure was the frequency of adverse effects reported at those doses.ResultsWe collected 661 posts across 5 online forums. The most commonly ingested dose reported was 150 mg (1-2 pills, depending on formulation), followed by 300 mg (2-3 pills). The most commonly reported adverse effects were sweating and a sensation of warmth, followed by yellow discoloration of secretions. The most common coingestants were antihistamines, cetirizine and loratadine.Conclusions and Relevance2,4-dinitrophenol is a mechanistically unique weight loss agent reported to be associated with sweating and a sensation of warmth at the most commonly reported ingested doses. Common co-ingestants are antihistamines, although itching was not directly reported as a side effect. Coingestion of an antihistamine, which can lessen the body’s ability to dissipate heat, could worsen the side effects of DNP. This is the first formal description derived from social media of DNP usage at nonlethal doses. Further investigation is needed to determine the therapeutic index of DNP. Less toxic derivatives may provide a starting point for pharmacological adjuncts to weight-loss.