Nothing To Lose?

What killed Baltimore Orioles rookie pitcher Steve Bechler? When the 23-year-old Bechler collapsed and later died during spring training, the initial cause of death was listed as "heatstroke," but when a bottle of Xenadrine RFA-1 was found in his locker, that diagnosis was called into question.

Advertised as a "natural" fat burner that increases energy, suppresses appetite, and accelerates weight loss, Xenadrine RFA-1 is an over-the-counter dietary supplement that contains the powerful stimulant ephedrine.

Ephedrine increases body temperature, elevates blood pressure, and constricts blood vessels. It has been linked with a variety of cardiovascular problems including strokes, hypertension, seizures, and even death.

Surely Bechler knew of the dangers of taking this herb-based weight-loss supplement and the use of ephedrine already is banned by the International Olympic Committee, the National Collegiate Athletic Association, and the National Football League, yet, he took it anyway. He had come to spring training overweight and out of shape, and management was decidedly displeased with the lackluster performance of their star rookie.

We can only speculate that Bechler was so afraid of losing his job that rapid weight loss appeared to be his only option for saving his nascent career.

If so, he was not alone. Xenadrine RFA-1 sales are part of a $40 billion dollar a year industry in America.

Dietary supplements containing ephedra, or its synthetic form ephedrine, continue to be sold despite mounting evidence of their danger.

· In February 2001 the US Army, Air Force, and Marines ordered a ban on the sale of ephedra products at military exchanges and commissaries. This action was taken after 30 deaths occurred among previously healthy active-duty personnel who were using the herb.

· In May 2001, the National Football League banned the use of ephedra after Minnesota Vikings offensive lineman Korey Stringer collapsed and died of heatstroke after reportedly using an ephedra product.

· In August 2001, a Northwestern University football player collapsed and died during a workout. He had consumed ephedra-based "Ultimate Punch" prior to practice.

Part of the problem is that ephedra's status is that of herbal supplement, which means it is not subject to the strict standards of the Food and Drug Administration. Nor do there appear to be marketing standards.

One website that sells Xanadrine RFA-1 advises potential consumers of the risks of taking the product by minimizing its dangers. Consider the following statement:

"In each cap, there is 10 mgs. of ephedrine from ma huang extract. If you are healthy with normal blood pressure, an irrational fear of ephedrine might be just a tad over-reactive."

The product's website also offers "product reviews" from customers that present potentially serious health issues in an equally dismissive way:

"I used Xendrine for about 1 month in conjunction with regular exercise and lost 20 lbs...However, I had an overwhelming feeling of anxiety often while taking this supplement. After a while I became very depressed...I recommend RFA for quick results but only on a short term basis."

The message is clear. If you want to quickly lose weight there may be negative consequences but they are temporary.

Unfortunately, the consequences for Steve Bechler-and other consumers of ephedrine-based products-have been permanent.

The real issue is how to address weight problems without resorting to the use of drugs.

This involves our teaching kids sound nutrition habits from an early age, and modeling healthy eating habits.

It means devoting research money to food addiction and learning what triggers compulsive overeating and other eating disorders. And it means allocating treatment money for those suffering from these diseases.

But on a human level, it also means learning to accept ourselves as we are. Perhaps thin does not have to be so "in," and maybe the Steve Bechlers of the world can be encouraged to take time to find a healthy solution to their weight issues.