Knowledge and practice about non-prescription weight loss supplements utilization among university students

Introduction

Obesity is a growing global health concern, with projections indicating that 24 % of the world’s population will be obese by 2030, as noted by Dini and Mancusi [1]. Defined by the WHO as “excessive fat deposits that can impair health,” obesity contributes to approximately 4.7 million premature deaths annually and is strongly linked to non-communicable diseases such as cancer, type 2 diabetes, cardiovascular disease, and kidney disease [2], 3]. Beyond physical health, obesity is associated with stigma, discrimination, and reduced overall well-being, as highlighted by Sánchez et al. [4].

Egypt ranks among the top 20 countries worldwide in obesity prevalence, with adult obesity rates increasing from 36 % in 2017 to nearly 40 % in 2019, according to national reports from the 100 Million Health Initiative (2018–2019). The healthcare burden is also significant, with obesity-related disease costs estimated at 62 billion EGP [2].

While lifestyle interventions remain foundational, the rise in obesity has fueled interest in pharmacological treatments, including dietary supplements [5]. These products are often marketed as quick and easy solutions, bypassing the effort required for sustainable behavioral change. Although clinical guidelines recommend anti-obesity drugs for specific cases, many over-the-counter supplements lack regulation, raising concerns over their safety, side effects, and potential drug interactions [6], 7].

The use of non-prescription weight loss products is on the rise, particularly among young adults, influenced by social media and peer recommendations – sources that may not be reliable, as Colangeli et al. point out [8]. This trend emphasizes the need to evaluate young people’s knowledge and practices surrounding these supplements to support appropriate health education and regulation.

Subjects and methods

Results

A total of 437 university students participated in the study. The mean age was 20.78 ± 1.74 years, with females representing 68.9 % of the participants. Most students were from the original governorate where the study was conducted (73 %) and lived in rural areas (55.8 %). Medical and health sciences students comprised 61.1 % of the sample, and the majority were in their 2nd academic year (45.5 %) (Table 1).

The average weight of participants was 66.78 ± 14.34 kg, height 164.09 ± 9.66 cm, and BMI 24.79 ± 4.72 kg/m². Only 5.7 % had a chronic disease. Regarding weight-related intentions, 36.8 % aimed to lose weight, while 14.5 % reported no effort toward weight change (Table 2).

In terms of overall practices, a small proportion of participants (12.6 %) reported prior use of weight loss supplements (Figure 1). Among users, only 56.4 % consulted a physician before using weight loss supplements, meaning that 43.6 % used them without medical supervision. While the majority demonstrated responsible behaviors – 71 % reported reading the product instructions, and 67.3 % ensured that the supplements were registered with national regulatory authorities, only 36.4 % checked official circulars for warnings about adulterated products.

Figure 1:

Using weight loss supplements among student participants.

With regard to other aspects of practice, 27.3 % of users recommended dietary supplements to others, raising concerns about peer-to-peer promotion without professional guidance. Notably, 40 % of users reported experiencing side effects, underscoring the health risks associated with unsupervised supplement use. The most frequently reported symptoms were headache, dizziness and fatigue; palpitations or shortness of breath; and gastrointestinal disturbances. Approximately 60 % of all participants reported social media and recommendations from relatives as key factors influencing supplement use (Table 3).

In terms of knowledge, among all participants (n=437), 70.3 % believed it was necessary to seek more information before using weight loss supplements. Additionally, 62.2 % were aware of potential hazards associated with their use. A large majority (83.5 %) recognized the possibility of adulteration with prescription drugs or undeclared chemicals, and 92.2 % agreed that adulterated slimming products pose a national health problem in Egypt (Table 4). A significantly higher proportion of supplement users (81.8 %) acknowledged the importance of seeking additional information prior to use, compared to 68.6 % of non-users who shared the same view (p=0.045). However, the remaining knowledge-related items showed no statistically significant differences.

Regarding the factors influencing knowledge and practice scores, the mean knowledge and practice scores among all participants were 3.15 ± 0.89 and 5.75 ± 2.24, respectively.

Statistically significant differences in knowledge scores were observed across college types (p=0.008) and academic years (p=0.005). Students enrolled in medical and health sciences faculties demonstrated higher knowledge levels compared to those in engineering, natural, and computer sciences. Moreover, second- and fifth-year students showed significantly greater knowledge scores than first-year students. No significant differences were found based on gender, residence, governorate, parental education, chronic disease status, or weight management strategy (p>0.05 for all) (Table 5).

As for practice scores, females reported significantly higher scores than males (p=0.040). A significant difference was also found in relation to weight management strategies (p=0.015), with those not attempting to change their weight reporting lower practice scores than participants trying to lose, gain, or maintain weight. No significant differences in practice scores were observed based on college type, academic year, residence, governorate, parental education, or chronic disease status (Table 5).

Logistic regression analysis identified three significant predictors of using weight loss supplements: attempting to lose weight, not consulting a physician before use, and having previously experienced side effects (p<0.05). Other examined factors were not statistically significant (Table 6).

Discussion

Numerous studies have been carried out among university students in Egypt. However, no study has been conducted to assess the knowledge and practices regarding non-prescription weight loss supplement use in this population. So, the current study aimed to determine the prevalence of slimming dietary supplement use among students of Beni-Suef University, Egypt.

The findings showed that 12.6 % of participants had used weight loss supplements. This prevalence is slightly higher than global estimates reported by Hall et al. [10], where the average use was 8.9 % in the general population, but much lower than figures reported in neighboring countries like the UAE, where nearly 39 % of university students reported using [9]. These differences could reflect variations in cultural norms, health awareness, access to supplements, or social pressures related to body image and beauty standards.

Interestingly, despite the relatively low overall usage rate, a concerning pattern emerged regarding the lack of medical supervision. Among users, 43.6 % reported not consulting a physician before starting supplementation. This aligns with global patterns of self-medication, as reported in several studies across different countries [9], 11], 12], but remains problematic considering the well-documented risks of unsupervised use, including adverse reactions and drug interactions. The ease of access to such products without prescriptions may partially explain this behavior and illustrate the importance of stricter regulation and public health interventions.

In terms of safety awareness, only 36.4 % of users reported checking official circulars for adulterated supplements, despite over two-thirds reading instructions and verifying product registration. This indicates that while students may demonstrate basic responsible behaviors, their awareness of deeper regulatory or safety issues remains limited. These findings echo previous studies suggesting that users often underestimate the risks associated with so-called “natural” or over-the-counter supplements [9], 13].

Another important finding was the influence of social factors. Around 60 % of participants reported being influenced by social media and family recommendations when deciding to use supplements. These informal sources of information – while convenient – are not always reliable and may promote unsafe practices. Previous studies have similarly identified social media, friends, and TV as common sources of information about weight loss products among youth [14], 15]. This suggests a need to integrate more credible health messaging into platforms that students frequently engage with.

A particularly noteworthy issue is the reporting of side effects. In this study, 40 % of users experienced at least one side effect, with common symptoms including headache, dizziness, gastrointestinal disturbances, palpitations, and fatigue. These figures are consistent with prior regional findings [16] and reinforce concerns that many weight loss products – even those marketed as herbal or natural – can have significant physiological impacts [7]. Despite experiencing side effects, many participants continued using the supplements, which reflects either a lack of awareness or prioritization of weight loss over health.

Regarding BMI and weight status, users had significantly higher BMI and weight than non-users. Higher BMI individuals are more likely to seek weight loss interventions, including supplements, as expected. The mean BMI among users (28.3 kg/m²) places them in the overweight to obese category, which aligns with previous findings indicating that individuals with excess weight are more likely to adopt non-prescribed weight loss strategies [11], 17].

The findings also revealed gender-based and academic variations. Females were more likely to use supplements and had significantly higher practice scores than males, which is consistent with previous research suggesting that women are more likely to engage in health-related behaviors and to be concerned about body image [18]. Additionally, students in health-related faculties and those in later academic years demonstrated higher knowledge levels, which is understandable given their academic exposure to relevant scientific content.

Despite this, higher knowledge did not always translate into safer practices. Knowledge scores were higher among health science students, but practice scores did not differ substantially by type of college. Similar discrepancies between knowledge and actual practices have been observed in previous studies, suggesting that information alone may be insufficient without behaviorally targeted interventions [19].

Lastly, logistic regression analysis identified three significant predictors of supplement use: actively trying to lose weight, not consulting a physician before use, and experiencing previous side effects. These predictors provide valuable insight for targeted interventions – especially for students attempting weight loss independently, who may need both counseling and education to prevent harmful self-medication.

Overall, this study highlights the need for structured educational campaigns, stronger regulatory enforcement, and active engagement with youth through trustworthy communication channels. As the popularity of weight loss supplements continues to grow – particularly among young adults – university-based health programs may play a key role in promoting informed and safe decision-making.

Conclusions

The study revealed that 12.6 % of university students reported using non-prescription weight loss supplements, with 43.6 % of them doing so without prior medical consultation. Notably, females constituted 80 % of the users. Although many participants demonstrated awareness of the potential health risks associated with supplement use, a considerable proportion continued to consume them without professional guidance. Furthermore, 40 % of users reported experiencing adverse effects, underscoring the urgent need for comprehensive awareness and educational interventions targeting safe weight management practices among university students.