Policy Translation to Improve Regulation of Dietary Supplements for Weight Loss and Muscle Building Sold to Youth in Massachusetts Municipalities

Abstract

This thesis describes DrPH candidate Kuanysh Yergaliyev’s DELTA doctoral project, which covered the 18 months between August 29th, 2017 and February 28th, 2019. The project is a policy translation effort that attempts to integrate research, policymaking, and collective action to enable change on a large scale in the prevention of disordered weight and body shape control behaviors using dietary supplements. While many dietary supplements may be safe to use, those sold for weight loss and muscle building are known to often be adulterated with illegal substances like steroids and prescription pharmaceuticals, and to include toxic concentrations of legal substances. The U.S. Food and Drug Administration only loosely regulates the safety of these products, and they are easily accessible to youth. The purpose of the DELTA doctoral project was to propose an improved regulatory structure around the sale of the weight-loss and muscle-building dietary supplements to youth in Massachusetts municipalities. This project had two components: qualitative research and advocacy. The goal of the qualitative research was to explore and understand the perceptions of key community stakeholders on the issue of dietary supplements sold to youth for weight loss or muscle-building purposes. The main findings were the following themes: 1) awareness of health risks; 2) perceptions of adolescent supplement users; 3) perceptions of adolescent access to supplements; 4) social environment and acceptability of supplement use; and 5) political considerations for local policy agenda setting. The goal of the advocacy component was to design an advocacy strategy to build political and public support for improved regulation of the sale of weight loss and muscle building dietary supplements at the municipal level. The advocacy strategy designed for municipal initiatives was informed by in-depth analysis of the key community stakeholders’ perceptions identified during the qualitative study, stakeholder analysis conducted for four Massachusetts municipalities and guided by the Power Prism® advocacy framework. Thorough literature review and information gathering helped to build a foundation to achieve both goals. This project allows policymakers and advocates to translate available research evidence on health risks associated with weight-loss and muscle-building dietary supplements into effective public health policy and regulation.