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J. Med. Toxicol. (2011) 7:205212 DOI 10.1007/s13181-011-0162-6
REVIEWARTICLE
2,4-Dinitrophenol (DNP): AWeight Loss Agent with Significant Acute Toxicity and Risk of Death
Johann Grundlingh & Paul I. Dargan &
Marwa El-Zanfaly & David M. Wood
Published online: 8 July 2011# American College of Medical Toxicology 2011
Abstract 2,4-Dinitrophenol (DNP) is reported to cause rapid loss of weight, but unfortunately is associated with an unacceptably high rate of significant adverse effects. DNP is sold mostly over the internet under a number of different names as a weight loss/slimming aid. It causes uncoupling of oxidative phosphorylation; the classic symptom complex associated with toxicity of phenol-based products such as DNP is a combination of hyperthermia, tachycardia, diaphoresis and tachypnoea, eventually leading to death. Fatalities related to exposure to DNP have been reported since the turn of the twentieth century. To date, there have been 62 published deaths in the medical literature attributed to DNP. In this review, we will describe the pattern and pathophysiology of DNP toxicity and summarise the previous fatalities associated with exposure to DNP.
Keywords Dinitrophenol . Weight loss . Toxicity. Fatality
Introduction
The pharmacologic treatment of obesity has been challenging. Previously, amphetamine derivatives, such as dexflenfluramine, fenfluramine and phentermine, were used as centrally active appetite suppressants; however, their use is associated with valvular heart disease and the development of pulmonary hypertension. Sibutramine (Reductil Abbott Laboratories), a newer centrally active appetite suppressant and the lipase inhibitor orlistat (Xenical, Roche) are currently being used as diet pills, but have unpleasant side effects. However, for the majority of individuals with morbid obesity (body mass index >35 kg/m2), obesity surgery (gastric banding) is often the treatment modality of choice, particularly in those associated severe co-morbidities [1]. Regular use of 2, 4-dinitrophenol (DNP) is reported to cause rapid loss of weight, but unfortunately is associated with an unacceptably high rate of significant side effects [2].
The first death due to DNP (C6H4N2O5) was reported in 1918 and was secondary to occupational exposure [3]. Currently marketing of DNP, which is predominately through the internet, is targeted towards primarily body builders who are attempting to lose fat but retain muscle bulk. Additionally, it is widely available on the internet and is marketed as a safe weight loss drug. Individuals are able...