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The US sales of weight loss supplements have increased steadily since 1994, with sales revenue growing 10-20% annually from 1997 to 2001, and Americans spending almost $2 billion on them in 2001. Concerns have risen about their marketing and use, with some supplements being marketed with overstated claims and associated with serious side effects. Federal agencies such as the Federal Trade Commission (FTC) and the Food and Drug Administration (FDA) have oversight responsibility, but their focus has been more on marketing than safety. The FDA faces difficulties in addressing safety concerns due to weaknesses in its adverse event reporting system and different standards for supplements than for drugs. State agencies have also taken action, with some statutes and regulations restricting the sale of certain supplements, and lawsuits being filed against manufacturers. Despite these efforts, little is known about the effectiveness of weight loss supplements, and some have been associated with potential physical harm, particularly for people with underlying health conditions.