How a diet scam was born: The rise and fall of green coffee bean

I thought I’d written my final post on the Dr. Oz-fueled green coffee bean extract (GCBE) diet supplement fad. But now there’s another appalling chapter, one that documents just how much contempt The Dr. Oz Show seems to show for its audience, and how little Dr. Mehmet Oz seems to care about providing medical advice that is based on good science. Last week it was revealed that the “naturopath” that Dr. Oz originally featured in his GCBE segment, Lindsey Duncan, didn’t disclose a direct conflict of interest when he spoke. After inaccurately describing the supplement’s effectiveness, he directed consumers, using keywords, to web sites that he owned or operated. The infamous “Dr. Oz Effect” worked, with Duncan selling $50 million in GCBE supplements in the following months and years. It has also been announced that Duncan and his companies have been fined $9 million by the Federal Trade Commission (FTC). The documentation released by the FTC [PDF] gives remarkable insight into how a scam to make millions was launched, and how the Dr. Oz Show is a willing platform for the routine promotion of dubious “experts” and worthless supplements.

Weekend Reading

An example of #badpharmacy

The photo above is from a pharmacy in Toronto. Acid base nonsense? Check? Cancer quackery? Check. Endorsed by a pharmacist? Check. Send me your own pictures of ludicrous pseudoscience and quackery for sale in a pharmacy, and I may feature it in a future post.

Here’s today’s updates to engage, inspire and possibly infuriate you…

Has Dr. Oz Jumped the Shark?

It was bound to happen. It’s that moment in a television show when the deterioration is irreversible. For the popular 1970’s television sitcom Happy Days, it was when a water-skiing Fonzi literally jumped over a shark. And I think it may finally have happened with the Dr. Oz show. From a scientific credibility perspective, The Dr. Oz show is past the point of no return.

Dr. Oz says Red Palm Oil is a miracle oil for longevity. The science says otherwise.

If there is an antithesis to the principles of science-based medicine, it’s probably the Dr. Oz show. In this daytime television parallel universe, anecdotes are evidence. There are no incremental advances in knowledge — only medical miracles. And every episode neatly offers up three or four takeaway health nuggets that, more often than not, seem to leave the audience more ill-informed about health and medicine than they were 30 minutes earlier.

After I completed my post on Dr. Oz’s prolonged embrace of the “miracle” that is green coffee bean extract, a number of readers brought me up to speed. Green coffee beans are yesterday’s miracle. The new weight loss miracle for 2013 is red palm oil. This constant drive for miracles must keep the producers in a perpetual panic. They need at least five miracles per week. Having now watched a few episodes, I’m reminded of the classic “That Mitchell and Webb Look” skit where two nutritionists pick a new superfood. It could be just a matter of time until we see white veal profiled as a superfood in a future Dr. Oz episode.

If there is a common characteristic of complementary and alternative medicine (CAM) proponents who believe themselves to be scientific (and I include Dr. Oz in this group), it is that they extrapolate from weak clinical evidence to grandiose claims by cherry picking the most supportive strands of evidence to give the impression of being evidence-based. They have the belief, and then they look for the supporting evidence to bolster the claim. In short, to paraphrase a quote attributed to Hahns Kuhn, they use scientific evidence like a drunkard uses a light post: for support, not for illumination. As I noted with green coffee bean extract, Dr. Oz extrapolated from ambiguous, preliminary data to recommendations to consume green coffee bean extract as a weight loss strategy. Frankly, the evidence isn’t there, so I didn’t have high expectations with the latest miracle. All I knew going in about palm oil is that it’s used in most industrial food production and the demand for it is linked to massive destruction of tropical rainforests and the slaughter of orangutans. But who doesn’t want the longevity that Dr. Oz promises? So I sat down and watched another episode.

Dr. Oz Doubles Down on Green Coffee Bean with a Made-for-TV Clinical Trial

“One of the most important discoveries I believe we’ve made that will help you burn fat – green coffee bean extract” – Dr. Oz, September 10, 2012, Episode “The Fat Burner that Works”

Dr. Mehmet Oz may be biggest purveyor of health pseudoscience on television today. How he came to earn this title is a bit baffling, if you look at his history. Oz is a bona fide heart surgeon, (still operating 100 times per year), an academic, and a research scientist, with 300+ or 400+ (depending on the source) publications to his name. It’s an impressive CV, even before the television fame. He gained widespread recognition as the resident “health expert” on Oprah, and went on to launch his own show in 2009. Today “The Dr. Oz Show” is a worldwide hit, with distribution in 118 countries, a massive pulpit from which he offers daily health advice to over 3 million viewers in the USA alone. For proof of his power to motivate, just look at the “Transformation Nation Million Dollar You” program he launched in 2011, enrolling an amazing 1.25 million participants. Regrettably, what Oz chooses to do with this platform is often disappointing. While he can offer some sensible, pragmatic health advice, his show’s content seems more focused on TV ratings than medical accuracy, and it’s a regular venue for questionable health advice (his own, or provided by guests) and poorly substantiated “quick fixes” for health issues. (And I won’t even touch Oz’s guests like psychic mediums.) One need only look at the number of times the term “miracle” is used on the show as a marker of the undeserved hyperbole. Just this week, Julia Belluz and Stephen J Hoffman, writing in Slate, itemized some of the dubious advice that Oz has offered on his show, with a reality check against what the scientific evidence says. It’s not pretty.

Green Coffee Beans for weight loss: Dr. Oz loves it, but where’s the evidence?

I can’t keep up with Dr. Oz. Just when I thought the latest weight loss miracle was raspberry ketone, along comes another panacea promising results with no effort. This time, it’s green coffee beans.

Everyone knows Dr. Oz, now. Formerly a guest on Oprah, he’s got his own show which he’s built into what’s probably the biggest platform for health pseudoscience and medical quackery on daytime television. In addition to promoting homeopathy, he’s hosted supplement marketer Joe Mercola several times to promote unproven supplements. He has been called out before for promoting ridiculous diet plans, and giving bad advice to diabetics. And don’t forget his failed attempt to actually demonstrate some science on his show, when he tested apple juice for arsenic which prompted a letter from the FDA about his shoddy methodology. His extensive track record of terrible health advice is your caution not to accept anything he suggests at face value. Yet it continues to frustrate me that pharmacies see his endorsements as a boon for sales of supplements, rather than what they really are  – an obstacle to science-based health care. So when the sign in front of my local pharmacy started advertising “Green coffee beans – as seen on Dr. Oz”, I tracked down the clip in question. The last time I saw Dr. Oz in action when when he had Steven Novella from the Science-Based Medicine blog as a guest, where there was actually a exchange (albeit brief) about the scientific evidence for alternative medicine. Replace Dr. Novella with a naturopath, and you get this:

Why Dr. Oz will not save pharmacy practice

Retail pharmacy is a competitive business, and these are tough economic times. And as I’ve pointed out before, retail pharmacies are increasingly selling ethically questionable products like homeopathy, positioning them as alternatives to real medicine. So I guess I should not have been surprised when a blog reader, (who is also a very prominent Canadian pharmacy leader) passed on the following to me from Pharmacy Development Services – a program to profile and promote products recommended by Dr. Oz: