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Dr. Oz’s Silly Weight Loss Recommendations Lead To Fat TV Ratings

Miracles are pretty rare events. Except on television’s “Dr. Oz Show,” where they appear with astonishing frequency. Oz of course doesn’t claim to raise the dead or part the Red Sea, but he does raise people’s hopes of parting with their flab. And he’s certainly not shy about flinging the word “miracle” about. But it seems miracles fade as quickly as they appear. Raspberry ketones, acai berries and African mango, once hyped as amazing “fat busters,” have already given way to newer wonders.

Granted, Dr. Oz, or more likely his producers, do not pull miracles out of an empty hat. They generally manage to toss in a smattering of stunted facts that they then nurture into some pretty tall tales. Like the ones about chlorogenic acid or Garcinia cambogia causing effortless weight loss. The former piqued the public’s interest when the great Oz introduced green coffee bean extract as the next diet sensation. Actually “chlorogenic acid” is not a single compound, but rather a family of closely related compounds found in green plants, which perhaps surprisingly, contain no chlorine atoms. The name derives from the Greek “chloro” for pale green and “genic” means “give rise to.” (The element chlorine is a pale green gas, hence its name.)

An “unprecedented” breakthrough, Dr, Oz curiously announced, apparently having forgotten all about his previous weight-control miracles. This time the “staggering” results originate from a study of green coffee bean extract by Dr. Joe Vinson, a respected chemist at the University of Scranton who has a long-standing interest in antioxidants, such as chlorogenic acid. Aware of the fact that chlorogenic acid had been shown to influence glucose and fat metabolism in mice, Vinson speculated that it might have some effect on humans as well. Since chlorogenic acid content is reduced by roasting, a green bean extracts was chosen for the study.

In cooperation with colleagues in India who had access to volunteers, Dr. Vinson designed a trial whereby overweight subjects were given, in random order, for periods of six weeks each, either a daily dose of 1,050 mg of green coffee bean extract, a lower dosage of 700 mg, or a placebo. Between each six-week phase there was a two-week “washout” period during which the participants took no supplements. There was no dietary intervention; the average daily calorie intake was about 2,400. Participants burned roughly 400 calories a day with exercise. On average there was a loss of about a third of a kilogram per week. Interesting, but hardly “staggering.” And there are caveats galore.

The study involved only eight men and eight women, which amounts to a statistically weak sample. Diet was self-reported, a notoriously unreliable method. The subjects were not really blinded since the high dose regimen involved three pills, the lower dose only two. A perusal of the results also shows some curious features. For example, in the group that took placebo for the first six weeks, there was an 8 kilogram weight loss during the placebo and washout phase, but almost no further loss during the high dose and low dose phases. By the time, though, that critics reacted to Oz’s glowing account, overweight people were already panting their way to the health food store to pick up some green coffee bean extract that might or might not contain the amount of chlorogenic acid declared on the label. As for Dr. Oz, he had already moved on to his next “revolutionary” product, Garcinia cambogia, unabashedly describing it as the “Holy Grail” of weight loss.

We were actually treated to the Grail in action. Sort of. Dr. Oz, with guest Dr. Julie Chen, performed a demonstration using a plastic contraption with a balloon inside that was supposed to represent the liver. A white liquid, supposedly a sugar solution, was poured in, causing the balloon, representing a fat cell, to swell. Then a valve was closed, and as more liquid was introduced, it went into a different chamber, marked “energy.” The message was that the valve represents Garcinia extract, which prevents the buildup of fat in fat cells. While playing with balloons and a plastic liver may make for entertaining television, it makes for pretty skimpy science.

Contrary to Dr. Oz’s introduction that “you are hearing it here first,” there is nothing new about Garcinia. There’s no breakthrough, no fresh research, no “revolutionary” discovery. In the weight control field, Garcinia cambogia is old hat. Extracts of the rind of this small pumpkin-shaped Asian fruit have long been used in “natural weight loss supplements” Why? Because in theory, they could have an effect.

The rind of the fruit, sometimes called a tamarind, is rich in hydroxycitric acid (HCA), a substance with biological activity that can be related to weight loss. Laboratory experiments indicate that HCA can interfere with an enzyme that plays a role in converting excess sugar into fat, as well as with enzymes that break down complex carbohydrates to simple sugars that are readily absorbed. Furthermore, there are suggestions that Garcinia extract stimulates serotonin release which can lead to appetite suppression.

Laboratory results that point toward possible weight loss don’t mean much until they are confirmed by proper human trials. And there have been some. Fifteen years ago a randomized trial involving 135 subjects who took either a placebo or a Garcinia extract equivalent to 1500 mg of HCA a day for three months, showed no difference in weight loss between the groups. A more recent trial involving 86 overweight people taking either two grams of extract or placebo for ten weeks echoed those results. In-between these two major studies there were several others, some of which did show a weight loss of about one kilogram over a couple of months, but these either had few subjects or lacked a control group. Basically, it is clear that if there is any weight loss attributed to Garcinia cambogia, it is virtually insignificant. But there may be something else attributed to the supplement, namely kidney problems. Although incidence is rare, even one is an excess when the chance of a benefit is so small. So Garcinia cambogia, like green coffee bean extract, can hardly be called a miracle. But it seems Dr. Oz puts his facts on a diet when it comes to fattening up his television ratings.

joe.schwarcz@mcgill.ca

Joe Schwarcz is director of McGill University’s Office for Science & Society (mcgill.ca/oss). He hosts The Dr. Joe Show on CJAD Radio 800 AM every Sunday from 3 to 4 p.m.


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2 Responses to “Dr. Oz’s Silly Weight Loss Recommendations Lead To Fat TV Ratings”

  1. Douglas Farrago MD says:

    Dr. Oz is out of ideas. His show is only about ratings. He is a sell out and stuck doing whatever his producers want in order to wow the idiot audience. In summary, Dr. Oz is a douche.

  2. Dr. Val says:

    Yes, he has succumbed to the “new is better than true” movement. He uses his medical background to make these nutty claims seem plausible. Some of what he says is accurate, but most is complete snake oil. That blend seems to work best for convincing the uninformed. We need to promote more critical thinking in our education system (<– pipe dream?) so that the public is better equipped to protect themselves from bad medicine. I am sad that my alma mater (Columbia) hasn't cut ties with Oz. I guess money is more important than truth too… :-( Keep tilting at windmills, my friend @DouglasFarragoMD!

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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

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Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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