So, if you haven't heard, something pretty cool went down this week:
Dr. Oz was called in by Senator Claire McCaskill to testify at a hearing about weight-loss scams. Many people in the fitness industry were outraged, assuming that McCaskill was calling on him as an expert witness.
What ensued was much more entertaining.
McCaskill blasted Oz for irresponsible conduct on his show - of promoting several sham products as "miracle" weight-loss cures. It was pretty glorious to watch.
When I listened to their conversation the first time through, I was struck by how good Oz was at saying a lot of words that sounded like a good defense, yet weren't coherent enough for me to register what he was actually saying.
So, I decided to write a transcript of the entire thing so I could analyze exactly what his defense was. I inject my commentary below, but if you just want the transcript, you can get it from the following link:
Senator McCaskill: "I can't figure this out Dr. Oz...I get that you do a lot of good on your show. I understand that you give a lot of information that's great information about health, and you do it in a way that's understandable. You're very talented, you're obviously very bright. You've been trained in science-based medicine."
The above is all true. Just watch a couple of episodes of Dr. Oz's show; you can find most segments online for free. Here's a modest clip - no product pushing, just giving out information and advice. This clip is pretty tame, yet he presents typically 'boring' information in a way that's entertaining for his audience. Yes, he has a knack for grabbing your attention. He's very compelling, seemingly genuine, and personable. Give the man credit where it's due.
It's also true that he has a background in science and science-based medicine. He got his MD from the University of Pennsylvania, and has been a professor of surgery at Columbia University for 13 years. He's practiced actual real medicine and been named in actual real studies. I mean just look at this resume, seriously.
So this is why I have a hard time believing his defense of promoting 'miracle cures' below...
Senator McCaskill: "Now, here are three statements you've made on your show:
- 'You may think magic is make-believe, but this little bean has scientists saying they've found the magic weight-loss cure for every body type. It's Green Coffee Extract.'
- 'I've got the number one miracle in a bottle to burn your fat! It's Raspberry Ketones.'
- 'Garcinia Cambogia: it may be the simple solution you've been looking for to bust your body fat for good.'
I don't get why you need to say this stuff, because you know it's not true! So why, when you have this amazing megaphone, and this amazing ability to communicate, why would you cheapen your show by saying things like that?"
You may have heard about some of these products. If you have, it's probably from crap advertisements like these from Facebook:
Dr. Oz agreed to come to Senator McCaskill because he does not appreciate his name being used to endorse these specific products.
It's true that he didn't endorse those specific brands, and it's wrong for the products to say that they themselves have been endorsed by Dr. Oz. He has an acceptable complaint, though he doesn't garner much sympathy from me or Senator McCaskill. But more on that much later down the page.
Dr. Oz: "Well, if I could disagree about whether they work or not, and I'll move on to the issue of the words that I used.
And just with regards to whether they work or not - take green coffee bean extract as an example - I'm not going to argue that it would pass FDA muster if it was a pharmaceutical drug seeking approval. But among the natural products that are out there, this is a product that has several clinical trials. There was one large one, one very good quality one, that was done the year we talked about this in 2012."
I know that everyone loves to hate on the government and especially the FDA. Certainly there are some legitimate criticisms.
But one of the less legitimate criticisms is that the FDA is suppressing cures for cancer and weight loss because of the heartless cancer / diet industries lobbying them. Yes, the FDA can take a long time approving things. But is this out of malice or out of being backlogged, under-staffed and under-funded?
In any case, to get a drug approved by the FDA, the following steps must happen:
- Test on animals to show reasonable expectation of safety
- Get approved to be tested on humans
- Go through several phases of testing to discover side effects, ensure safety, show that it works, and figure out appropriate use and dosage on varying populations. This is the hard part.
- The FDA reviews the findings and can approve the drug for market
So when Dr. Oz says that the drug wouldn't pass FDA muster, that means that the drug does not have sufficient evidence to show it works. Because he literally just admitted this, he is willingly promoting a product as a "miracle cure" to millions of viewers when he knows good and well it has not been shown to work.
Good thing that supplements don't have to be approved by the FDA then, huh?
Senator McCaskill: "I want to know about that clinical trial. Because the only one I know was 16 people in India that was paid for by the company that was...at the point in time you initially talked about this being a 'miracle,' the only study that was out there was the one with 16 people in India that was written up by somebody who was being paid by the company who was producing it."
Dr. Oz: "Well this paper argued that there was no one paying for it, but I have the four papers...five papers actually, plus a series of basic science papers on it as well.
Here is the study that McCaskill is referring to. It's funny that the paper claims no conflicts of interest, but was paid for by the company selling the supplement - Applied Food Sciences, Inc. in Austin, Texas. If you're interested in a detailed review of this study, I recommend checking out Science-Based Pharmacy's review.
I'm uncertain what other papers Dr. Oz is referring to. If I knew, I'd look them up. Unfortunately I can't find much research on green coffee bean extract in the first place. In fact, I've only found papers showing that the supplement is far from a miracle drug; at best promoting only modest loss of a couple pounds, if that.
There just isn't enough good evidence out there that green coffee extract is worth taking. It's therefore irresponsible to tout it as a "miracle cure." It's like trying to convict a man of a crime before the evidence has been analyzed because it's merely possible he did it.
"Dr. Oz: But, Senator McCaskill, we can spend a lot of time arguing the merits of whether green coffee bean extract is worth trying or not worth trying. Many of the things that we argue that you do with regard to your diet are likewise criticizeable.
Should you be on a low-fat diet, a low-carb diet...I spent a good part of my career recommending that folks have a low fat diet. We've come full circle in that argument now and no longer recommend that. Many of us who practice medicine, because we realized it wasn't working for our patients."
Here Dr. Oz is attempting to deflect the fact that there is little evidence coffee bean extract is worth buying. He is doing this by changing the subject to the current low-carb / low-fat diet controversies. The fact is, low-fat diets aren't inherently "bad" diets anyway. It's just that you can't tell a patient to go on a low-fat diet and expect them to understand you don't mean to gorge on Snackwell cookies...if they follow your advice at all.
Going on a low-fat or low-carb diet, however, is free and doesn't require buying products. So there's yet another difference.
Dr. Oz: "So it is remarkably complex, as you know, to figure out what works out for most people even, in a dietary program. In the practice of medicine we evolve by looking at new ideas challenging orthodoxy and evolving them."
Yes, you challenge orthodoxy with great evidence.
When debating something controversial, I often see people argue, "Galileo was right, but he was punished for his ideas at the time," or, "Barry Marshall was a laughing stock when he said stomach ulcers were caused by bacteria, but he ended up being right," as if those situations are comparable to what they're doing.
But the difference is that these men had evidence on their side to back up their statements, not just a hunch. That this evidence was initially feared or ignored is human folly, yes. And it was eventually corrected.
But there is not currently good evidence that these "weight loss miracles" are actually miracles. This is why we don't believe in unproven cures - not because we're willfully ignoring claims or just being ignorant. If solid evidence came out that they were useful, we'd change our minds.
Extraordinary claims require extraordinary evidence...and a little bit of time to ponder its merits and re-adjust our worldviews accordingly.
Dr. Oz: "So...these are the five papers, these are clinical papers. And we can argue about the quality of them, very justifiably. I can pick apart papers that show no benefit as well. But at the end of the day, if I have clinical subjects, real people having undergone trials - and in this case I actually gave it to members of my audience. It wasn't a formal trial..."
Senator McCaskill: "Which wouldn't pass...the trial you did with your audience, you would not say that would ever pass scientific muster?"
Dr. Oz: "No, I would never publish the paper, but it wasn't done under the appropriate IRB guidance - that wasn't the purpose of it. The purpose of it was for me to get a thumbnail sketch of, 'is this worth talking to people about or not?'
That would be all fine and dandy, except that Dr. Oz talked to people about green coffee extract being a miracle cure before he did this little audience 'experiment'! (Also check out that clip to hear from Dr. Oz why he came to talk to McCaskill.)
Dr. Oz: "But again, I don't think this ought to be a referendum on the use of alternative medical therapies. Because if that's the case then listen, I have been criticized for having folks coming on my show and talking about the power of prayer. Now again, as a practitioner, I can't prove that prayer helps people survive an illness..."
Senator McCaskill: "It's hard to buy prayer."
Dr. Oz: "Yes, it's hard to buy prayer, that's the difference..."
Senator McCaskill: "Prayer is free."
Dr. Oz: "Yes, prayer is free, that's a very good point! Thankfully prayer is free...but I see in the hospital, when folks are feeling discomfort in their life, and a lot of it's emotional, when they have people praying for them, it lightens their burden."
Here's the prayer episode in question. Just skip to 4:10 to get to where they talk about the power of prayer. I imagine the criticism was about a medical doctor bringing someone on his show suggesting that the supernatural is a reliable method for curing what ails us.
As a funny aside, you can buy prayer if you want, no problem!
Dr. Oz: "And so my show is about hope. And I want - and as you've very kindly stated - we've engaged millions of people in programs, including programs we did with the CDC, to get folks to realize that there are different ways - that they can re-think their future. That their best years aren't behind them, they're in front of them. That they actually can lose weight.
So, if I can just get across the big message that actually I do personally believe in the items I talk about in the show, that I passionately study them...I recognize that oftentimes they don't have the scientific muster to present as fact."
This is the most telling part of the transcript, in my opinion.
Dr. Oz realizes that the information he gives is not factual - he just stated that exactly above. He is literally admitting to deceiving his audience. You can passionately study the mechanics of a Shake Weight, that doesn't make it work any better.
There are entire schools devoted to witchcraft where you can study for years and spend lots of money if you want. You can believe with all of your heart that you can cast spells. That doesn't make the witchcraft any more credible. Reality doesn't change.
He wants to give his audience hope? Give them the stories of people who lost weight using real, effective, proven methods rather than ineffective pills and expensive supplements.
It's like he doesn't trust his audience with the truth. Losing weight is hard and requires a lot of effort... but don't tell the common folk, they'll lose hope and give up. We must lie to them for their own good!
You know a great way to lose hope? Being told you'll lose weight with a product, spending $50 on it, then not losing any weight. The bottle then joins six of its brethren in the back of a kitchen cabinet, commemorating all the times you've tried - and failed - to lose weight.
Dr. Oz is right - your best years aren't behind you, and you can lose weight. Just not by doing nothing other than taking green coffee extract.
Dr. Oz: "But nevertheless I give my audience the advice I give my family all the time. And I've given my family these products, specifically the ones you mentioned, and I'm comfortable with that part.
Where I do think I've made it more difficult for the FTC is that in an intent to engage viewers, I use flowery language. I used language that was very passionate. But it ended up not being helpful, but incendiary. And it provided fodder for unscrupulous advertisers. And so that clip that you played, which is over two years old, and I've hundreds of segments since then, we have specifically restricted our use of words.
And I'm literally not speaking about things that I would otherwise talk about. There's a product that I have never talked about in the show that I feel very strongly about, because I know what will happen."
'Flowery' is certainly one way to describe his language. I'd use 'grossly over-exaggerated' or 'completely incorrect,' but that's just me.
So, he claims he has learned his lesson... but has he?
Here's a segment he did not too long ago about how litramine will "flush fat fast" and "literally helps you poop out unwanted fat fast." I suppose that's not exactly errr....flowery. But I'm not seeing any big changes in your game plan going on here, Dr. Oz.
Dr. Oz: "I'll say something very...in fact we did a show, with yacon syrup, which you did not bring up. It's a South American root that had a big study published on it, I think a very high quality study, where they showed that not only did it help people lose weight but it more importantly helped their health. It was men and women who were diabetic, done by an academic center down there - it was not funded by industry - and we talked about it. And I used as careful language as I could, and still there were internet scam ads picking one or two supportive words.
Well of course I support them, I wouldn't be talking about it otherwise, but it still ended up out there."
Here's the segment on Yacon. Sorry...careful language? What's careful about this?
- "The shocking results - how women lost weight with no diet, and no exercise! The secret syrup revealed!"
- Bring a clip of a woman on the show saying "I lost 13 pounds with no exercise!"
Not exactly being modest with the words there, I don't think.
Senator McCaskill: "Well, I...listen. I'm surprised that you are defending...I mean I've tried to really do a lot of research in preparation for this trial, and the scientific community is almost monolithic against you in terms of the efficacy of the three products that you've called miracles.
And when you call a product a 'miracle' and it's something you can buy, and it's something that gives people false hope, I just don't understand why you need to go there. You've got so much you do on your show that makes it different and controversial enough that you get lots of views - I understand you're in a business of getting viewers.
But I really implore you to look at the seven...and I would ask you to look at the seven list that the FTC put out on "The Gut Check." The seven...it's very simple:
Causes weight loss of 2 pounds a week for a month without dieting or exercise; Causes substantial weight loss no matter how much you eat; Causes permanent weight loss, like you said looking to 'bust your body fat for good'
...if you just look at those seven, and if you spend time on your show telling people that this is the seven things you should know, that isn't magic in a bottle, that there isn't a magic pill, that there isn't some kind of magic root or acaii berry or raspberry ketone that's going to all of a sudden make it not matter that you're not moving and eating a lot of sugar and carbohydrates.
I mean...do you disagree with any of these seven?"
Here's a link to "The Gut Check" article in question. Good stuff.
Dr. Oz: "Senator McCaskill, I know the seven, I say those things on my show all the time."
Senator McCaskill: "Well then why would you say something is a miracle in a bottle?"
Dr. Oz: "My job, I feel, on the show is to be a cheerleader for the audience. And when they don't think they have hope and when they don't think they can make it happen, I'm willing to look and I do look everywhere, including alternative healing traditions, for any evidence that might be supportive to them.
So you pick on green coffee bean extract. With the amount of information I have on that, I still am comfortable telling folks that if you can buy a reputable version of it...and I say this all the time: I don't sell it and these are not for long-term use.
And by the way, with green coffee bean extract as an example, it's one pound per week over the duration of the different trials that have been done. That happens to be the same amount of weight that was lost by the hundred or so folks on the show who came on, and half of them got a placebo. We've actually got fake pills, gave it to half the people, real pills, to the other half, and it's sort of the same thumbnail. I'm looking at a rough idea.
Look, we know the answer to the question "How can I lose weight?" It's eat less and move more.
What makes that difficult, (and complicates an actual useful answer) among many other factors, is the current food and social environment...and people like Dr. Oz who are promoting a new miracle cure every other week, leaving people confused about what does and doesn't work.
If Dr. Oz truly wanted to be helpful to people, he wouldn't be grasping at straws - massively promoting and exaggerating the benefits of anything that has one tiny study to show it might help you lose one extra pound when combined with diet and exercise.
A poorly-constructed study like the ones he does with his audience don't give him a rough idea. They're worthless - and he admitted that when he said they wouldn't stand up to scientific scrutiny.
Dr. Oz: "If you could lose a pound a week more than you would have lost, doing the things you should be doing already - you can't sprinkle it on cabasa (?) and expect it to work - but if that trial data is what's mimicked in your life and you get a few pounds off, it jumpstarts you and it gives you confidence to keep going. And then you start to follow the things we talk about every single day, including all of those seven items, I think it makes sense."
If the only thing that people needed to lose weight and keep it off was to lose the first couple of pounds quickly, then low-carb diets or fasts would be the answer to our weight-loss woes, since they will get you to drop weight initially very quickly. Plus, doing that is free and actually proven. Unfortunately it doesn't always last.
As well, note how he says that you need to be doing the things "you should be doing already." I assume that means eating a sensible diet and exercising. Why is it that all weight-loss pills or fitness products say you must combine them with diet and exercise for results?
Oh yeah, it's because it's diet and exercise that get you results, not the product.
Senator McCaskill: "Well, I'm going to give time to my colleagues now, and hopefully I'll have a chance to be able to visit with the other witnesses in the next round.
I will just tell you...I know that you feel you are a victim. But sometimes conduct invites being a victim. And I think if you would be more careful, maybe you wouldn't be victimized quite as frequently."
Dr. Oz: "Senator McCaskill, those topics you mentioned are over two years old. I have not been talking about products in that way for two years, and it has not changed at all what I am seeing on the internet, and frankly it is getting worse. So I completely heed your commentary, and I realize - to my colleagues at the FTC - that I have made their jobs more difficult. That's why I came today.
I'm cheerleading for this process. I want to do anything I can to help, but taking away those words doesn't change the problem that's already happened."
As we've shown above, Dr. Oz is still talking about products with 'flowery' and exaggerated language. He hasn't changed, but recognizes the problem is still occurring.
So Dr. Oz recognizes that it's bad for his name when other companies claim that he has personally endorsed their products, but doesn't want to have to change his actions so that doesn't happen.
He wants to continue peddling ineffective products on his show for...ratings...or money...or whatever, but without suffering the backlash and negative consequences of doing so.
I agree that advertisers should not be allowed to fake Dr. Oz's endorsement. But honestly, to me that's a different issue.
Dr. Oz should not be allowed to lie to and deceive his audience - which he above has admitted to doing.
Now, I get that there will never be a regulation that doesn't allow him to say whatever he wants on his show. The real solution then lies in educating his audience.
How we do that is another subject entirely. But hopefully by showing them something like the analysis above, they can at least recognize he has faults and has given them bad advice at least once.
And if he's done it once...maybe he's done it twice. And maybe he could do so again. And maybe his word isn't gold...