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| Dr. Mehmet Oz |
Then he told his audience about a “breakthrough, ” “magic, ” “holy grail, ” even “revolutionary” new fat buster. “I want you to write it down, ” America’s doctor urged his audience with a serious and trustworthy stare. After very carefully wrapping his lips around the exotic words “Garcinia cambogia, ” he additional, sternly: “It may be the simple solution you’ve been looking for to bust the body fat for good. ”
In Dr . Oz’s New York City studio, garcinia extract or hydroxycitric acid found in fruits like purple mangosteen-sounded fantastic, a promising new tool for your battle against flab. Outside the Oprah-ordained doctor’s sensational world of amazing new diet programs, there’s no real debate about whether garcinia works: The best evidence is actually unequivocally against it.
The miracle cure isn’t really a miracle at all. It is not even new. Garcinia cambogia has been studied as a weight-loss aid for more than fifteen years. A 1998 randomized controlled trial looked at the effects of garcinia as a possible “antiobesity agent” in 135 people. The conclusion: The pills were no better than placebo for weight and fat loss.
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One of those authors, Edzard Ernst, has dedicated their career to analyzing research on alternative and complementary medicine; he discovered that the supplement may be linked to adverse gastrointestinal effects. He told us, “Dr. Oz's promotion of this and other unproven or disproven alternative treatments is irresponsible and borders on quackery. ”
Still, people march into pharmacies or even their physicians’ offices every day asking for Dr . Oz - endorsed treatments - even when these remedies are backed by the barest of evidence or non-e at all. Oz’s satellite television patients spend tremendous amounts of money on products he recommends, a trend that has been dubbed the “Oz Effect. ” After he promoted neti cooking pots, for example , Forbes magazine reported sales and online searches for the nasal irrigation system rose by 12, 000 percent and 42, 000 percent, correspondingly.
Who can blame his viewers? Oz may be the most credentialed of celebrity wellness promoters. He’s a professor and vice-chair of surgery at Columbia College College of Physicians and Surgeons. He earned his degrees at Flowers League universities, namely Harvard and the University of Pennsylvania. He’s won the slew of medical awards (in addition to his Emmys) and co-authored hundreds of academic articles. He’s clearly a smart guy with qualifications, status, as well as experience. It’s reasonable to assume he is well-versed in the scientific method and also the principles of evidence-based medicine. “Because he’s a physician, that lends a certain expert and credibility to his opinions, ” said Steven Novella, a medical neurologist and assistant professor at Yale University School of Medicine who has used Oz to task for his science. “But it lends credibility in order to anything he says. ”
And lately, a lot of what Oz has been stating is downright wrong (scroll to the end if viewing as a single page).
To support the awesome assertions about the flab-fighter Garcinia cambogia, the doctor created in the TV show an atmosphere of accessible scientific certainty. He brought out researchers as well as physicians in white coats who discussed what they said was compelling proof for the weight-loss panacea. There was an inspiring testimonial from a member of the audience. Plastic material models even demonstrated how garcinia could suppress appetite and stop fat through being made. The show had the same easy manner as Oprah discussing Leo Tolstoy with her book club.
Throughout the episode, Oz maintained his trademark girlish childish wonder and excitement as he delivered a message many of us long to hear: The pill could help us “burn fat without spending every waking moment exercising as well as dieting” and even combat “emotional eating. ” Oz peppered his excitement which includes caution: “Please, listen carefully, ” he said with a shrug of their shoulders and his hands raised defensively in the air, “I don’t sell the things. I don’t make any money on this. I’m not going to mention any brands for you, either. I don’t want you conned. ”
Oz has acknowledged on air flow that as soon as he mentions a product, manufacturers clamor to get up websites declaring their brand was endorsed by him. They put his face on tablet bottles and placards in health-food stores. They link to his show’s web site and columns. His PR man, Tim Sullivan, told us that along with every product Oz talks about, “the next morning I wake up to fifty Google alerts from companies saying ‘Oz recommends raspberry ketones. ’ ” He says Oz’s legal team prosecutes these unauthorized endorsements “aggressively. ”
Still, Oz seems to have a penchant for peddling products. Millions follow their advice through the TV and radio, as well as his books, newspaper columns, as well as magazine articles. And examples of his pseudoscience abound.
Take a breaking-news segment regarding green coffee-bean supplements that “can burn fat fast for anyone who wants to lose weight. ” Oz cited a new study that showed people lost 17 pounds within 22 weeks by doing absolutely nothing but taking this “miracle pill. ”
A better look at the coffee-bean research revealed that it was a tiny trial of only 16 individuals, with overwhelming methodological limitations. It was supported by the Texas-based company Applied Meals Sciences Inc., a manufacturer of green coffee-bean products. Oz didn’t point out the potential conflict of interest, but he did say he was skeptical. To ease his thoughts, he conducted his own experiment: It involved giving the pills to two audience people for five days and seeing what would happen. Unsurprisingly, both women reported becoming less hungry, more energetic, and losing two and six pounds, correspondingly.
There are many reasons why this made-for-TV “study” would not be published in any reputable healthcare journal or meet the approval of Oz’s peers: The sample size had been minuscule. The women were not followed for long enough to know whether the effects of the health supplement were real. They were neither randomly selected nor unaware of what they were using. They also knew they were going to have to announce their weight in public to countless viewers. That pressure, combined with a strong placebo effect, was the most likely cause of their own shape change, if one can call it that at all.
As another example, with regard to Day 6 of his “7-Day Miracle Plan to Boost Your Metabolism, ” Ounce told viewers “zinc reduces hunger by increasing your level of leptin” and that they usually takes 12 to 15 mg of the mineral daily. He probably based his statements on a study of mice that raised a possible link between zinc, protein hormone, and weight loss.
But experiments involving people don’t bear this out. The double-blinded, randomized, controlled trial in humans found that zinc supplements failed to cause significant changes in weight, body mass index, body fat percentage, or waistline circumference. Nor did leptin increase. One study suggested zinc may even lower protein hormone levels.
On a Jeopardy-themed episode about the “best flat-belly foods of all time, ” Ounce shared advice on what to do to get rid of a “muffin top. ” He recommended walnuts, yogurt, and olives, which he said are “great for keeping your own belly flat. ” Besides the fact that consuming any of these high-calorie foods in excess is going to do the opposite of keeping a person slim, there’s also no good evidence for targeted weight loss such as shedding love handles, especially by eating particular foods.
He has recommended fish oil supplements supplements for improved cardiovascular health and vitamin D to stave off colon, prostatic, and breast cancers and to slow aging. While some evidence supports the importance of seafood and vitamin D in the diet, studies on supplements have not shown protecting effects.
Oz calls raspberry ketone supplements another “miracle in a bottle in order to burn your fat. ” Again, there’s no proof for this claim. All research on raspberry ketones have been conducted on rodents or cells, never that individuals. At the end of a blog post on ShareCare, the website for “quality healthcare information” which Oz co-owns, even he concluded: “Positive early results in the lab can be encouraging, but these do not always mean the same outcomes will occur in humans. ”
Sullivan, Oz’s PR representative, tried to soften the claims. He explained, “An verbal adjective like ‘miracle’ is used as an editorial device to describe anecdotal results, as exemplified by the guests on our show. Our audience are not scientists, and the show must be more lively than a dry scientific discussion. ” Even with the multiple alerts, the little miracles flew off store shelves.
A legion of doctor-bloggers offers dedicated thousands of hours to dissecting and debunking Oz’s claims. One of them is actually Steven Charlap, a preventive medicine physician in Delray Beach, Fla. “Patients were bringing in shopping carts full of different pills, ” Charlap recalls. “When I would ask them, ‘Why do you take a certain pill? ’ I found very often, the actual response was, ‘I heard about it on the Oz show. ’ ”
To comprehend where his patients were getting their health advice, Charlap began viewing the program. “I was shocked that someone with his credentials-someone who apparently nevertheless operates on patients and therefore must still be fully cognizant of a physician’s very first priority, which is to do no harm-would be recommending all types of different pills, numerous that had never undergone rigorous scientific scrutiny, as miracle cures or even magic pills to a very susceptible audience. ”
One of the first Oz-approved products Charlap looked into was milk thistle. Oz suggested the supplement as a “quick fix” for nights when you have one too many gin and tonics. The herbal treatment, according to Oz, “boosts your liver’s enzyme function, which helps to detoxify against excess alcohol. ”
But Charlap noted that while some studies suggest dairy thistle may be helpful for people with liver disease, the evidence is unclear on its some other health benefits. So when a woman on milk thistle came into Charlap’s clinic for her yearly wellness visit, he asked if she had any problems with her liver organ, an abnormal liver-function test, or any other medically justifiable reason for using the item. The answer was no: She used milk thistle because her “other doctor” informed her to do so. She was taking Oz’s medicine.
Oz, Charlap noted, has also motivated people to take two baby aspirin every night before bed to prevent heart assaults. For people at high risk for coronary heart disease, the authoritative U. S. Preventive Services Job Force would agree with him. But for healthy and older folks, aspirin may have damaging side effects-including bleeding ulcers-which are well-documented and may outweigh any possible benefits. Aspirin can also hurt patients who are on anti-coagulants or who have a brief history of gastric or stomach ulcers, a warning Oz does not mention in the show. An exasperated Charlap asked: “Where is the ‘first, do no harm’ when he does something like that?
Beyond potential damage to people’s health and purses, this type of peddling can also foster doubt and mistrust of science. As Edzard Ernst put it: “Prominent people like Oz do have considerable influence. If this influence is utilized to promote quackery, bogus treatments will seem credible. Using bogus treatments with regard to serious conditions may cost lives. ”
Interestingly, for all the health wonders this individual promotes, Oz himself doesn’t rely on magic pills or quick fixes to keep his salubrious air. He monitors his weight and exercises daily. Based on a New York Times profile, his diet consists of berries, spinach, raw walnuts (soaked in water to “amplify their nutritional benefit”), and a dark eco-friendly concoction of juices from cucumber and parsley. The Times journalist called this “the most efficient, joyless eating I have ever seen. ”
This doesn’t can make for good TV, though, which gets at the tension between the worlds of technology and entertainment. Science is a process, moving along in increments, with prevents and starts, mostly very slowly. As a result, new treatments are usually only somewhat better than older ones, actual breakthroughs are rare, and good medicine is usually dull. Showmen like Oz, however , must be anything but humdrum-five times every week.
Whenever speaking to us for Maclean’s magazine last year before a Toronto appearance, Ounce said he has to mix the low and high, hope and reality, to make sure this individual attracts enough viewers to stay on the air. He offered raspberry ketone dietary supplements as an example of how he tries to give people hope. “I do actually think from the data we have so far it could be a nice little nudge. The amount of weight you will lose is two, three, four pounds more than you would have. But a fresh nudge. ”
He continued: “If you went line by line with the show and try to figure out what part of it is glitzy stuff, like icing within the cake, and what part is the meat of the cake, I bet that’s the best ratio: Three-quarters is meat and potatoes, hard-core stuff you got to do, but that’s the medication. ”
Much of what Oz says about high-calorie foods, exercise, even smile flossing, isn’t bad at all.
But as Novella noted, “I can see how it is challenging to put out as many shows as he’s doing-that’s his problem. It is his job to do that and have minimal standards. ”
Why Oz would market junk also raises questions about his links with industry. Though Sullivan keeps Oz has “no financial or business ties to any companies that make any kind of retail product, including any that appear on the show for routine protection, ” he is not without at least indirect financial rewards for some of the wellness products and information he shares.
He promotes and is a scientific adviser for your website RealAge. com, which helps people calculate their body's age as well as promotes better living through non-medical solutions. Yet, according to a New York Times analysis, “Pharmaceutical companies pay RealAge to compile test results of RealAge members as well as send them marketing messages by e-mail. ” A seemingly benevolent wellness website has helped line Oz’s pockets through behind-the-scenes links to industry-and has Oz acolytes unwittingly handing over their personal health information in order to pharma.
Oz wouldn’t be the first celebrity physician to promote bogus medicine with regard to personal gain. In 2012, it was revealed that CNN medical contributor Dr . Received Pinsky-a board-certified addiction specialist-was paid by GlaxoSmithKline to encourage the off-label use of the antidepressant Wellbutrin. Pinsky once said on-air that the drug might help females achieve more orgasms during intercourse-a suggestion that set GlaxoSmithKline off along with delight. According to an internal memo, the TV doc had successfully “communicated key strategy messages” to his massive audience. Apparently he performs well.
So how tend to be we supposed to tell medicine from miracles? As a general rule, said Victor Montori, a good evidence-based medicine guru at the Mayo Clinic, “If studies are cited, then that cannot be, at the same time, a secret revealed just to you now. If the studies are the proper job, the effects are usually very small. ” Referring to Oz’s holiday weight-loss advice, he additional: “It is very unlikely that an important compound hidden in the garcinia could have a large effect. ”
We can also arm ourselves with the knowledge that not all evidence is made equally, and celebrities-even famous doctors-are not credible sources of health information.
A few other rules for sifting nuggets of good evidence from gobbledygook include: Research including humans is typically more relevant than animal models; prospective, randomized, controlled tests are usually better than retrospective, observational analyses; large studies are better than small studies; multisite studies are better than single-site; and systematic syntheses of all the available evidence are more helpful than individual studies presented out of context.
Our own doctors will probably know more about there is no benefits good for us than our favorite celebrities, their doctors, or even America’s doctor, the actual wonderful wizard that is Oz .
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