Wednesday, January 17, 2007

DietLand: a brief history of federal oversight(s).

Consumer demand for the next weight-loss godsend is such that "revolutionary products" that lack any scientific foundation (and may be unsafe) typically generate millions in ill-gotten revenues before the government steps in.

Mostly, though, the government opts out. (As is often true of regulatory impotence, the reasons can be traced to a cozy, strange-bedfellows relationship between politicians and heavy hitters in the drug, weight-loss and food industries.) Even when it becomes impossible for Washington to ignore what's going on, the results of its enforcement actions amount to less than meets the eye. A dozen years ago, the Food and Drug Administration (FDA), unnerved by the proliferation of useless and dangerous weight-control products, spearheaded passage of the Dietary Supplement Health and Education Act of 1994 (DSHEA). In theory, the law more precisely defined dietary supplements and their ingredients; amplified FDA policies on nutritional labeling; tightened up then-sloppy guidelines for point-of-purchase materials promoting supplements; added new requirements covering the use of testimonial claims and supportive matter; and granted the FDA the authority to establish so-called "good manufacturing practice" regulations to ensure product potency and uniformity.

Trouble is, many of DSHEA's regulations turned out to be unenforceable if not downright counterproductive. It probably isn't coincidence that since DSHEA, the number of major FDA actions against the diet and fitness industry has actually shrunk. Though there may be political factors in play here—such as a more laissez-faire Republican administration calling the shots—critics also allege that by putting the government's policies and tactics down in black and white, DSHEA gave scammers a blueprint for exploiting its gray areas and finding loopholes in its language.

The post-DSHEA years witnessed an avalanche of carefully worded ads and other publicity for products in all personal-care industries. (Notably, this explains why the phrase "reduces the appearance of fine lines" [emphasis added] has become staple text for all anti-aging potions. It's the kind of phrase that gets in under the consumer's radar. In reality, the manufacturer is conceding that its product, far from removing or even "treating" wrinkles in any therapeutic way, merely covers them up. A consumer who buys pricey anti-aging products is, therefore, buying more of what she already owns aplenty: make-up.) This trend is clear in the results of an ambitious 2002 multi-disciplinary study of weight-loss advertising involving shared staff from the Federal Trade Commission, Bureau of Consumer Protection and other watchdog groups. Researchers compared ads in eight leading national magazines in 1991 to those in the same magazines a decade later. The principal author of the study's executive summary, Harvard's Dr. George Blackburn, concluded that misleading advertising not only remained "rampant and potentially dangerous," but that the nature and magnitude of the deception had actually gotten "dramatically" worse since 1991.

A further case in point: Some months before ephedra was pulled from shelves, supplement makers who'd been reading the tea leaves (green ones, no doubt) scrambled to develop replacements and today are having a field day selling new addictive stimulants that are too obscure to set off any alarm bells at the FDA. Most of these substitute compounds work as diuretics, promoting water loss, similar to the popular (and later discredited) diet pills of the 1970s. And—also like those earlier pills—they may cause electrolyte imbalances, altered endocrine function and other potentially serious health problems.

Consider, too, electronic muscle stimulators, promoted as aids in fat loss and overall "body shaping." Hooked up to the user much like an electrocardiogram, an EMS device supplies tiny jolts of electricity that cause muscles to expand and contract passively—without any exertion on the user's part. Most often such products are touted as "abs builders" (even though studies show that "exercising" abdominal muscles in this manner is in no way analogous to a gym workout). After a flood of TV spots for EMS-type products that promised to help buyers "get six-pack abs without doing a single crunch!", the FDA in 1995 clarified its longstanding skepticism of the devices, denouncing as plainly "fraudulent" the marketing of EMS units for any type of body shaping. Nonetheless, a 2005 survey of dozens of (anonymous) health-club owners revealed that a decade later, the FDA stricture continued to be widely flouted by neighborhood gyms, who don't advertise the service, but simply offer it to regular customers as an adjunct to their workouts.

Complicating matters it that sub-agencies within the government are actively working at cross-purposes with the rest of the anti-fraud initiative. Chief among them is the National Center for Complementary and Alternative Medicine. (If you own a copy of SHAM, see pp. 219-222 for a "nice" overview of NCCAM and its ills.) NCCAM lends legitimacy to far-out health regimens that range from improbable to asinine, at the cost of billions of dollars in public funds wasted since the agency debuted as the Office of Alternative Medicine in 1992. NCCAM has been a particular champion of "natural" regimens that claim to promote weight loss and offer other general health benefits. Current NCCAM budget: $123 million.

The real shame of it all is that, while the government has been ineffectual at combating the industry's excesses, weight-loss marketers have been adept at turning the government's own procedures to their advantage. One favored tactic is to patent or trademark weight-loss products—as if patents or trademarks = credibility. It's important to realize that in issuing a patent, the U.S. Patent Office is saying only that a product differs in some material way from other registered products. Neither a patent nor a trademark constitutes an endorsement of a product's utility or safety…no more than the copyright on a product's labeling or advertising materials constitutes an endorsement of the accuracy or honesty of those materials.

In observance of DSHEA's 10th anniversary, the FDA announced a major push to improve the "transparency, predictability, and consistency of its scientific evaluations and regulatory actions to protect consumers against unsafe dietary supplements making unauthorized, false, or misleading claims." Among the agency's partners in this ongoing endeavor are such federal bureaucracies as the NIH Office of Dietary Supplements, the National Toxicology Program in the Department of Health and Human Services and, regrettably, NCCAM. So we'll see.

I for one am not optimistic. (But you already knew that.)

Only the data are slim. Part 2.
Only the data are slim. Part 1.
Hoodia wanna believe?*
Waste size.

* Careful readers will note that this post is now back, "by popular demand." Actually, by special arrangement with two editors.


Luther "Luke" Setzer said...

Consumers have a positive obligation to think critically about product claims rather than rely on a nanny state to do their thinking for them.

Steve Salerno said...

I hear what you're saying, Luke, but I'm not sure this is as cut-and-dried as it would appear. What about situations where even the flow of information is to some degree tainted--i.e. controlled by people with a vested interest? When it comes to weight loss and nutrition generally, I think that unless a person were willing to devote practically his or her entire life to sorting through the (mis)informational maze (including a fair amount of firsthand research), a certain degree of confusion is bound to result. And are you saying that the government has no responsibility to try to protect people from advertising that is blatantly false, and may cause well-intentioned consumers to do damage to themselves?

Citizen Deux said...

I have a very overweight brother and sister (both younger), to the point that I am genuinely concerned about their health. I undertook a lifestyle change at the start of the summer to improve my own health and drop some weight. After enrolling with a trainer, reviewing with my doctor(s) and talking to a nutritionist, I started.

Guess what. After four months, some rigorous exercise and moderation in my diet, I weigh 20 lbs less!

The problem Luke points out is the problem of the path of least resistance. We typically want results if they are quick and painless (and preferably cheap!)

False and misleading advertising charges are tricky since most come with VERY hefty disclaimers.

A famous "out" is a claim made by many New Age hucksters who claim their "therapeutic" techniques are provided as ordained ministers and should not be used to replace legitimate healthcare providers, but please make your check payable to ...

Check out this famous one on Gary Craig's website EFT

Anonymous said...

You are way too negative, man. By your logic or whatever you want to call it, nobody would ever try anything and none of us would ever loose a pound.

Anonymous said...

Steve, thought you might want to know the following from a Jack Canfield e-mail blast: On January 31st I’m taping an appearance on The Oprah
Winfrey Show featuring Rhonda Byrne, creator of the ground-breaking, feature-length movie (and now bestselling book) The Secret. We'll be joined by fellow Secret teachers Dr. Michael Beckwith, James Ray and Lisa Nichols.

Case said...

Steve, I like the new direction of the blog, and the fresh content. I just happen to be reading Joseph Campbell's The Power of Myth and felt the need to seek some relevant text. If you seek you will ... :) Anyway, I ran across a line on page 117 under the Sacrifice and Bliss chapter that I think speaks to your ongoing frustration with the lack of critical thinking regarding dieting in our culture. Campell said: "It's characteristic of democracy that majority rule is understood as being effective not only in politics but also in thinking. In thinking of course, the majority is always wrong." Now, he was not speaking specifically on the topic of passing the latest and greatest diet fad through a critical filter, but this quote does highlight that the "filter" many people use in judging the effectiveness of the latest diet is majority rule, or simply the apperance of a majority. I think the frustrating thing for you is that many diet programs pass the appearance of majority rule, which is a very low bar indeed, and thus are accepted as effective simply by appearing on TV or reaching the best seller list. Do you think this is relevant to the current discussion?

Case said...


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Steve Salerno said... why didn't I think of that? And you know what makes matters worse? My No. 1 son, as I think they used to say on Bonanza, is an internet guru in NYC... So why didn't HE think of that??

Yes, the phenomenon you reference is of course aligned with, or perhaps the modern-day, celebrity-worship analogue of, Goebbels' Big Lie. The simple fact is that anything that appears on TV these days--anything--achieves a certain credibility, as if mere visibility = actual value. It almost doesn't matter what the content is; consumers will want to consume it. (Remember William Hung and "She Bang"...?) If you can somehow get yourself on Oprah with a diet plan that promotes the notion of eating drywall for breakfast and then having sex with a dead lemur, your diet plan will sell. No one really thinks anymore. In fact, the notion of critical thought is unfashionable--because thought runs counter to faith, and faith is framed (and sold) as the answer to everything. I'm sure we'll see more of that notion in action when Oprah runs her show on The Secret (see above comment).