Diet Supplements, Dr. Oz, and a Great Way to Lose Time & Money

dr oz

 

There are a ton of different products promoted for your health, some good and some bad; take a stroll down to the “diet supplementation” section in your local Walgreens and take a glance at some crappy ones. Or if you really want the full experience, take a stroll to a local GNC and look at their “diet supplementation” section. You’re going to see a whole lot of “WOW SUPER FAT BURNING PRODUCT IN THIS BOTTLE” products and some epic before/after pictures of a girl in a bikini (I think they use the same person in all the pictures, will need to verify this, though).

So, whats the deal with these kinds of supplements? Well, there aren’t really any “perfect” supplements out there. Even the products with good research to support their benefit, such as garlic to lower cholesterol, can pose a potential complication to certain population groups (those at risk of bleeding). [3] Some of the supplements with the strongest evidence to prove their efficacy and safety, oddly receive a false reputation for being very dangerous, e.g., creatine. [1]

In any case, the amount of supplements out there are vast and the information available is varied. That’s when reliable, unbiased, evidence based information outlets (such as www.examine.com) become super valuable. With that said, the average consumer may not go through the process of reviewing the literature regarding different over the counter supplements and herbal products. That’s when the role of health care professionals (especially pharmacists, since they are the most accessible ones) come into play. Unfortunately. we have some highly qualified healthcare professionals (looking at you Dr. Oz) who have an enormous following to whom he gets to spoon feed garbage information. Working in the pharmacy as a pharmacy intern, I have first handedly seen the brainwashed face of many middle aged women reluctant to listen to any advice based off of science or research in favor of the the good looking medical doctor with his own tv show. Yes, Dr. Oz does indeed make a lot of recommendations without any scientific evidence. [5,6]

Enough bashing of doctors that have their own television show even though they shouldn’t. Let’s get to the meat of the article. Here’s a fun fact, these herbals and supplements you’ll find in the vitamin isle are not FDA approved. One of the many jobs the Food and Drug Administration has is to make sure foods and drugs are strictly regulated to ensure the safety and efficacy of “FDA approved” products. This includes the over the counter bottle of Tylenol you have in your medicine cabinet and the the box of pop-tarts under your bed. So if these herbal products and magic fat burning capsules aren’t FDA approved, how do they end up on the shelves of your local convenience stores? As a generalization, most of your magic fat burning pills you see on the shelf, their manufacturer completed a crappy trial or two showing that their product resulted in weight loss. These claims will be super fabricated due to bad study designs and a manipulation in explaining the results. Let’s use an actual example using a popular fat loss supplement, garcinia cambogia, using a meta-analysis published in 2010, looking at its use as a dietary supplement. But first, I should probably explain what a meta-analysis is first…

A meta-analysis is when researchers will look at all the relevant literature on a topic and select those studies which fit a certain criteria (criteria which basically makes the study reliable). They will analyze the results, crunch the numbers, and come up with an overall conclusion on the data. A well done meta-analysis can really provide good information on a topic since they look at basically all the literature available on a topic.

So, what did this meta-analysis find? They concluded that the average weight loss seen from usage of garcinia cambogia versus placebo (an inactive pill used to compare the efficacy of something) was an extra 1.9 pounds. So, this product MIGHT help you lose an extra 2 pounds in over the period of a month or two in addition to a low calorie diet. Not to mention, these trials are short term (2 to 12 weeks) so the long term effects of garcinia are not known. That’s in addition to the short term adverse effects of garcinia, which include: headache, skin rash, common cold, and gastrointestinal symptoms which lead 88 people in total to drop out of the studies included in the meta-analysis. [4]

To really summarize the point of my analysis on garcinia, think of this. When you grab a bottle of garcinia camboga, in very large font in the front of bottle it’s going to say something like “SUPPORTS APPETITE CONTROL AND INHIBITS FAT PRODUCTION”. In very small font in the back it’s going to say “*These statements have not been evaluated by the Food & Drug Administration”. Luckily their statements have been evaluated by our kind folks who completed the meta analysis. So in my opinion, what would be the more honest, accurate, and consumer friendly label description?

“Hi, we’re garcinia camboga and as a result of a lot of different unwell designed studies, it’s been shown that versus placebo, we offer a potential extra 2 pounds in weight loss over the period of a few months (in addition to a low caloric diet). There were some people in the studies who felt their appetite was controlled, but it wasn’t a statistically significant effect. In addition, you might get some crappy side effects like stomach upset, headaches, rash, and a cold. The long term effects of this product are not known and could potentially lead to liver toxicity which will likely be reversed upon discontinuation, based on prior case reports. [4] We recommend if you do want to spend 15 dollars a month to possible lose an extra 2 pounds DO NOT use longer than 3 months. Thanks!”

This obviously will never happen because then people like Dr. Oz won’t have a television show and these companies wouldn’t make any money.

To conclude, I really want to highlight the “so what”. What is the real clinical relevancy of the misguidedness alongside these weight loss supplements? People are going to waste time and money on these products which are going to offer them no long term benefit and minimal, if any, short term benefit. That time and money could be used towards things which will actually benefit the person. In addition, people often have the expectation they can go about their normal lifestyle (which led to their unhealthy body composition in the first place), take the weight loss supplement, and lose weight. Can you think of a greater combination of time wasting and ignorance? I can’t. All of this bad and misleading information is just another reason why we have an obesity epidemic. Can you imagine all of the efforts put towards these weight loss supplements were geared towards healthy lifestyle changes instead? Then the section for garcinia cambogia could be replaced with FNDFitness t-shirts and merchandise instead.

References:
[1] Cooper, Robert, Fernando Naclerio, Judith Allgrove, and Alfonso Jimenez. “Creatine Supplementation with Specific View to Exercise/sports Performance: An Update.” Journal of the International Society of Sports Nutrition. BioMed Central, n.d. Web. 25 Apr. 2015 <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3407788/&gt;.

[2] Dara, Lily, Jennifer Hewett, and Joseph Kartaik Lim. “Hydroxycut Hepatotoxicity: A Case Series and Review of Liver Toxicity from Herbal Weight Loss Supplements.” World Journal of Gastroenterology : WJG. The WJG Press and Baishideng, n.d. Web. 25 Apr. 2015. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2773866/&gt;.

[3] “Garlic – Scientific Review on Usage, Dosage, Side Effects | Examine.com.” Garlic – Scientific Review on Usage, Dosage, Side Effects | Examine.com. Examine, n.d. Web. 25 Apr. 2015. <http://examine.com/supplements/Garlic/&gt;
[4] Onakpoya, Igho, Shao Kang Hung, Rachel Perry, Barbara Wider, and Edzard Ernst. “The Use of Garcinia Extract (Hydroxycitric Acid) as a Weight Loss Supplement: A Systematic Review and Meta-Analysis of Randomised Clinical Trials.” Journal of Obesity. Hindawi Publishing Corporation, n.d. Web. 25 Apr. 2015 <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010674/&gt;.
[5] Specter, Michael. “The Operator – The New Yorker.” The New Yorker. The New Yorker, 4 Feb. 2014. Web. 25 Apr. 2015. <http://www.newyorker.com/magazine/2013/02/04/the-operator&gt;.
[6] Swiss, Jamy. “JREF Swift Blog.” Dr. Oz: A Hazard To America’s Health. James Randi Educational Foundation, 12 May 2013. Web. 25 Apr. 2015.

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