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Snake Oil

Inside the Dr. Oz PR Machine

I mentioned last fall that the Federal Trade Commission had gone after an egregiously faked-up “study” that was being used to sell green coffee bean extract as some sort of miracle weight-loss drug on the Dr. Oz show. The agency has now gone after “Dr.” Lindsey Duncan, the guest who was pushing the stuff. Update: here’s the complaint.
That link will make you want to spit on the floor. Duncan is accurately described as a snake-oil salesman – his “degree” is from an unaccredited mail-order diploma mill, and he’d never heard of green coffee bean extract before the Dr. Oz show staff contacted him to see if he could be a guest to talk about the stuff. He assured them that yes indeed, he was just the man for the job, and got his web site lined up to sell bushels of the stuff. It does not seem to have occurred to Dr. Oz or his production staff that the guy who was confidently recommending a particular brand of green coffee bean extract as the stuff that would take off 16% of your body weight without dieting or exercise might just possibly have a financial stake in the business. Or if that thought did cross anyone’s mind, they certainly didn’t let it disturb them.
My contempt for Dr. Oz has actually increased, which I hadn’t thought likely. But think of the contempt that its staff and its guests must have for their viewers – now that’s impressive.

32 comments on “Inside the Dr. Oz PR Machine”

  1. Hap says:

    I wonder if they could get Dr. Oz for some sort of negligent fraud – given his position, his show’s total lack of any fact-checking would seem to indicate something beyond mere stupidity. Maybe “soliciting fraud” might be an alternative.
    Maybe his show and Ranbaxy’s PR people could get together – I’m sure there are huge fields of contempt they could mine together, preferably without safety equipment or minesweepers.

  2. oldnuke says:

    Gotta love this article’s title regarding the quack:
    Subtle! 🙂

  3. Anonymous says:

    This stuff isn’t even worth blogging about anymore (if it ever was), it just raises his publicity.

  4. anon2 says:

    I think one lesson here is that Physician ≠ Scientist.
    Surgeons (Oz is a surgeon) use surgical protocols to perform a planned operation. Good surgeons are able to modify these protocols in the middle of an operation (for emergency reasons) and excellent surgeons modify these throughout their careers (and then teach others). 95% of practicing physicians are not involved in experimentation and simply are not trained to think critically about how that PCSK9 drug works, they merely prescribe based on standards of care and guidelines issued by their specialty’s professional organizations. These days a large percent of their time isn’t even involved with doing those procedures as there are insurance/coding/reimbursement issues they spend time with. The critical thinking is why we have scientists in a lab (and statisticians on the keyboards) doing this stuff. We also have a small organization called the FDA that can help discern snake oil.
    The bottom line is that if physcian of specialty X is speaking about specialty Y, you can’t believe every word of it. Much less specialty X speaking about magic beans.

  5. anon2 says:

    That was supposed to be a not equal sign.
    Physician does not equal Scientist

  6. Brains says:

    Yes, and a mechanical engineer is not a physicist. I would, however, expect a competent engineer to:
    a) know the basics of the scientific method.
    b) recognize the limits of the scope of their own knowledge.
    c) apply item A to exclude obvious bull.

  7. boo says:

    It really is disturbing to me that my alma mater continues to have him employed as the Vice Chairman of the Department of Surgery.

  8. qetzal says:

    Only if the engineer is competent and ethical. I expect that Oz is perfectly competent. It’s the ethical part that he’s lacking.

  9. Hap says:

    1) The initials after your name or the places you’ve worked don’t matter very much if you can’t be trusted. It ought to be obvious but doesn’t seem to be taken into account.
    2) I’m assuming he’s already in debit in his self account, but as long as people keep giving him money in return for integrity he doesn’t have, he has little to lose by continuing to sell. At some point, the people that keep funding his gravy train have to accept some blame – whether out of wishful thinking or lack of knowledge that they can or will not address, they are willing to accept his advice at face value. The contempt seems inbuilt into the world of scams (because many of those that fall for them are greedy or should know better), and this looks like a scam with a bigger audience.

  10. Pmd says:

    If you haven’t already, google and watch last week tonight with John Oliver, the dr oz episode (it’s on YouTube). Short, brilliant, hilarious and says everything that needs to be said about oz, senator hatch and dietary supplements in just 15 minutes.

  11. KOH says:

    I currently work in Asia and one of my local colleagues informed me that she recently bought snake oil (apparently from a real snake) to treat chilblains and that it worked wonders; the increase in temperature had nothing to do with it, of course. I couldn’t stop laughing at that thought that there are still actual snake oil salesman out there.

  12. KOH says:

    I currently work in Asia and one of my local colleagues informed me that she recently bought snake oil (apparently from a real snake) to treat chilblains and that it worked wonders; the increase in temperature had nothing to do with it, of course. I couldn’t stop laughing at that thought that there are still actual snake oil salesman out there.

  13. Lane Simonian says:

    I don’t listen to Dr. Oz, so I have no idea how often he goes over the line: is it once or twice a year or is it every other show? I prefer someone like Jerome Burne (Body of Evidence). He is not always right either but he often makes very well-reasoned arguments based on diligent research.
    Do all supplements work?–of course not. Are all supplements safe?–of course not. Have some people died from supplements?–apparently very rarely.
    Are all medicine effective?–of course not. Are all medicines safe?–of course not. Have some people died from medicines?–several thousand a year (and not just from overdoses or negative combinations). My favorite line on modern medicine comes from Stephen Colbert–“abuse only as directed.”
    The idea that no natural product can be used to treat any medical condition is just as ridiculous as arguing that any natural product can treat any medical condition. Indeed the cognitive dissonance among some scientists is just as high as among the people they consider to be quacks. A little humility and willingness to look at the evidence goes a long way and that applies whether you are a scientist or not.

  14. Oblarg says:

    I don’t think you’ll find many scientists at all who’d say “no natural product can be used to treat any medical condition.” That claim would fly in the face of observable fact – loads of very effective drugs on the market today are natural products.
    The rub is that if the thing works and is safe, you should be able to demonstrate that it works and is safe. Actual drugs, natural products or not, make it through the FDA. Supplements are exempt from those pesky requirements. Your post sets up a false equivalence between products that are forced to pass very rigorous safety and efficacy testing and products that, as has been noted on this site, likely don’t even contain what is on the label. Are the drugs that make it through the clinical trial process perfect? Of course not. Are they better than products that haven’t been tested at all? You betcha.

  15. Anonymous says:

    Yes, you are building something of a strawman argument here, by putting the words “no natural product can be used to treat any medical condition” into scientist’s mouths.
    i don’t know any scientist who would believe that. Natural products can work just the same as synthetic, but in both cases evidence is needed.

  16. MTK says:

    What a bunch of self-backslapping mularkey.
    Who the heck here is arguing that “no natural product can be used to treat any medical conditions”? I would venture that every person who regulars this blog knows that penicillins are, for example, natural products.
    But thanks for lecturing us about humility anyway. We should all strive to be more like you.

  17. Lane Simonian says:

    The problem is that some scientists reject out of hand human clinical trial evidence that natural products can treat a variety of diseases. I have seen this happen multiple times (and not just to my posts). The scientific response is we need further studies; the non-scientific response by supposed scientists is that these studies are a bunch of junk (even when there is no evidence to support that conclusion). These “scientists” have already predetermined what will work and what will not.
    I would suspect that if supplements were regulated then it would be more likely that they would contain what they say they contain and nothing more or less. More importantly, with incentive and funding to test supplements, we might be able to better determine which claims are truthful and which are not. I know this approach might scare some in the supplement industry (and perhaps with legitimate reasons), but a level playing field might actually help some in the supplement industry, particularly those which produce products that might actually live up to their claims.

  18. Secondaire says:

    #17, don’t engage #13. It’ll go on forever and everyone’s blood pressure will be raised. Trust me.

  19. steve says:

    NIH set up a whole institute to test all these “alternative” medicine remedies. Have they found even a single one that had any efficacy whatsoever? Think of all the money that’s been wasted chasing after horse manure.

  20. dave w says:

    Snake oil, per se, is one thing – what’s really scary is the dangerous, poisonous stuff that’s being promoted for “health benefits” – such as the so called “miracle mineral solution” (which is actually acidified sodium chlorite!)

  21. Secondaire says:

    @21 – Jeez. I knew nothing about this stuff (MMS), beyond that some guy was hawking it saying that it was tested as an AIDS curative in a prison in Malawi. Lying, poisoning, and studies of extremely dubious ethics…it’s like they had a Buy One Get Two Free sale on scientific/medical misconduct…

  22. Lane Simonian says:

    #15, #16, and #17 meet #19 and #20. For those really wanting to raise their blood pressure (or perhaps lower it) can read the following:
    Debunking the Debunkers: The Therapeutic Validity of and Essential Oils
    The Dubiousness of the Dubious Labels of Aromatherapy

  23. steve says:

    Blood pressure still low, I guess BS nonsense articles don’t raise it. All these “alternative medicine” articles always use soft end points like “stress reduction” or pain, which are notoriously subject to placebo effects. Interesting that they never try to show you can decrease cancer mortality or restore heart function after MI by sniffing an oil.

  24. Lane Simonian says:

    I can apparently download only one article per post, so here is the best scientific review of the anti-oxidant and anti-inflammatory effects of essential oils. (please open the pdf if interested).
    Scientists who don’t look at all the evidence with an open mind are no more superior than those they criticize for doing exactly the same thing.

  25. Anonymous says:

    Save the open mind and superior bullshit for the gullible. Scientists should critically evaluate evidence.
    As for the review you link to, the evidence is very much lacking on beneficial anti-inflammatory effects of essential oils. The author also seems to have a very poor understanding of immunology. If you feel this to be the best review on the topic, then possibly you need to re-evaluate the evidence more critically after learning more immunology.

  26. Lane Simonian says:

    If you have a specific criticism of the author’s knowledge of immunology provide it.
    The anti-oxidant and anti-inflammatory nature of some essential oils have to do in part with their scavenging of peroxynitrites. From the above study:
    Peroxynitrite is formed by phagocytes for killing invading microorganisms, nevertheless if in high
    concentrations can oxidise several host biomolecules by nitration with the consequent cellular damages
    being responsible for diverse diseases [26].
    Essential oils vary in their anti-oxidant and anti-inflammatory activity. Here is one study regarding inhibition of tyrosine nitation.
    Miguel cites over 150 articles. I suppose they are all junk.

  27. steve says:

    I’m sure that there are lots of the magical anti-oxidants in oils, just as they exist in lots of places. Doesn’t mean that sniffing them cures disease. Scientists believe in hard endpoints and clinical results, not just stringing together a bunch of random data points.

  28. Secondaire says:

    What #28 said.
    Lane, nobody is saying anyone’s studies are junk. However, one must always be skeptical – just because something (natural or synthetic) works in cell culture in a petri dish, or against a purified protein, or even in a mouse – may mean it merits some more investigation, but does not mean at all that those results translate into human studies or show real clinical efficacies. Medicinal chemists always operate in a permanent state of “that’s great, but…” Until there is clinical data showing efficacy in a wide variety of people over time, or until someone files for FDA approval (or approval by the analogous regulatory agency of their country), the data are just that – preliminary. And until those experiments are done, and we’ve got hard results beyond preliminary data, “possibles” and personal anecdotes, your horse is dead, please, get off it.
    And of course someone who runs an essential oil shop will make references to myriads of articles like the ones cited in this review. I’m sure people have done plenty of studies on essential products that don’t do what they’re predicted to do, but hey, confirmation bias means more business for him!

  29. steve says:

    Show me one double-blind, placebo controlled study with adequate statistics and a hard (i.e., objective) endpoint and I’ll start snorting the stuff myself.

  30. Anonymous says:

    “the essential oils studied significantly suppressed the protein and mRNA expression of the cytokines in stimulated cells, assuming therefore, that the inhibitory effect of these essential oils on the expression of the pro-inflammatory cytokines occurs mainly at transcriptional level”
    No competent immunologist would make that statement.
    Also, articles do not have to be junk for them not to support a conclusion. Over-extrapolating inhibition of TNF production of a mouse cancer cell line, in response to LPS (mice and humans react very differently to this), as something that is anti-inflammatory in humans is a large jump.

  31. Lane Simonian says:

    @31. Thank you for being more specific. The anti-inflammatory effects of some essential oils are likely the result of inhibition of specific kinases (especially tyrosine receptor kinases and p38 MAPK) or by later scavegening peroxynitrites and hydrogen peroxide.
    @30. This is not a complete list of clinical trials using aromatherapy and few if any meet your criteria, but I am providing it to show that there is some limited clinical trial evidence supporting the use of aromatherapy for certain medical conditions.
    Larger scale clinical trials are certainly needed. The problem is that essential oil companies cannot afford to have these trials fail whereas certain pharmaceutical companies cannot afford to have them succeed.

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