The Great Fat Fraud

Recent reports in The New York Times and elsewhere have highlighted a growing trend among large and mid-size corporations to penalize healthcare plan participants who are deemed to be “obese.”

Companies that focus on obesity are looking in the wrong place to cut back on spiraling health care claims costs.  The idea that someone’s health status automatically deteriorates as their weight increases is a myth that has been perpetrated by a lot of very poorly designed research studies.  Almost all of those studies looked only at death rates and weight, and completely ignored fitness. When studies have taken fitness into account, a very different picture emerges.

When researchers split their study groups into those who are fit and those who are not fit, what they find is that people who are fit, regardless of their weight, have one half the death rate of people who are thin and sedentary. It is only for people who are sedentary that death rates climb as weight increases.

It would be massively unfair to penalize someone who is fit but heavy when that person is likely to have half the healthcare claims experience of someone who is thin but sedentary.  Corporations that impose or are planning to impose obesity penalties must have a fitness exception.  People who are heavy must be given an opportunity to prove that they are fit with a simple treadmill test, and those who are fit must not be penalized.

In fact, if corporations really want to focus on what is driving health care costs, they should be rewarding everyone who is fit, regardless of their weight.

Yesterday, the FDA sent out a formal warning letter to a marketing company named 1-800-GET-THIN and to eight gastric banding surgery centers that use the 1-800-GET-THIN marketing service.  The letter specifically referenced billboard advertising and marketing materials.  The letter reads in part:

“These advertisements fail to reveal material facts, including relevant risk information regarding the use of the LapBand, age and other qualifying requirements for the LapBand procedure, and the need for ongoing modification of eating habits, as provided in the approved LapBand labeling. Therefore, the advertisements are misleading within the meaning of section 201 (n) of the Act and misbrand the LapBand under section 502(q) of the Act. In addition, while some of your advertisements make mention of risks and suggest a physician consultation, these advertisements do not adequately state the LapBand’s relevant warnings, precautions, side effects, and contraindications. Therefore, the advertisements also misbrand the LapBand under section 502(r) of the Act.”

“Failure to promptly correct these violations may result in regulatory action being initiated by FDA without further notice. Such action could include seizure, injunction, and civil money penalties.”

Some of the nasty side effects from gastric banding include nausea, vomiting, difficulty swallowing, gastroesophageal reflux disease, indigestion, abdominal pain, leaking of the gastric band, stretching of the new stomach pouch so it no longer restricts the amount of food you can eat, moving of the gastric band from its original position requiring another surgery to reposition it, erosion of the band through the stomach wall and into the stomach requiring additional surgery, and stretching of the esophagus.

However, the most serious problem with gastric band procedure is that it fails about 50% of the time.  A long-term study that followed laparoscopic banding patients for a period of thirteen years found that “nearly 50 percent of the patients required removal of their bands” during that period.

On Wednesday, the FDA issued a warning concerning more than 30 “natural” over-the-counter diet pills.  It stated that the “FDA has identified an emerging trend where over-the-counter products, frequently represented as dietary supplements, contain hidden active ingredients that could be harmful.” The FDA issued warnings for the following products: Slender Slim 11 Advanced Slim 5 A-Slim 100% Natural Slimming Capsule Dream Body Slimming Capsule Ja Dera 100% Natural Weight Loss Supplement Leisure 18 Slimming Coffee Lishou Magic Slim Tea Magic Slim Weight Reduction Capsule P57 … Continue reading →

Last June the news hit like a bombshell.  The headlines screamed, the presses rolled.  “Now Yo-yo Diets Are the Secret to a Longer Life –  Yo-yo dieting can extend life and has long-term health benefits, new research has found.  On-off diets that shed and put weight back in quick succession have long been criticized.  But in a huge U-turn, scientists now claim they are better than not dieting at all.” “Yo-yo Diets ‘Better than No Diets’ Study Finds –  Yo-yo dieters were given new hope … Continue reading →

You didn’t think that Weight Watchers, which is the 800 pound gorilla in the commercial weight loss industry, was going take all this researchaganda hoopla from Jenny Craig lying down did you?  Not a chance. So in September of this year, they got their own researchaganda piece published in Lancet, which is the British equivalent of the Journal of the American Medical Association.  This study (you have to create an account to see it but, the account is free) was, of course, paid for by … Continue reading →

The ideal weight loss industry researchaganda piece is one where the sponsoring company has total control.  This was the case with the Jenny Craig marketing piece masquerading as research that we discussed in Part 2 of this series.  They funded the research, they paid for the food and program fees for the participants, they managed the process with their best counselors, and they undoubtedly hand-picked the researcher who led the study. However, the vast bulk of researchaganda is not so tightly controlled.  Control has to … Continue reading →

In its June, 2011 issue, Consumer Reports compared seven commercial weight loss programs – Atkins, Jenny Craig, Nutrisystem, Ornish, Slim-Fast, Weight Watchers, and Zone. And the winner was …. Jenny Craig.  Why?  According to the article, “What gave it the edge over the other big names we assessed” was, believe it or not, that researchaganda puff piece published in the Journal of the American Medical Association (JAMA) that we discussed in the last post. “92% of the participants stuck with the Jenny Craig program for … Continue reading →

In October, 2010, The Journal of the American Medical Association (JAMA) published a paper entitled  Effect of a Free Prepared Meal and Incentivized Weight Loss Program onWeight Loss andWeight LossMaintenance in Obese and OverweightWomen, A Randomized Controlled Trial.  The publication of this paper in JAMA has to be counted as one of the greatest reseachaganda coups of all time. The study was paid for by Jenny Craig.  The lead investigator was Cheryl L. Rock, PhD, RD, a professor at the University of California, San Diego, … Continue reading →

If you sell a product or service, wouldn’t it be wonderful if you could get some prestigious researchers to write a scientific paper proclaiming that what you do works like a charm and that you are the greatest?  And wouldn’t it be even better if that paper could get published in a really prestigious, peer-reviewed journal such as the Journal of the American Medical Association (JAMA) or Lancet, which is the British equivalent of JAMA. Well if you are Jenny Craig or Weight Watchers, it … Continue reading →

Back in February of this year, the FDA rejected Orexigen Therapeutics’ application to approve the weight-loss drug Contrave. Contrave is mix of two medications, naltrexone and bupropion, both already on the market.  Bupropion is the active ingredient of the antidepressant Wellbutrin and the anti-smoking aid Zyban.  Naltrexone is used to treat heroin and alcohol addiction. Although the FDA’s advisory panel voted a tepid 13-7 in favor of approval, the FDA rejected the application because many people who took the drug had elevated blood pressure levels … Continue reading →