Blog | Tuesday, June 19, 2012

Weight loss miracle?


Americans are fat. That's fact, not judgment. The reasons for our obesity are complex, without simple answers. Some of it is social: availability of cheap, bad foods; sedentary lifestyles encouraged by the way our society has developed. Some of the reasons are biochemical. Obesity is a complex medical condition which, once present, reinforces itself through hunger responses driven by hormones and neurochemical changes in the brain.

Given obesity's complexity, it's not surprising that we've failed to find a "cure." A pill to cure obesity would need to affect several hormonal axes, neurotransmitters in the brain, and our society's social ills. Despite the absence of a true obesity pill, fake ones are very popular with a global market of about $1 billion yearly.

One of the hardest things about being a doctor is telling people that there are no easy answers. Whether it's diabetes, breast cancer, or obesity, we have few magic bullets in our bags. Some doctors cannot deal with bad news, so they ignore it or even make up solutions that don't exist.

Take Dr. Oz, the cardiovascular surgeon who has risen to prominence through his appearances on Oprah and now has his own show. Many of us in practice dread his name. It's hard to find a doctor who hasn't had to debunk Oz's wild claims which often waste our time and our patients' money.

One of the latest wild, unfounded claims from Oz ("claims from Oz;" I've got to remember that one) is "Raspberry Ketone: Fat Burner in a Bottle." His unbridled enthusiasm for this product is embarrassing.

His video makes him look like a sideshow barker, with the hyperbolic language, grandiose gestures, and distracting tricks (the balloons and liquid nitrogen, liquid N2 is always cool). But the content is far worse.

Raspberry ketone (RK) is a chemical compound which gives raspberries their characteristic aroma. Some have hypothesized that it may have a role in fat metabolism and potential as an aid to weight loss. This hypothesis has been tested--a little bit. A study in rats found that RK, when fed to rats getting a high-fat diet, may mitigate their weight gain. Another study found that certain kinds fat cells in the lab behaved differently (expressed different cytokines, accumulated fat differently) when exposed to RK.

There are a couple more similar articles--and not one study of the effects of obesity in humans, the one claim exuberantly advertised by Oz.

This is unconscionable behavior from a physician. His show is an infomercial in all but name. People suffering from obesity deserve better than a doctor who shills for the latest patent medicine.

References
Morimoto C, Satoh Y, Hara M, Inoue S, Tsujita T, Okuda H. Anti-obese action of raspberry ketone. Life Sciences. 2005. 77(2), 194-204. DOI: 10.1016/j.lfs.2004.12.029
Park K. Raspberry Ketone Increases Both Lipolysis and Fatty Acid Oxidation in 3T3-L1 Adipocytes. Planta Medica, 2010. 76(15),1654-1658. DOI: 10.1055/s-0030-1249860

Peter A. Lipson, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. After graduating from Rush Medical College in Chicago, he completed his internal medicine residency at Northwestern Memorial Hospital. This post first appeared at his blog, White Coat Underground. The blog, which has been around in various forms since 2007, offers "musings on the intersection of science, medicine, and culture." His writing focuses on the difference between science-based medicine and "everything else," but also speaks to the day-to-day practice of medicine, fatherhood, and whatever else migrates from his head to his keyboard.