Blog | Thursday, July 12, 2012

Dr. Oz and the never-ending infomercial

Many pieces about Dr. Mehmet Oz start something like this: "Dr. Mehmet Oz, respected cardiothoracic surgeon ...." I have no idea what kind of surgeon he is, and I'm betting most people who write about him don't know either. Given his extensive training, he's probably a technically good surgeon. Looking at his list of publications, he's done some interesting work. So why has he gone off the deep end of imaginary medicine?

Two reasons come to mind: Either he's a true believer and is able to hold onto real medical science and superstitious health ideas at the same time, or he's in it for the money. Or both.

He sure seems to be in bed with some sketchy people. Over at his website he's posted the "Oz-Approved 7-Day Crash Diet." Oz has helped developed evidence-based guidelines on the prevention of heart disease, so maybe it's only the title that's wacky.

Nope. The whole thing is out to lunch. It's a diet developed by Dr. Joel Fuhrman, a name well-known to medical skeptics. His writings seem to indicate a belief that all diseases are preventable, and that diet is key to this prevention. No sane physician would argue against proper diet in the prevention and treatment of disease, but no knowledgeable physician would argue that proper diet can prevent all heart attacks and strokes.

Given the source of Dr. Oz's "crash diet," we need to examine the details. Is it standard evidence-based dietary advice dressed up fancy, or is it something only tangentially related to reality?

The secret? It's not a starvation diet, but the exact opposite. His plan allows you to eat all you want and still lose weight. The key is in feasting on nutrient-dense foods--rich in vitamins, minerals, phytochemicals and antioxidants--that are low in calories. Many of the superfoods you are familiar with fall under the nutrient-dense category. According to Dr. Fuhrman, the more of these kinds of foods you eat, the faster you will lose weight.

Stepping back a few hundred yards, we've got to remember a few simple facts: To lose weight, you have to expend more calories than you ingest. To feel sated, you need to pick foods that are more satisfying per calorie. It's pretty much that simple. Which means it's not easy.

The quote above is wrong in so many ways. What is the "exact opposite" of a starvation diet? I would imagine a gluttony diet. Any time someone tells you "eat all you want and still lose weight" they are wrong, unless they can change how much you want, for example, with moderate doses of amphetamines. Eating properly can help curb appetite, but not often down to the needed level.

He goes on to describe certain "super foods" that are "antioxidants," have "antiangiogenesis" properties, and other nonsense. Like many pieces of Oz's I've examined, he leaps from hints gleaned in the laboratory to strong clinical recommendations, which is often a recipe for disaster.

I don't think it's fair to paint someone with guilt by association. The fact that Oz has been recognized by Bastyr University, an institution dedicated to medical superstition, shouldn't mean that he adheres to the same superstitions. But if he promotes dubious, hyperbolic and counterfactual health information, he paints himself into an ugly corner previously reserved for hucksters, geeks and carnies.

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.