TV diet doctor spreading the ‘gospel of healthy living’

Let’s face it. There are a zillion ways to make money selling a diet book. All anyone needs is a gimmick to cut calories, then write how easy your plan is to follow and that everyone is guaranteed to lose weight. Promise they’ll never need to diet again. Be sure to warn about the dangers of obesity and unhealthy lifestyles, then vow that your diet will save them and lead to a healthier, happier and longer life, prevent cancer, promote regularity or even give them youthful complexions. Give impressive explanations that make your plan sound like it’s based on science (no evidence is required as you’ll need only a few anecdotes and inspiring photos). Being able to say you’re a doctor or professor is certain to make people believe you know what you’re talking about. Finally, get endorsements from celebrities or high-profile television shows as they’ll guarantee your diet book will be a best seller. :)

By taking their diets directly to the media and public, TV diet doctors bypass the medical community, as well as any scrutiny that would come if they were published in the medical literature. So, not surprisingly, some of the wackiest fad diets are seen on TV.

But consumers deserve a special alert about the risks that come with one of the fastest-growing gimmicks.

Diets are creating online communities to provide support and send dieters targeted come-ons for other stuff, and the paid sponsors are rarely openly disclosed. The electronic tools that are offered for registered participants promise to track their progress for them online. Dieters type in health and other personal information, food records and weights. These are not unlike product warranty cards or new online medical records. They appear harmless, but the information is put into a database of consumer portfolios and can be sold to marketers, giving vast numbers of people access to your personal information and putting your privacy and safety in jeopardy.

Few people, however, stop to consider what protections are in place when they volunteer personal health information to third parties who aren’t their doctors or healthcare providers. The truth is, there is no protection for how their personal information can be shared, sold and used. And people have no control over what happens with their information. The federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy law does not even apply.

According to the U.S. Department of Health and Human Services, there is no protection for personal health information used by “noncovered entities” (all those other than healthcare payers, clearinghouses and medical providers), and the groups specifically exempt from having to comply with HIPAA privacy protections include personal health record or wellness services and other companies “such as life insurers...” The potential for abuse, such as using the information to financially penalize or deny insurance coverage or benefits, or employment is very real.

Diet challenge

Dr. Ian Smith* — a TV and radio diet doctor, and author of three diet books and diet expert for the VH1 Celebrity Fit Club — has launched a nationwide 50 Million Pound Challenge targeting African-American communities, the goal is 50 million pounds of weight loss among participants. Key to this marketing drive is a 14-city church tour, which began last fall, to the largest and most influential Black churches across the country. According to his press release, it’s backed by numerous African-American leaders, civic and health organizations.**

“In tandem, the online Challenge community and the church can be the ultimate support group,” said Dr. Smith. The African-American community is especially hard hit by ‘weight-related’ health risks, such as heart disease, stroke, cancer, diabetes and other health related problems, he said. His church tour and 50 Million Pound Challenge rallies and gatherings have added to his celebrity.

This Challenge is said to be the largest and most far-reaching national “health” initiative ever directed to the African American community. According to today’s press release, more than 310,000 people have signed up onto its online community thus far. He told Gail King (of Oprah) on her radio show on April 16th, that 80% of African-American women and 70% of men are too fat and he hopes to get 5 million people signed up.

To join the Challenge, participants can only register online, and then record the pounds they lose on its electronic database. In return, they’ll “gain support and motivation by working with others in the congregation on a similar journey.” They’ll also receive a free diet booklet that’s a scaled-down version of his full diet [you can download a copy here, without registering for the Challenge], a CD and pedometer. According to Dr. Smith, this online site will track everyone’s progress and registered users will be sent information and updates throughout the Challenge. “When we reach our goal we plan to let the whole country know about it!”

“We will continue to take the Challenge message and weight loss tools to the people,” he said. “The churches, traditional cornerstones in African-American communities, are a natural pulpit for delivering our important message. I thank our sponsor State Farm for making it possible for us to spread this ‘gospel of healthy living.’”

The sponsor of this 50 Million Pound Challenge is State Farm Insurance. State Farm says on the Challenge website:

Although each company has different underwriting requirements, those who are overweight may pay more for life and health insurance coverage. Losing weight can improve your health and can also help lower your insurance premiums. When you have any changes in your health relating to build, please talk to a State Farm agent about ways to get the right coverage at the right price.

On the FAQ page, State Farm says that the information participants provide in registering for this Challenge and weight tracking “will not be used by State Farm for underwriting or rating purposes.” Under the law, however, they can use this information any way they choose, and for more than marketing.

On the 50 Million Challenge website, State Farm’s Privacy Principles say they do not share customer medical information with anyone unless “it is permitted or required by law” — neglecting to say that the law already permits them to do so. For more information about the privacy of medical information, they merely provide a copy of HIPAA, which few people read closely or understand. There is no evidence that they intend to use this vast database in any way other than to benefit Black communities, but…

Should the potential value of this enormous database of African-Americans, all of whom are “overweight” or “obese,” prove irresistible, be requested for research or marketing by some entity, or become another of the third parties the CDC contracts with in its nationwide data collection efforts... they will be free to use or sell the information, with no recourse for participants.

Fat Smash celebrity diets

Dr. Ian Smith’s latest diet books are the Fat Smash Diet and Extreme Fat Smash Diet. These have helped stars through the Celebrity Fit Club lose weight quickly, he says. On the Extreme Fat Smash diet, Dr. Smith says most people will lose 12 pounds in just 3 weeks.

The Fat Smash diet is a 90-day program with four phases. The diet for the 50 Million Pound Challenge is based on this diet. In the promotional booklet, he says:

With a positive attitude and a willingness to work hard, you can accomplish almost anything you want. This is especially true when it comes to weight loss... One of the most important keys for success is getting your mind in the right place....Losing weight isn’t as complicated as people would have you believe.

He quotes the usual claims about an obesity epidemic and that obesity is linked to cancer. He repeats that discredited claim that 90,000 cancer deaths could be prevented every year if people had a “normal, healthy body weight,” which he defines as a “normal” BMI. And he says that cancers can be prevented by “good eating,” and that certain fruits and vegetables are “cancer fighters.”

The Fat Smash diet is the more conservative of the two. About it, he says:

Diets don’t fail people, rather people fail diets. The Fat Smash Diet is a 4-phase forgiving program that is as much about helping people make the necessary lifestyle changes to lead a healthier, happier, and longer life as it is about getting rid of all of the extra weight.

Dr. Smith and WebMD say that this is a simple plan that’s easy to follow and teaches a lifestyle approach focused on eating healthfully. But this is the furthest thing from a healthful, normal eating plan. It is a strict diet.

Phase One is a 9-day detox period “to rid your body of harmful toxins from processed foods and environmental factors, making it easier to lose weight.” You eat 5 times a day of “mostly fruits and veggies and clean your body and mind of impurities naturally without fasting or putting any toxins into your system.” It is a severely calorie-restricted phase with unlimited amounts of water and only limited amounts of unsweetened decaf herbal tea to drink. You’re also allowed limited portions of plain oatmeal, egg whites, low-fat milk and beans/tofu.

The remaining weeks’ menus begin by determining if you are an “alpha, beta or gamma,” based on how easily you’ve lost weight in the past, and then gives you a menu plan for your “dieting profile.” All foods are low-fat, low-salt and only to be eaten raw, grilled or steamed. Nothing fried. You are not allowed to eat within 1 1/2 hours of going to bed. There is an extensive list of forbidden and allowed foods.

Phase two is called a “foundation” phase when you can add small portions of lean meats to your detox diet. The next phase is called the “construction” phase which lets you add brown rice and whole grain foods with protein. The last phase is the “temple” phase which is supposed to be what you stay on for life and, with portion control, lets you add limited amounts of “white” starches and a few glasses of wine or beer per week.

If you fall off the wagon, you go back and repeat the detox phase and then continue. And if you want to lose more weight you can just keep cycling through the phases again. As one (hungry) reviewer wrote, there is a reason this diet book isn’t called the No Pain Happy Face Diet. Reading the countless diet forums of struggling dieters trying to follow these Fat Smash diets finds people absorbed by weighing themselves and what they can and can’t eat at various phases: beans are okay in phase 1, but not if they’re baked beans; pickles are okay in phase 1 but only 2 a day; veggie burgers are okay but not if they contain bread or cheese; only 2 cups of unsweetened decaffeinated tea is allowed per day; no honey in phase 1 and no more than 1 tablespoon a day in phase 2; no sugar-free jello or peanut butter until phase 3; no fruit juice or diet drinks in phase 1; air-popped popcorn is allowed but no butter or flavoring; etc...

Is there any evidence the Fat Smash diets are effective?

No results have ever been published. These new diets haven’t been around long enough to determine if anyone maintains a clinically meaningful weight loss for 5 years or, more importantly, if they improve long-term health. There is no reason to suspect that these fad diets will be any different than the half century of evidence of endless other weight loss diets. One person on the Fat Smash Forum reports that she’s just recently reached her goal weight.

Nor does any scientific or medical evidence support any of the claims made about detoxification; about special cancer preventive properties of produce or certain healthy foods; many of the claims about popularly-defined healthy eating or the ability of a healthy lifestyle to enable people to live longer; or even for the scare that obesity causes cancer. Nor is there any evidence that online dieting support and communities result in more effective sustained weight loss.

Diets do fail people, no matter how well-intentioned their authors might be. These diets will no doubt make this author loads of money and fame, but at what costs to those who buy his books and work hard to follow these diets, only to gain the weight back?

© 2008 Sandy Szwarc

* Dr. Ian Smith is a TV and radio diet doctor, rather than a practicing physician. The bio on his website describes his appearances in media. He received his M.D. credential from the University of Chicago Pritzker School of Medicine, a 4-year pass-fail curriculum, but there is no note that he ever went on to do the three to seven more years of residency training in order to practice medicine, or any additional fellowship training for any specialty. He is not listed as having a license to practice in Illinois or New York, the states he has listed as residing, or as having a membership in the American Medical Association.

** According to Diversity Inc., more than 50 leaders have joined the effort, including the American Diabetes Association, the Congressional Black Caucus Foundation, the National Urban League, the Institute for the Advancement of Multicultural & Minority Medicine, and the American Council on Exercise.