What’s behind Oz

A writer at the New York Times is finally beginning to get that those health risk assessments that ask about our lifestyle and health history are really fronts to sell drugs. One of the largest and most popular ones — that’s convinced more than 27 million consumers to fill out detailed questionnaires about their health and private lifestyle habits — is RealAge. As Stephanie Clifford writes, “while RealAge promotes better living through nonmedical solutions, the site makes its money by selling better living through drugs.” Pharmaceutical companies pay RealAge for the names of people revealing certain “health risk factors,” she found, for targeted marketing.

As Clifford reports:

Online Age Quiz Is a Window for Drug Makers

… While few people would fill out a detailed questionnaire about their health and hand it over to a drug company looking for suggestions for new medications, that is essentially what RealAge is doing. The test has received widespread publicity because of its affiliation with Dr. Mehmet Oz, a popular author and regular on “The Oprah Winfrey Show.” Dr. Oz — “America’s Doctor,” as he is known on Oprah — is a RealAge spokesman and adviser… Whether they are attracted by Dr. Oz’s appeal or by the ads all over the Internet for the test, people come to the site, then provide an e-mail address to take it. They are asked throughout the test if they would like a free RealAge membership. If people answer yes to any of the prompts, they become RealAge members, and their test results go into a marketing database.

RealAge allows drug companies to send e-mail messages based on those test results. It acts as a clearinghouse for drug companies, including Pfizer, Novartis and GlaxoSmithKline, allowing them to use almost any combination of answers from the test to find people to market to…

The questions on health assessments are designed to identify people with potential health risk factors. Through intense marketing, the public has been led to believe these indices are measures of potential age-related chronic diseases and amenable through healthy diets and lifestyles. In actuality, they aren’t. They are primarily measures of aging, heredity and social class, and virtually all normal adults will have “high” numbers in need of a pill. As the vice president of marketing at RealAge told the newspaper, it can even identify those of low income for specific marketing.

Yet few people who take these online tests realize that by doing so, they’ve “signed up” and become “members.” As Clifford explains:

RealAge’s privacy policy does not specifically address the firm’s relationship with drug companies, but does state, in part, “we will share your personal data with third parties to fulfill the services that you have asked us to provide to you,” and it adds test results to its database only when respondents become RealAge members… “Literally millions of people have unknowingly signed up,” said Peter Lurie, the deputy director of the Health Research Group at Public Citizen, a public interest group in Washington. The company, he said, “can create a group of people, and hit them up and create anxiety even though the person does not have a diagnosis.”

RealAge acts as the middleman between the drug companies and its “members,” she writes. And there’s gold in those questionnaires:

Its access to health information has made RealAge valuable. Founded in 1999, it was acquired by Hearst Magazines in 2007 for an estimated $60 million to $70 million. Though its sales — and the fees it pays Dr. Oz — are not public, it is profitable, and had about $20 million in revenue when Hearst acquired it.

Whether marketed as anti-aging, preventive wellness, or lifestyle medicine, these alternative modalities are the current fad and are as prevalent in mainstream medical arenas and public policies. But they are not sound medicine. “There are no lifestyle changes, surgical procedures, vitamins, antioxidants, hormones or techniques of genetic engineering available today that have been demonstrated to influence the processes of aging,” as the world’s foremost experts on human aging have emphasized. They should be viewed as nothing more than entertainment, they said. Like reading your horoscope.

The unsupportable premises behind lifestyle medicine aren’t just as seen on Oprah. They’ve become core to the growing political movement of a new vision for public health.

Congress — the same people making decisions over our healthcare — has embraced Dr. Oz, too. He was the featured expert witness a few weeks ago at Senate hearings by the Committee on Health, Education, Labor and Pensions called: “Integrative Care: A Pathway to a Healthier Nation.” This hearing coincided with the summit on integrative medicine. Bravewell Collaborative funded and commissioned the private Institute of Medicine to hold this summit to guide a reform of our nation’s healthcare system towards a national agenda of integrative medicine.

The senior member of the Congressional committee, Chair of its Subcommittee on Retirement and Aging, and leading the Senate in Kennedy’s group working in secret to reform the nation’s healthcare system, issued a press release promoting the hearing. Senator Barbara A. Mikulsk said integrative medicine is the key component of healthcare reform and a healthier nation. As she explained during her introduction of Dr. Oz, he founded the Health Corps Foundation to promote health and wellness in children by combating child obesity and school-based programs to teach lifestyle skills and “wellness.”

“Dr. Oz, I am very interested in your views about how integrative health care can play a greater role in care delivery, improve health outcomes, and promote a healthier America, particularly through your work at Health Corps to educate children about wellness and self-empowerment,” she said. “Finally, I am interested in your views of how Congress can work to improve integrative health care policies and perceptions so that integrative health care practices can be more widely adopted.”

Dr. Oz testified that his Health Corps is a “proactive health movement that responds to the obesity crisis through school-based health education and peer mentoring, in addition to community outreach to underserved populations—mostly Hispanic and African American as well as groups with lower than average educational levels.” These health service corps will reinforce the government’s messaging on lifestyle medicine and take it door to door. After defining a health crisis, he went on to repeat the popular obesity myths, saying:

Along with educating students in healthy lifestyle principles, we extend our mission to their families and communities… Our goal is to shift the paradigm towards health and wellness now and for the future of our children.

Obesity in the United States has reached epidemic proportions, with more than 35% of Americans classified as obese and an additional 30% as overweight. Obesity has been a steadily rising trend since the late 1970s. Experts now predict that, without an intervention, the majority of the country will be obese by 2012. Alarmingly, the steepest increase is in children and adolescents. Obesity is directly linked to high blood pressure, type 2 diabetes and atherosclerosis. In turn, these unhealthy conditions are the major cause of heart attacks, strokes and heart failure. We are now seeing cardiovascular disease in teenagers and the average age of first heart attacks has dropped by over 10 years in the overweight patient. Other morbid conditions linked to obesity are certain cancers and arthritis….

Another featured speaker familiar to JFS readers was Dr. Mark Hyman, M.D., who described lifestyle medicine as a new paradigm needed to reform the healthcare system and as “personalized patient-centered care based on how our environment and lifestyle choices act on our genes to create imbalances in our core biologic systems. Those imbalances show up as signs and symptoms we call disease.” He called for the government to establish a new office for health and wellness.

As our country faces growing healthcare needs with an aging population, and medical care becomes increasingly sophisticated, these are the interests that want to decide what medical care we receive, the research that’s funded, and what is taught in medical and nursing schools. It won’t be science.