Yesterday I was watching television and was bombarded with the following infomercial for a dietary supplement called Lipozene:
No doubt your bull-you-know-what detectors are going haywire already, as well they should. But before you write off Lipozene as a joke, consider this: there’s nothing that the manufacturer of Lipozene—the Obesity Research Institute (ORI)—does that prescription drug companies don’t do every day. In fact, by analyzing Lipozene’s marketing, we can get a clear picture of the fundamental building blocks of Big Pharma’s business practices.
The active ingredient in Lipozene is glucomannan, a complex carbohydrate found in the konjac plant. Since glucomannan is an insoluble fiber, it absorbs water to form a thick gel that coats the stomach, making you feel full—thus reducing your eating.
For all that ORI’s advertisement irritates, it does contain a kernel of truth: the appetite-suppressing effects of glucomannan have been shown to help weight loss. A 1984 study showed that 1 gram of glucomannan before meals helped obese people lose an average of 5.5 lbs over eight weeks. Of course, this specific number is never cited in the Lipozene materials, with advertisements instead touting the fact that 78 percent of every pound loss was pure body fat and that “people were not asked to change their daily lives.”
Unfortunately, this isn’t true. First of all, none of the
glucomannan studies have involved Lipozene, and second, in all studies
(ORI claims there are 12 in total that support its claims), the
supplement was partnered with changes in diet and exercise. People were
in fact asked to change their daily lives. As ABC news pointed out
in an expose earlier this month, the information does in fact appear in
the TV ad—it’s that tiny, indecipherable disclaimer text on the bottom
of the screen.
Another disturbing wrinkle in the research is the fact that more recent
evidence from 2003 has shown that fiber does not actually have “a
significant effect on hunger, satiety, or weight.” According to Nancy Howarth from Tufts University,
even when there is an impact, “fiber consumed intact in foods ha[s]
more effect,” than synthesized supplements, but we still don’t know for
sure—“this needs to be tested.” If fiber does help weight loss, your
best bet is to eat Bran Flakes.
Distorting research findings and over-selling effectiveness—if this
sounds familiar, it should. This is exactly what prescription drug
companies do all the time. I’ve written previously
on restless leg syndrome (RLS), which is a condition of twitchy legs.
The ads for RLS quietly note, in small text, that RLS might be helped
by more exercise and stretching—while at the same time trumpeting the
message that RLS is a horrendous disease that requires medication.
GlaxoSmithKline did something similar when they coined the concept of “social anxiety disorder” and hired a PR firm to
“cultivate the marketplace” before launching their drug, Paxil. What
was once shyness, embarrassment, and self-consciousness is now a
disorder, happily “treatable” through Paxil, although the medication’s
website makes a point of noting the importance of positive thinking, relaxation, and reasonable goals in helping to treat social anxiety disorder.
In the end, the fact is that every company that wants you to buy one of
their miracle cures must do two things: they need to downplay the fact
that their product is potentially unnecessary and fuel the idea that they offer a guaranteed, effective remedy.
What better way to do both than to pay lip service to other
supplemental, self-help treatments? After all, if a company recognizes
these other options, it means they’ve thought things through and still
know their product is the best—so why doubt them?
This sort of sleight of hand has become all the more intense with the rise of direct to consumer (DTC) advertising.
Drug companies’ funding on DTC advertising more than quintupled between
1997 and 2004, from $700 million to more than $4 billion. We are now
the only nation besides New Zealand in the world to allow DTC
advertising, a reform which took effect in 1997 (hence the surge in
spending). It’s worth noting that New Zealand gets closer and closer to
banning DTC advertising every year.
Today, in the U.S., DTC advertising has been generally limited to
television ads and the occasional website advertisement, but if ORI is
any indication, the connectivity of the Internet may open a whole new
can of worms.
Five days ago, a press release announced that ORI has partnered with Double Click Performics,
“a provider of digital marketing technology and services” to manage an
online advertising campaign. The basic idea is that websites agree to
host Lipozene ads through Performics technology, and the website owners
get a cut of the sales. As the announcement puts it, “when you promote
the Lipozene program you get a $10 commission and 120-day commission
duration on each referred sale. And thanks to a quality site designed
for optimum conversion rates, plus free shipping on every order, you’ll
enjoy solid commissions every month.” This is so-called multi-level marketing,
a cousin of the legendarily foolish pyramid scheme. As hackneyed as
this may seem, in a DTC market-place, there’s no reason to think that
drug companies wouldn’t undertake a similar strategy.
And really, how different is this marketing strategy from what prescription drug companies do with doctors today? Consider how doctors are paid millions to market and recommend prescription drugs. Or consider this case: In 2003, GlaxoSmithKline inflated prices
for some of its drugs, including cancer drugs, in order to market the
drugs to health care providers. The pitch was that doctors could keep
the difference between the actual price of the drug and its inflated
reimbursement rate—in other words, give docs an incentive to prescribe
Glaxo drugs so they can skim a little off the top. This is exactly like
the ORI marketing scheme, albeit it in a more insular, expert-driven
sense. In both cases, the manufacturers offer third parties with financial incentives to increase volume.
With such questionable practices, how are companies like ORI and Glaxo punished? Primarily through fines. In 2005, the FTC fined
the institute $1.5 million in consumer redress for making false claims
about some of its earlier diet pills, FiberThin and Propolene. Yet here
it is again, singing the same tune—a clear indication that the money
ORI paid out was a hit that it could take and still keep on plugging.
The list of prescription drug companies that have had to pay money for
their questionable practices is long—but the cycle continues
That’s because there is a lack of meaningful penalties. As
with ORI, most prescription drug companies who deceive medical
consumers end up paying fine that they consider part of the cost of
doing business. Or, in more serious scandals, pay up in court to
aggrieved parties. But for those with deep pockets, shelling out a few
million here and there is ultimately a slap on the wrist—a small
setback that can easily be recouped through future profits. Consider
this: in the six months after the Medicare prescription drug programs
took effect in 2006, the pharmaceutical industry’s profits increased by
a whopping $8 billion. Fining just isn’t going to cut it.
It’s easy to dismiss Lipozene as hucksterism preying only on the
stupid. But let’s not fool ourselves: prescription drug companies use
the same playbook—and our institutions let them.
It doesn’t have to be this way. Most nations in the world ban DTC
advertising. In five states and Washington D.C., state laws mandate
disclosure of payments made to physicians by pharmaceutical companies.
With a greater investment in health awareness, nutrition, and lifestyle
programs, the U.S. could wean itself off of unnecessary “me too”
medications. A stronger, more dynamic FDA could provide an actual
counter-force to the misleading claims circulating out in the market.
Currently, the FDA is woefully unable to regulate DTC advertising—as a 2006 GAO report noted, the agency is slow, ineffective, and utterly inadequate when it comes to DTC oversight.
Until there is the political will to implement these and other
reforms, scoff at Lipozene all you like but don’t forget this: if ORI’s
customers are suckers, then you and I are too.