Learning from Lipozene: The Anatomy of a Drug Scam

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.

31 thoughts on “Learning from Lipozene: The Anatomy of a Drug Scam

  1. I am beginning to distrust the honesty of my doctor when it comes to his treatment suggestions, and not because I read this blog.
    There’s just so much money a doctor can make by ordering extra x-rays and scans and whatnot, it would take a saint not to do it. For years, I always assumed my doctor was being overly cautious. Now, I truly wonder.
    Our healthcare system is broken.

  2. The rise in snake oil was completely predictable. Once the FDA was enjoined from taking useless products off the market (dietary “supplements”) then what followed was inevitable.
    The same thing applies to drug promotion and advertising. The regulations had been put in place because of what people had experienced at the turn of the 20th Century.
    Either the lessons have been forgotten or greed has trumped safety and efficacy. The BS about the market sorting things out is just that – BS.

  3. Jeff and Robert,
    It is indeed a sad state of affairs, and over the past decade, things have gotten much worse. We essentially allow ourselves to be taken for a ride just as exploitive as Lipozene because our institutions are often unwilling or unable to do their jobs when it comes to containing costs, protecting the public interest, and generally making sure that the business of medicine doesn’t become just another business.
    Thanks for commenting.
    Niko

  4. I just got off the phone with customer service to cancel my auromatic monthly order. I should have cancelled when I stopped taking them after a week….they made me nauseous and I vomited up to 4 or 5 times a day. A friend of mine stopped taking it when it made him feel ‘crazy’ and he had to go to the hospital. He never had problems before or after the lipozene. I felt awful on them! They should be banned!

  5. I recently came across your blog and have been reading along. I thought I would leave my first comment. I don’t know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.

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  7. currently there are many natural products as both drugs for the reduction of body fat, now the extent to which the population has been encouraged in the health care personnel and the implementation of such products? It would be important to do …

  8. It is important to have outstanding control of our body weight, that the existence of diseases that come from this condition, so it is essential to maintain a healthy and good food accompanied by exercising daily, excellent topic.

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  11. Lipozene is packaged and pitched with the implicit claim of weight loss miracle drug situation. Product and the claims comes from the Institute of Clinical Research obesity.

  12. Hello,
    Nice blog, A similar supplement is amino acids. Proteins are made up of amino acids, and when you ingest a protein, it is broken down into its amino acid components and then reformed into muscle protein.

  13. I ordered lipizone because I needed to lose weight and had tried for years. Then I checked it out on the computer and one place said the anyone with diabetis should not take it. I called the company and she assured me it was ok. I sent it back the next day. I am wondering if I will get my money back. I am a veteran and go to the VA hospital. They do not send you for every test and scan they have, just what they think is necessary. My husband was not a vet and I took him to his doctor who had been his doctor for 10 years before we got married. He sent him for tests on everything. He wanted to see an eye doctor. His doctor made him come in so he could check his eyes and then refer him. He knew the condition of his eyes. My husband is passed away now and I have to deal with my health problems myself. What do you think of natural herbs, etc. On the labels it say see your doctor before taking this if you are taking prescribed meds. No MD is going to tell you it is OK.

  14. I was with you right up until you bashed social anxiety disorder. Social anxiety disorder is not simple “shyness, embarrassment, and self-consciousness.” The fact that you describe it that way without referencing its DSM definition and/or criteria for diagnosis is extremely disingenuous. I mean it sounds like you don’t think mental illness is real at all if you’re unwilling to accept the diagnosis is real. Paxil is far from the only medication on the market to treat it and it’s not even close to being the oldest. You owe it to readers to tell the full story. You’re probably really lucky in that you will never have to deal with the problems anxiety disorders pose and the way they debilitate people. You should realize not everyone is that lucky, though.

  15. The most flagrant fraud that we have seen for yearsi is the Statin PI and sfter market studies. The Statins established by their action that the LDL cholesterol was not a risk factor in itself foe Cardo-vascular disease or heart attacks and strokes but more of a fellow-traveller and the FDA insisted that muscle pain was unusual and the first step on the road to rhabdomyalysis and Kidney Failure. Any one who paid any attention to the data and patient feedback knew that myalgias were seen in about 13% of patients taking statins, that it was variable in that some patients could be restarted in the future or a new statin coukd be started without muscle pain at some time in the future with no side effects. The statins also totally debuked the LDL-CHOLESTEROL theory. From the first day of Statin Therapy there was a risk redcing effect 30 days before the LDL-C showed maximum reductions and eztemibi which in combination with the statins had a verY profound effect on LDL-CHOLESTERPO BUT WAS NO MORE EFFECTIVE THAN STATIN ALONE. Also, strangely enough. there are a large population of slender women with no other risk factors whose LDL may be elevated but show no saluatory effect of the statins whatsoever, even with reduction of tt LDL-C.

    • Robert–

      After taking Statins for a month or so, my husband stopped taking them. He didn’t like the way they made him feel.
      That was years ago—he hasn’t had any heart problems since.

      See my post titled “The Cholesterol Con”– parts 1 and 2

  16. I really enjoyed reading this blog. As a nurse with many years practice I get very infuriated at the lack of truth in the advertisements of all types so called snake oil cures and over the counter medication and prescription medications. The only thing to be done is educate the public and to never take any thing that is claimed without proper research, and there is a lot on the net about everything making research much easier. Please everyone always assume the ads are a lie first then investigate. Thank you

    • Pat Nelson–

      Thank you. Yes, whenever reading an ad, we should be skeptical.

      I think most people have learned to be skeptical when reading ads about many products.
      But when it comes to medications, they assume: “They can’t be lying about this. People could be hurt!”

      Unfortunately for-profit pharmaceutical companies are like other for-profit companies: they are in business to make money.
      The government makes an effort to monitor their ads, and from time to time they have to pay large fines for false advertising.
      But the companies see this as simply “part of the cost of doing business. “

  17. I have taken Paxil for many years. No I don’t love taking it, because of side effects, drowsiness, diarrhea, etc. but it saved my life. It does what GSK claims it will do; takes away panic attacks, and raises Serotonin levels so you can get out of bed in the morning, and even hold a job. Mental Illness is real and those who suffer from it are grateful that there is something out there that works. Some of my problems are hereditary and some are from environmental factors. Psycho therapy helps, but has never “cured” me. Yes, the drug companies are out to make a buck, or billions of bucks. But, they do provide help to people who are suffering. I have to credit them that.

    • Rita–

      Everything you say is true– especially about the reality of mental illness. So often it is partly hereditary, partly environmental. I’m glad you have found something that allows you to function.