I thought I’d written my final post on the Dr. Oz-fueled green coffee bean extract (GCBE) diet supplement fad. But now there’s another appalling chapter, one that documents just how much contempt The Dr. Oz Show seems to show for its audience, and how little Dr. Oz seems to care about providing advice based on good science. This week it was revealed that the “naturopath” that Dr. Oz originally featured in his GCBE segment, Lindsey Duncan, didn’t disclose a direct conflict of interest when he spoke. After inaccurately describing the supplement’s effectiveness, he directed consumers, using keywords, to web sites that he owned or operated. The infamous “Dr. Oz Effect” worked, with Duncan selling $50 million in GCBE supplements in the following months and years. This week it was announced that Duncan and his companies have been fined $9 million by the Federal Trade Commission. The documentation released by the FTC [PDF] gives remarkable insight into how a scam to make millions was launched, and how the Dr. Oz Show is a platform for the routine promotion of dubious “experts” and worthless supplements.
The story of GCBE is really the story of Dr. Mehmet Oz, and his eponymous daytime television show. If you’re trying to sell a supplement, yet you don’t have actual scientific evidence to back up your claims, The Dr. Oz Show is your ticket to recognition and sales. No other show on television can top The Dr. Oz Show for the sheer magnitude of bad health advice it consistently offers, all while giving everything a veneer of credibility. Yet, this is a symbiotic relationship. Oz needs products that excite his audience. After all, everything is a “miracle” to Oz (He’s found 16 so far). The story of green coffee bean extract actually began in April, 2012, in a revealing email from the show to Duncan [PDF]:
“We are working on a segment about the weight loss benefits of green coffee bean and I was hoping that Lindsey Duncan might be available to be our expert. Has he studied green coffee bean at all? Would he be able to talk about how it works?” At that time, Duncan had no familiarity with the purported weight-loss benefits of GCBE, nor did Defendants sell GCBE. Nevertheless, within a few hours, a senior member of the Defendants’ public relations team replied: “Awesome! Thanks for reaching out, Dr. Lindsey does have knowledge of the Green Coffee Bean. He loves it!” Later that day, Defendants contacted a manufacturer of GCBE and, on or about the same day, submitted a wholesale order for GCBE raw material.
Note that the topic had already been decided upon before hand-picking the “expert” to profile it. Duncan was known to the producers, having promoted another supplement on the show before. Why Duncan? While he called himself “Dr. Lindsey Duncan”, Duncan has a naturopathy degree from the Clayton College of Natural Health, a school that the State of Texas considers a “fraudulent or substandard degree”, as it’s on a list that Texas maintains called “Institutions Whose Degrees Are Illegal To Use in Texas“. Not only is Duncan’s naturopathic degree shoddy, Texas doesn’t recognize the degree of Naturopathic Doctor at all. Despite this, Duncan lives in Texas and presented himself as “Dr. Lindsay” in the media repeatedly. Aside from the FTC prosecution, Duncan has also been prosecuted by the State of Texas [PDF] for Violations of Texas Education Code and for False, Misleading and Deceptive acts:
In addition to the use of the honorific “Dr.,” Mr. Duncan presents the appearance of a health practitioner, which he has done in television show appearances, media interviews, speaking engagements, and video promotions, by donning lab coats and making references to clinical experience and practice. Mr. Duncan’s acts and practices mislead the public into believing that he is disseminating health advice or knowledge, but such advice or knowledge is based on educational background and training which he does not have and when his underlying motivation is to sell products in which he has a financial interest.
Duncan and his companies have been selling supplements since at least 2010, and the FTC documents note how his marketing strategy has been directed at securing television appearances on programs like The Dr. Oz Show and The View. Duncan and his companies appeared to use a consistent approach:
- Find a supplement to sell.
- Get Duncan on television, pretending to be a health professional.
- Have Duncan promote products in which he has a direct financial interest.
- Do not disclose the conflict of interest.
- Have Duncan describe how to find product on the internet, suggesting search terms he knows will direct traffic to his own website (e.g., “pure”).
- Used pre-arranged search engine optimization (SEO) to drive internet searches to his own website.
- Buy Google AdWords advertisements to capture even more traffic.
The FTC documentation gives a “behind the scenes” perspective of The Dr. Oz Show. When the show’s producers contacted Duncan about GCBE, they did no work to independently verify he had any credible expertise or education that might suggest he would be an appropriate guest to provide medical advice. They did not appear to ask if he had any conflicts of interest. It seems they simply decided he would be their “expert”. The producers and Duncan then actively collaborated on the segment’s script. Duncan edited the script to ensure he could subtly verbally promote the brands in which he had direct financial interest. To do so, he emphasized that viewers should look for “pure” GCBE online which was a keyword he’d linked with his own brand. He emphasized that consumers should buy 400mg capsules, the type his company sold. Subsequent to the taping, the producers went one further, asking Duncan which web sites he recommended. He recommended his own, without disclosing his relationship with those companies. He then set up several fake websites that all linked to his own sites, with the intention of boosting his Google ranking to the top.
Duncan went even further. He contacted Walmart with “extremely confidential” information, offering to sell them GCBE based on the expected Dr. Oz effect. He also tried to buy up a large supply of the raw GCBE material, apparently with the intention of reselling it after the expected surge in interest.
Normally, I don’t recommend weight loss supplements, especially weight loss supplements that claim “easy weight loss” or “fast weight loss,” but the Green Coffee Bean has truly amazed me.
– Not-a-Doctor Lindsey Duncan on The Dr. Oz Show, broadcast April 26, 2012.
Duncan’s strategy worked. The episode was first broadcast on April 26, 2012. It’s worth watching again. Sales surged.
The real shame of the entire GCBE saga is that the signs it was bogus were always available. After Duncan’s first appearance on Dr. Oz, I reviewed the study itself, and concluded it looked questionable. The trial was small, not properly blinded, poorly written and didn’t pass the sniff test for credible research. The findings were suspicious, with participants losing as much weight on the placebo as the drug. There was no information presented to confirm it was a safe product. Anyone on Oz’s staff that spent an hour actually reading and understanding the paper should have seen there were serious problems with its credibility. The claims and statements made by both Duncan and Oz were outlandish, with the entire episode triggering most of the Federal Trade Commission’s “red flags” in advertisements for worthless products. And all of this was well before the investigation that subsequently determined that the entire study was fraudulent, prosecuted by the FTC, and subsequently, retracted. These investigators were so incompetent, they couldn’t even fake data convincingly. The FTC has now concluded that Duncan ought to have known the trial and its conclusions were questionable:
The defendants’ representations that GCBE would cause rapid and substantial weight loss without diet or exercise had no scientific support. The study the defendants continually referenced in their advertising, even absent Duncan’s mischaracterizations of it, suffered from serious facial flaws that should have been evident to the defendants. Accordingly, our complaint alleges that the defendants’ efficacy claims were false or unsubstantiated, and that their clinical proof claim was false. The proposed order approved by the Commission includes appropriately strong injunctive relief and requires the defendants to pay $9 million in equitable monetary relief.
It’s worth noting the extent of the hoax that Duncan perpetuated after the show was broadcast. The other spokepeople for Duncan’s products that appeared on television and radio? They were paid, often without disclosing a conflict of interest. The online reviews from “ordinary consumers” on Amazon.com? Also paid for by Duncan and his companies. The video testimonials on his websites? Those were his employees. It was all a carefully-orchestrated facade to drive sales of his own products.
I actually do personally believe in the items I talk about on the show. I passionately study them. I recognize that oftentimes they don’t have the scientific muster to present as fact. Nevertheless, I would give my audience the same advice I give my family, and I have given my family these products.
– Dr. Mehmet Oz Senate subcommittee testimony, June 17, 2014 (Emphasis added)
The green coffee bean extract saga didn’t end there. Each time Dr. Oz revisited the topic, even without Duncan on the show, Duncan’s sales spiked. In 2013, Oz discussed GCBE on his show again. This time, the bad science was all on Oz’s hands. Oz conducted a clinical trial on his audience, without obtaining IRB (research ethics) approval. 50 women were randomized to the supplement or placebo for two weeks. Not surprisingly, there were no substantive effects found: The GCB group lost about 2 pounds, and the control group lost about 1 pound. Without any detailed statistics being presented, it was impossible for anyone to evaluate the Oz “research”.
The next nail in the GCBE coffin came in 2014. Dr. Oz appeared at Senate subcommittee hearing where he was verbally eviscerated for his promotion of GCBE and other weight loss products, in the face of no credible evidence. That same year, the FTC announced it was suing a Florida-based company (Applied Food Sciences) for its promotion of Green Coffee Antioxidant (GCA), a supplement containing GCBE. In September, the FTC announced it had a deal and settlement from Applied Food Sciences (AFS) and it was a bombshell. Not only was the advertising misleading, but the trial itself was fraudulent:
The FTC charges that the study’s lead investigator repeatedly altered the weights and other key measurements of the subjects, changed the length of the trial, and misstated which subjects were taking the placebo or GCA during the trial. When the lead investigator was unable to get the study published, the FTC says that AFS hired researchers Joe Vinson and Bryan Burnham at the University of Scranton to rewrite it. Despite receiving conflicting data, Vinson, Burnham, and AFS never verified the authenticity of the information used in the study, according to the complaint.
Despite the study’s flaws, AFS used it to falsely claim that GCA caused consumers to lose 17.7 pounds, 10.5 percent of body weight, and 16 percent of body fat with or without diet and exercise, in 22 weeks, the complaint alleges.
Although AFS played no part in featuring its study on The Dr. Oz Show, it took advantage of the publicity afterwards by issuing a press release highlighting the show. The release claimed that study subjects lost weight “without diet or exercise,” even though subjects in the study were instructed to restrict their diet and increase their exercise, the FTC contends.
Now, with the Duncan settlement, the GCBE saga seems to be complete.
Green coffee bean extract would be a fringe supplement today if it weren’t for the “Dr. Oz Effect” and a supplement seller that knew exactly how to exploit it. We’ve seen this story before. Shoddy science, a bogus product, a conflicted seller and unrealistic claims of efficacy. Oz and his show were either oblivious to the facts, or indifferent to them. At no time did Oz appear take his responsibility as a medical doctor seriously. While Duncan and his companies have been fined, it’s clear that the Dr. Oz show played a big part in this enormous, yet avoidable, weight loss scam.