Stop The Weight Loss Madness

This past week, I saw no less than ten patients who wanted to lose weight. Each described in their own unique way how the extra weight was contributing to some perceived problem they had with the weight's effect on their image, energy level, health, etc.

To each patient, I said the same thing. Stop focusing on losing weight and start focusing on what you can and cannot do to your body to help it function at its optimal level.  To each, I conveyed how the human body was developed over millions of years, with its most latest form, homo sapiens being around two hundred thousand years old. Over this period of time, human biology has evolved a full host of protective mechanisms to ward off disease. Of course, we all know these mechanisms sometimes fail miserably. It is very unfortunate when it does, and my heart goes out to those who suffer seemingly happenstance illness. Nevertheless, these mechanisms work for most and that is why the human body can usually protect itself fairly well against poor eating, lack of exercise, inadequate sleep, mounting stress, etc. for at least the first five or six decades of life.  It's not that damage isn't being done, it's just that the damage isn't always so obvious until later.

I often share with patients the story of the my growing up in Brooklyn, NY and how one day the red lights turned on in on the dashboard of my father's old car.  I share how my father drove it to a nearby gas station and spoke to the attendant and asked if he could help with the red light, to which he replied, "yes, I can disconnect it."  Now even to a young boy that was a ridiculous statement. Little did I realize that during medical school and my residency, my teachers and mentors would primarily educate me on how to turn off patients' red lights. As doctors have become successful in eliminating symptoms without addressing the underlying problem, akin to turning off a red light warning of problems, patients have been confused into thinking they don't really have a problem. A case in point is a patient this week telling me that he was very healthy with normal blood sugar despite the fact that he was a diabetic on high blood sugar medication and nearly morbidly obese.

For some reason, Americans seem to disassociate the reasons they gained the weight with the effects such reasons have on their health beyond the number on a weight scale.  They gain weight because they ate too much, they ate the wrong food, they barely moved, they slept poorly and were always hungry, etc. That is why I tell people to stop worrying about the numbers on the scale and to start paying close attention to the details of their lives. Although there is no perfect plan for staying healthy as the old Yiddish saying goes, mensch tracht un Got laft, men plan and G-d laughs, it still pays to plan. Therefore, by focusing on those elements of your life that you do have control over, you can shift the odds of staying and getting healthy in your favor. By doing so, one of the benefits is usually weight loss.

I have always believed that for virtually all problems, there are solutions.  Over the past three years, by investing the time and listening carefully to what patients are telling me, in partnership with them, I have helped them identify such problems and come up with workable solutions.  It has been a three year whirlwind and I am so grateful that I had the opportunity to so positively effect so many lives.  However, as clinically successful and emotionally rewarding this endeavor has been, the time has come for me to move on to my next challenge. I will always be grateful for all that my patients have taught me and the wonderful personal stories they shared.

I know that those who embraced my philosophy about taking care of the one body they had by eating healthy foods in moderation, avoiding unhealthy foods altogether to the extent possible, physically staying  active over the course of a day as much as possible beyond simply going to a gym for a specified work-out, improving sleeping habits, managing stress more effectively with good meditation and relaxation techniques, nurturing relationships and being grateful for the good things in life, have and will continue to reap great benefits from developing such good health habits.

To the rest of you I say, while good health is never guaranteed, a healthy lifestyle can shift the odds in your favor. Choices do have consequences so please choose wisely. Stop chasing weight loss like a lost puppy and focus on what really matters--your overall well-being.

Government Reports Extra Weight May Be Healthy. Really?

Is anyone else shaking their heads in disbelief over the new government study that shows that people who are overweight are less likely to die in any given period than people of normal weight?  This study was based on a review of 97 other studies.

First of all, many are calling the study proof of the "Obesity paradox," although the study clearly showed that obese people, that's people with a BMI above 30, had an overall increased risk of dying. Also this was an observational study, not a cause and effect one, which already makes the results somewhat questionable.

Second, if 67% or so of the population is overweight and 36% is obese, which means that 31% are overweight and not obese, that only leaves 33% of the population as either normal weight or underweight.  Included in the 33% are people who have lost weight due to illnesses such as cancer, eating disorders, hyperthyroidism, malnutrition, etc.

The study does not account for why people fall into the normal and underweight category (healthy or unhealthy lower weight) given the preponderance of people in the overweight category.

Third, it doesn't account for people who have normal BMIs, but high waist to hip ratios which signifies excess white fat, the dangerous kind of fat. A recent Mayo Clinic study showed  that among 14,000 study subjects, those with a normal BMI, but a high waist-to-hip ratio, were the most likely to die of heart-related disease during the 14-year follow up, even at higher rates than those in obese ranges.

Fourth, it is well established that people in advanced stages of cancer and diabetes do better with additional weight because as the body wastes away, it takes longer to do so. G-d forbid you should need excess weight for that reason.

Fifth, the study did not assess people who were underweight as it is known that such people have increased mortality. The underweight people were lumped together with the normal weight people to come up with a total death rate, so one can expect that the underweight inclusions skewed the numbers somewhat.

Sixth, the study did not address people who are overweight on the road to becoming obese, as opposed to those who are chronically overweight. By not knowing if recent illness is contributing to change in weight, we can't do an apples to apples comparison.

Seventh, the study underscores why BMI may not be the most reliable indicator of unhealthy weight because it does not take into account the muscle to fat ratio. Athletes, for example, could have increased muscle mass that will increase their BMI and put them into the overweight (even sometimes obese) category despite their otherwise good health.

Eighth, it is well know that excess weight, in and of itself, does not mean you are unhealthy if you don't have concomitant increases in cholesterol, blood pressure or blood sugar.

Ninth, is there a difference between a BMI of 25.1, which puts you into the overweight category and 29.9, which keeps you out of the obesity category? The study does not address gradations of being overweight.

Tenth, and finally, it not entirely clear to me what exactly is the point of this study. Is it to tell people that being overweight is not as bad as most people think? Should people who are overweight, but not obese be less concerned about their diet and lifestyle?

Of greatest concern, should people who are overweight, but not obese, make sure that they don't lose any weight as that may increase their risks for death?

I am not surprised that this is a government study as I find such studies to sometimes be the most generically misleading. Such a study would seem to offer comfort to the 67% of Americans who find themselves in the overweight category as you can rest assured that most people will not even bother to look past the headline that states that extra weight may be healthy. They will just take comfort in the notion that that extra piece of bread or serving of pasta may be health promoting.

G-d help us all if the government keeps doing these types of studies. Next thing we know they will tell us to cut out fats and eat more carbs. Oops, they did that already and we all know what happened.

Update, February 3, 2913:  A recent study offers support for the notion that far more important than BMI is the waist to hip ratio. This measurement of "belly fat" is more indicative of overall health because the build-up of white fat cells at one's midsection is more reflective of overall inflammation within blood vessels and risks for heart disease.  So those who took heart from the study that it's better to be heavier than be normal weight, please understand that this referred to well distributed weight and not weight concentrated around your gut.

Vitamin D Blood Tests May Be Unreliable--Particularly In Overweight People

As the Vitamin D debate rages on, it seems that practically every day a new related study emerges.

Vitamin D, the reigning health topic du jour, has been linked to cancer, diabetes, obesity, the autism spectrum, unhealthy aging, and a myriad of other health issues--basically everything. (the more illnesses it is linked to, the more pills marketers can sell).

There are many dubious pundits claiming that there is an epidemic of vitamin D deficiency, with some proclaiming that as many as 75% of all people are deficient, and therefore, everyone should be supplementing with Vitamin D tablets, particularly those who get little sun exposure and the elderly.

I don't agree with the statistics regarding the number of people with deficiency because I think the blood tests don't tell the whole story, and a recent study involving obese and non-obese people makes me think I am right. Notice the emphasis on think, not know. (By the way, another recent study revealed that two out of three of the main pieces of equipment used by blood labs to measure Vitamin D often report artificially low numbers.)

Before I get to the main study, here's what everybody seems to agree on in regards to Vitamin D:

1. Vitamin D is a group of fat soluble substance most call a vitamin. (There is some disagreement if it's really a vitamin as the body can produce it on its own, unlike all other vitamins which must be derived from external sources. However, Vitamin D is often called the "sunshine vitamin" because the body can produce it from cholesterol after your skin is exposed to sun.)

2. Human beings can consume two forms of Vitamin D: cholecalciferol (vitamin D₃) or ergocalciferol (vitamin D₂). The liver apparently converts Vitamin D to calcidiol and the kidney converts some of it to the active form called calcitriol. Blood tests measure only calcidiol.

3. Vitamin D deficiency can cause osteomalacia (rickets in children), a disease related to softening of the bones due to problems with bone mineralization.

4. There is more vitamin D stored in fat or adipose tissue than typically circulates in the blood. That makes sense because it is fat-soluble. (There is some disagreement if they are positively or negatively correlated, eg. whether they increase and decrease together.) What is known for sure is that generally the more fat you have, the more Vitamin D is stored in such fat.

5. Routine Vitamin D blood tests only measure circulating Vitamin D (calcidiol) and not fat stored Vitamin D. (There are ways, such as liquid chromatography, to measure fat-stored vitamin D, but they are not part of normal testing.)

6. Obese people have lower levels of circulating and higher levels of fat-stored Vitamin D than non-obese people.  Basically, the more fat you have, the more of your Vitamin D is stored in it and the less you have circulating and easily measurable. (This could explain why some scientists claim there is more Vitamin D deficiency today than ever before. It could be a result of an increasing weight among Americans with 2 out of 3 now deemed overweight and 36% purported to be obese.)

7. Vitamin D blood levels increase with weight loss. (It is not clear what happens to the total amount of fat-stored Vitamin D with weight loss, but presumably it decreases.)

8. Wild fish such as salmon are still a great source of Vitamin D.


Here are the questions whose answers have less agreement, if not outright disagreement.

1. What levels of blood circulating Vitamin D define deficiency and inadequacy?

2. Can the body tap into fat-stored Vitamin D when needed?

3. Why do vitamin D blood levels increase with weight loss?

4. Why do obese people have lower levels of circulating blood Vitamin D?

5. When and how much supplementation is necessary and appropriate for different levels of deficiency or inadequacy.

6. In the absence of deficiency or inadequacy, does extra Vitamin D offer any special protection against cancer, diabetes, heart disease, diabetes, etc.?

The recent study about Vitamin D, I referenced above, showed that in comparing obese young men to normal weight young men, the obese young men when exposed to tanning radiation akin to sun exposure actually seemed to produce 57% less Vitamin D than the non-overweight young men exposed to the same radiation. The results suggest that the obese get less Vitamin D from sun exposure that the non-obese. 

The authors of the study contend that the reason for this result is that the fat or adipose tissue in the obese men may absorb the additional Vitamin D produced.  The authors also put forth the supposition that obese people have less Vitamin D to start with because they spend less time in the sun.

This study triggered an exhaustive research effort by me to better understand the science of how vitamin D moves in and out of fat storage. More specifically, I wondered if one has a high level of Vitamin D in fat storage and a low level in blood circulation, would the Vitamin D come out of storage before a clinically evident deficiency develops. In other words, can you depend on your fat-stored Vitamin D to play a helpful role and prevent deficiency? If your fat-stored vitamin D provides the body with necessary Vitamin D, then we can dispense with all the blood tests for circulating Vitamin D because they would be unreliable indicators of deficiency and inadequacy.

The study, among others, seemed to suggest that the more obese you are, the more of your Vitamin D would go into fat storage and therefore there would be less in blood circulation. This means that the more obese you are, the more Vitamin D deficient you would be on blood measurement. If this would be a true deficency, one would expect to see cases of osteomalcia among the morbidly obese.

Guess what? After reviewing every published study available on pubmed, it was startling that there was not a single case or study reported that demonstrated bone related problems with rising obesity. In fact, it doesn't even seem to lead to osteoporosis, another bone related disease, and in fact, scientists have long believed that obesity protects against osteoporosis.  (Some recent studies out of China that differentiate between obesity based on body mass index versus actual body fat composition suggest that obesity based on high fat composition may not be preventive of osteoporosis.)

Furthermore, the only studies linking osteomalacia to obesity involve obese patients who undergo a surgical procedure to lose weight called the jejunal-ileal bypass. This procedure can sometimes lead to malabsorption, a condition in which the body can't absorb certain nutrients, in which case all kinds of problems and deficiencies become more likely.

This knowledge raises a serious question regarding the validity of the widely used Vitamin D blood test. If the test does not correlate to clinical symptoms, of what value is the test?  When the test shows a low level, is it because it is actually absent throughout the body or because much of it is stored in the fat, thereby undetectable by the blood test?

Although the study postulated, and other studies have also shown, that Vitamin D levels increase with weight loss, allegedly due to more outside exercise and therefore more sun exposure, I offer an alternative theory.  I say theory because I can't support what I suspect is the case because I couldn't find a single study that has considered this issue. Like all theories, it needs to be tested.

I postulate that as body fat shrinks, stored Vitamin D is released into circulation. What I don't know if having more blood circulating versus fat-stored Vitamin D actually makes a health difference? The answer to this question is imperative to know definitively before we compel so many people, particularly the overweight and obese to unnecessarily supplement with Vitamin D for the sole purpose of increasing circulating levels of Vitamin D.

Until the role of fat-stored Vitamin D is elucidated, I think most of the rest of the studies on Vitamin D will be essentially meaningless because you aren't measuring all the Vitamin D in the body.

For example, another study showed that there is an increased incidence of developing metabolic syndrome and a larger waist circumference after five years in patients with low blood Vitamin D.

My questions, which this study did not fully answer, are did they really have low total body Vitamin D or was it low in the blood because most of it was stored in fat. Also, did the low Vitamin D levels put them at greater risk because they were already overweight and/or pre-diabetic or because they had low sun exposure and poor dietary intake?  Finally, does low Vitamin D cause problems or indicate they already exist?

Perhaps it is not the Vitamin D blood level that matters but the presence of excess fat? Perhaps it is the excess Vitamin D that is stored in the fat that is causing the problems? We must know more about the role and activity of the fat-stored Vitamin D to answer these questions.

Maybe Vitamin D is a proxy for something else. It won't be the first time in medicine that we discovered that something was not what we thought it was. For example, we thought ulcers were caused by stress and it turned out to be mostly bacteria infections. We thought homocysteine controlled heart disease and it turned out to be only a bio-marker. We thought taking beta-carotene would prevent cancer, but it turned out that to be just the opposite. We thought statins were great for us...wait, many, but fewer still think that but maybe that will change some day as well.

From my perspective, I will no longer be recommending, in the absence of symptoms, Vitamin D supplementation for levels above 25 in overweight and obese patients. I will however, continue to strongly recommend (and offer extensive support to) overweight people to help them lose weight, not only for the sake of increasing their Vitamin D levels, but also for all the other health benefits such weight loss confers.

Also, for those without history of skin cancer, I continue to advocate for at least 15 minutes per day of sun exposure to extremities or belly, as long as reddening of the skin is avoided. Based on my current knowledge, this appears to beat supplementation almost every time, even in the elderly.

Vitamin D is obviously a complicated issue that begs for real clarity. Major studies are underway which may offer some real answers.  However, if they don't consider the role of fat-stored Vitamin D, they may actually be of little value. Let's hope for the some good answers and in the interim, try to stay healthy the old fashioned way- get up, get out, and move around.  Of course, watch what you eat because it is still the single most important determinant of health.

What A Difference A Day Makes

Over the past few months, the big health related news was the Institute of Medicine's report regarding the increasing percentage of obese Americans. The expected increased girth of the nation raised alarms because of all the other medical problems that are likely to ensue.  Unfortunately, we will not have to wait because a new medical report by Virginia Fried and colleagues was just released by the U.S. National Center for Health Statistics, part of the U.S. Centers for Disease Control and Prevention. The report titled, NCHS Data Brief, "Multiple Chronic Conditions Among Adults Aged 45 and Over: Trends Over the Past 10 Years," is truly frightening. 

According to new research, between 1999-2000 and 2009-2010, the number of Americans aged 45 and older with two or more chronic conditions has grown, with senior citizens especially at risk of developing both diabetes and high blood pressure. The study reveals that the percentage of Americans in the 45 to 64 year age group with two or more of the conditions grew from 16 percent to 21 percent and in the 65 and older age group, the percentage increased from 37 percent to 45 percent.

The report also revealed that 23 percent of adults aged 45 to 64 with at least two chronic conditions -- out of the list of nine -- either didn't receive necessary medical care or delayed it because of cost. That's up from 17 percent a decade earlier. The percentage of people in that group who didn't get necessary prescription drugs due to cost also grew from 14 percent to 22 percent over the period. Isolating individual conditions in people aged 45 or older, high blood pressure grew from 35 percent to 41 percent, diabetes from 10 percent to 15 percent, and cancer from 9 percent to 11 percent.

The most troubling part is that these numbers are expected to get even worse.  But I have reason for hope because of someone I spent time with today.

I met with a patient of MDPrevent today who has been participating in our LEAN Weight Loss program.  Prior to starting the program, her cholesterol was about 230, her fasting blood sugar was around 120, and her body mass index (BMI) was over 30. In the span of a few months, she has shed 16 pounds, dropped her BMI to 27.5, dropped her cholesterol to the 160s, and her fasting blood sugar to around 105. She accomplished this without any medications, surgery or supplements. She did it simply by changing the way she eats based on what she learned in our program. The best news is that her program was covered 100% by Medicare so it didn't cost her a penny.

Starting a new practice over the past couple of years has had its challenges. However, today it all came together when I witnessed first-hand again what a profound effect a change in lifestyle can have on someone's health. I am so proud to be part of such an effort and take great satisfaction in knowing that our team of Preventioneers are truly making a difference one life at a time. The best news is that our program is covered 100% by Medicare for those who qualify.

Is Obesity A Problem?

You probably think you know the answer to this question. From a medical perspective, your answer probably evolves around the fact that obesity leads to the development of chronic diseases such as diabetes, heart disease, cancer, dementia, arthritis, etc. These diseases lead to costly medical care which still leads to premature death. That sounds like a problem.

Well, based on a new study from the University of California Davis published in the Journal of the American Board of Family Medicine, you may be wrong. The study, which tracked 50,994 Americans between the ages of 19 and 90 for a total of six years, suggests that obesity itself may not be a harbinger of impending death; rather, hypertension and type 2 diabetes, which are often associated with obesity, are what leads to an early meeting with the grim reaper.

You may ask isn't that a question of semantics? Aren't obesity, diabetes, and hypertension so closely related that they may be considered one and the same? Isn't diabesity, as some call it, the right name for it? The answer may surprise you.

The study showed that obese people without these conditions were no more likely to die than non-obese people, and non-obese people with these conditions were more likely to die than obese people without them. So it's not weight per se that kills you, but the diseases that often, but not always, accompany excess weight.

In fact, in my practice I have seen many people who did not suffer from a weight problem, but were still struggling with diabetes. Well, that seems to make sense because weight itself is not the main factor in the development of diabetes and some people who are naturally heavier than others, still seem to enjoy good health.  (I remember many years ago when I worked in a summer sleep-away camp that there was a rather heavy young man that was an incredible athlete. He moved faster and stronger than most of his leaner peers. One would be hard pressed to say that he was unhealthy.) 

Nonetheless, this California study is consistent with a new movement that advocates HAES, which stands for Healthy At Every Size. The HAES camp believes that your health is more important than your size or body mass index (BMI) and I agree.

From the inception of MDPrevent, I have been telling patients not to focus on their weight loss; rather, I have been teaching, begging, exhorting, cajoling, and a number of other words ending in 'ing' to improve their health by eating certain foods and avoiding others, by staying more physically active all day long, by taking steps to ensure a good night's rest, and by developing strategies to manage stress effectively. My lectures often also focus on the need for a strong social network, the benefits of engagement and purpose, and the value of surrounding yourself with like-minded individuals. So, yes, one study doesn't prove anything, but it's not the first study to show the wisdom of focusing on your health and not your weight.

So now you may be thinking that obesity is not a problem, but you would be wrong. Obesity is still often associated with the predominance of chronic disease development. Even in the Albert Einstein College of Medicine study that identified Eastern European Jews who seem to have a longevity gene and who claimed to eat whatever they want, the results showed that those who survived into their 90s were almost always lean. Perhaps they had a genetic predisposition to being lean, but again, lean won almost every time.

I think the most serious reason obesity is a problem is because we don't as a society really seem to understand it. Quite frankly, my head is spinning from reading all the studies and books that purport to have defined, if not offered the perfect solution, to the problem. The list is almost endless.

Here's my abridged version of solutions offered (not saying they work or don't work; just listing to make a point):

Don't eat processed foods that contain white sugar and flour, avoid almost all carbs even the complex ones in fruits, eat more proteins, be a Vegan, eat more meat, drink more dairy, avoid saturated fats, avoid gluten, drink more water, balance your energy intake and output, don't live near fast food restaurants, eat more smaller meals, snack, don't snack, use small plates, eat breakfast within 30 minutes of waking up, don't eat breakfast until after you exercise, don't eat past seven at night, take dietary supplements that speed up metabolism, avoid anything other natural foods, stay physically active all day, go to Weight Watchers, follow the Adkin's diet, the South Beach Diet, the Zone Diet, the Cookie Diet, the grapefruit diet and countless other diets, take HCG and other appetite suppressants, take medications like Orlistat or Tenuate, have lap-band or stomach bypass surgery, etc.

Yes, there are quite a number of pundits that feel they have the solution, and that's a huge problem. Given so many choices, analysis paralysis sets in and we end up doing nothing or a little of this and a little of that, and that my friend is what I think is the biggest problem with obesity.

At this point, after reading countless books, articles, and studies, watching documentaries, attending conferences,  speaking to thought leaders, and working with patients, my solution is simple. Pick something that you think you can live with that has at least some decent science supporting it and STICK WITH IT. Getting healthy and losing weight takes time to do it right. It takes effort and concentration and it doesn't happen overnight. For many it will be a life-long struggle. Sacrifices will have to be made. Favorite foods may need to be given up perhaps forever. Trade-offs will be made and battle-lines drawn. That's the reality of the situation for most and I challenge anyone to prove otherwise.

If you need support, get it. If you are a do-it-on-your-own type of person, that's fine, but have a plan and follow it religiously.

If you are looking for some direction and/or insight, here's my suggestions: avoid processed foods, stay active during as much of the day as possible, drink fluids to keep your urine a pale yellow, don't take any pills you don't absolutely need to take, make fruits, vegetables, beans, nuts, and whole grains the bulk of your diet, eat some wild salmon at least 2-3 times a week, get at least 7 hours sleep a night, learn how to manage stress better, nurture relationships, and find something that gives you pleasure to engage in consistently both physically and mentally.

If you follow this advice, I can't promise what weight, if any, you will lose, but I'm pretty sure you will be healthier than you are now. In the final analysis, I hope you agree that being healthy is the most important goal.

Ignore Dr. Oz on Sage Leaf Tea and Alpha Lipoic Acid

Contrary to what some may think, I don’t enjoy blogging about Dr. Oz.  Why? It requires a lot of effort to identify the facts and if I don’t exert the effort, I am ultimately no better than him with his inaccurate proclamations.  Having written about the good doctor ad nauseum, I had planned to ignore his most recent show called "Snack Attack: Eat More and Weigh Less" this past Friday that originally aired February 17, 2012.   

As fate would have it, one of my guests at Friday night dinner asked me about the show and specifically about the Sage Tea he recommended to lose weight.  My short respite from analyzing the products Dr. Oz recommends was over.

So here we go again. The episode started with Dr. Oz claiming that “recent studies prove that snacking on the right foods at the right time can turn your body into a fat-burning machine.” He then went on to present that eating certain snacks of 200 calories or less two hours before dinner will result in less food consumed at dinner. One of those snacks he presented included prosciutto, a cured ham, which he recommended wrapping around 2% mozzarella cheese, and adding 2 olives, 1 cup zucchini, and 1/4 cup chickpeas.

I’d like to see a study that showed that eating prosciutto and mozzarella cheese two hours before dinner helps you lose weight. I highly doubt it. What do you think? He also states on his website in reference to this episode that “Get your metabolism going with a pre-dinner snack, 1-2 hours before your main meal. Doing so will help you stop eating once you're full, which is sometimes hard to do.” Why would snacking help you stop eating when you are full if eating non-snack food often doesn’t do that?  Enough said.

Of course, he also recommended a product—in this case a cup of Sage Leaf Tea--as a way to lose weight. After a few hours of research, including pubmed.com, Cochrane.org, naturalstandard.com, and infopoems.com, I could only find one reference to the use of Sage Tea for anything whatsoever related to weight.

It was a study titled “Antihyperlipidemic effects of Salvia officinalis L. leaf extract in patients with hyperlipidemia: a randomized double-blind placebo-controlled clinical trial.” This single study involving a whole 67 people showed that Sage Leaf may be useful in decreasing lipids. Mind you, that doesn’t mean losing weight. 

By the way, where do you think the study was done. Wait for it, here it comes—Iran.  Yes, that’s right--The People’s Republic of Iran, that bastion of scientific integrity known for its war-mongering, terrorist-supporting, Holocaust-denying oppressive government. Now that’s a source of a study I’m not sure anyone should rely upon.  There was not a single additional scientific reference to the use of Sage Leaf tea for weight loss, metabolism booster, etc. that I could find.

But Dr. Oz wasn’t done for the day pushing pills.  He then recommended 200 mg. Alpha-Lipoic Acid (ALA) as another weight loss aid.  Now here’s where it gets good. 

Like with Sage Leaf, I began an intensive search and here’s what I found--a South Korean study titled, “Effects of Alpha-Lipoic Acid on Body Weight in Obese Subjects” published in early 2011, that stated to the authors’ knowledge, “this is the first study to show that alphalipoic acid treatment led to a significant weight reduction in obese human subjects.” There appears to be no published study since, so this seems to be the first and only study of its kind. 

Second, the study initially involved 360 obese subjects (of which about 1/3 dropped out for different reasons including adverse side effects) consuming 1,800 mg (9 times the dose recommended by Dr. Oz).  

After 20 weeks of treatment with 1800 mg per day of alpha-lipoic acid, the results showed “modest but statistically significant reductions in body weight and BMI.” How much weight did they lose after 20 weeks of 9 times the dose recommended by Dr. Oz? They lost 1.8% of their weight. In a two hundred pound person that would be 3.6 pounds.  At 1,200 mg (or six times the Dr. Oz’s recommended dose) the weight loss was even less at about 2 pounds for a 200 pound person.

For full disclosure, there was another study, published in 2010, for which I could only access the abstract titled, “Alpha-lipoic acid supplementation: a tool for obesity therapy?” The conclusion of this Italian study according to the authors was “Our study indicated that LA is an ideal antioxidant candidate for the therapy of obesity related diseases. Further clinical studies should be considered to highlight the role and efficacy of LA treatment.” However, this was not a double-blind randomized controlled study and no data on caloric intake was given. By the way, they consumed 800 mg, or 4 times the dose recommended by Dr. Oz. Apparently, the South Koreans discounted this study as well based on their statement that they had performed the first study on the effects of ALA on weight loss.

Need I say more? Dr. Oz has little scientific basis (and for that matter, no business) recommending such a product at a dose that has no valid and conclusive scientific evidence to support his recommendations.

Of course, that never seems to stop him and it didn’t here.