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‘We Couldn’t Say It in Print If It Wasn’t True’: Akavar’s Version of Truth in Advertising

Article

Harriet Hall

Volume 32.5, September / October 2008

An ad for a weight-loss product falsifies its own slogan by printing outright lies. An attempt to find the advertised “published research” becomes a surreal odyssey.

I like to read advertisements for quack remedies. I’ve come to suspect that “clinically proven” means “we gave it to three of our friends and got them to say it worked.” When the ads cite published medical studies, I like to track down and read those studies. I usually find that they have nothing whatsoever to do with the product in question and I get a lot of amusement from the pseudoscience and the testimonials.

I really hit the jackpot when I noticed an ad for a weight-loss product called Akavar 20/50. It made the usual claims: eat all you want and still lose weight. But it had the best advertising slogan ever: “We couldn’t say it in print if it wasn’t true!” I laughed out loud. Anyone can say anything in print until they get caught. These diet ads all say things that aren’t true, and the Federal Trade Commission can’t begin to catch them all.

The ad describes research results on Akavar as “staggering.” It claims to have published scientific research showing that twenty-three out of twenty-four patients using Akavar’s active ingredient lost weight and describes a controlled, randomized clinical trial of the actual product in which twenty-three out of twenty-four patients lost “a substantial amount of weight.” Two questions immediately came to mind: why were the numbers the same in both studies, and if a single active ingredient worked just as well, why was there any need to develop the Akavar formulation?

There was a toll-free number to call for further information. I called and asked where I could read the two studies they referred to. The man who answered was flummoxed: “No one’s ever asked me that before.” He had to go for help. Finally he came up with the names of two journals but no further information.

I searched PubMed for anything in either of those journals that might even remotely be considered studies of Akavar and couldn’t find anything. I wrote the company’s customer service representative and asked for more information. That led to the following surreal e-mail exchange over the next month and a half.

September 30: [Me] Your ad for Akavar describes a high rate of success in clinical studies. I’d like to read those studies for myself. I called your 800 number and the person who answered told me there were two studies published in the Journal of Human Nutrition and Dietetics and in the journal Medical Psychopharmacology. He was unable to give me the full citations, and I have searched PubMed and elsewhere and have been unable to locate the articles. Could you give me the exact citations (date, author, title of article, journal, volume, and page number)? Or better yet, could you possibly send me electronic copies of the articles? I would really appreciate it.

October 9: [Akavar] Thank you for your interest in Akavar 20/50. I will be happy to submit a request to our Compliance dept. and have these studies prepared for you to send via email or via mail. We request to know as to what use these will be used for and will require a phone number and address. As soon as I have this information I will submit the request and have these prepared for you to save any trouble of having to look these up yourself. Thanks so much.

October 9: [Me] I would prefer you send them by e-mail. What they will be used for? To help me decide for myself whether there is adequate evidence to recommend Akavar 20/50 to patients.

October 10: [Akavar] Thank you so much for this. I will forward this request to compliance and send via email when they have finished preparing the study.

October 15: [Me] I’m still waiting. The delay is making me wonder... if you really have legitimate scientific studies to back up your claims, why are they not posted on your web site or linked to the PubMed abstracts or at least listed in such a way that they can be located by interested physicians?

October 17: [Akavar] I apologize for the delay. I will follow up with our Compliance/Legal department to see if they have prepared these for you or not. I will let you know shortly.

October 30: [Me] It is now October 30, and I still have not received the studies. If they are not available in electronic format, all I really need is a proper citation: title of article, name of journal, names of authors, date, volume and page. If these studies really exist, and if they really support your product, your company certainly doesn’t seem very proud of them! If you cannot provide me with the citations, I will be forced to assume they do not exist and I will report your company for false advertising.

November 2: [Me again] OK. Still no response. I will have to give you a deadline. If you have not sent me the citations by November 5, I will take it as an admission that you are crooks who tell deliberate lies in your advertising and I will report you to the FTC. I will remind you that ALL I’m asking is that you tell me where I can find the clinical studies you advertise as supporting your product.

November 2: [Akavar] I just spoke with our Legal department as I have been out of the office this week. They informed me that they are contacting you via mail as they are requesting more information from you. I can not handle this request other than our legal department. This was sent to the address you provided me below and should be received within normal postal delivery time. [I never received anything by mail.] I apologize sincerely for this delayed response. It should be taken care of now. Thank you.

November 2: [Me] How about you give me the e-mail address of the legal department so you don’t need to act as intermediary? There is no reason for them to request more information from me—that is ridiculous! And even if they are mailing me copies of the studies, there is no reason they can’t also immediately provide me with the citation information via e-mail. Reputable companies usually display that kind of information proudly on their web sites, often with a link to the studies.

November 5: [Akavar] Our compliance/legal department has prepared the following for you and are sending via email at your request via the above attachments. Please respond accordingly. Thanks again for your patience.

[Attachment] We have received your request to provide you with all studies relating to our Akavar 20/50 product. Due to the confidential nature of these studies, we cannot release these studies without a signed Non-Disclosure Agreement. Our standard Non-Disclosure Agreement is enclosed. Pleases [sic] review and sign the Agreement. Upon receipt of the signed Non-Disclosure Agreement, we will happily provide you the information you requested. . . . [This was accompanied by a complicated, multi-page legal document.]

November 5: [Me] You have GOT to be kidding!! I did NOT ask for “all” studies relating to your product. I did NOT ask for any proprietary information. All I asked for was the correct citations for the two published studies referred to in your advertising. This is not anything that requires any signature or agreement. Published studies are in the public domain. This is becoming a surreal experience. Perhaps I’d better start all over again by copying my initial request: [My initial e-mail was copied here.]

Let’s make this really simple:

  1. Are there two published studies?
  2. If so, please provide me with the information I will need to locate and read those studies: Name of author(s), title of article, name of journal, volume, page number and date of publication.

November 7: [Akavar] Any update from MKF?

November 7: [Me] No. Who or what is MKF?

November 13: [Akavar] We regret that you refused to sign the NDA, which would have allowed us to provide you the highly confidential, proprietary data related to Akavar. We are, however, enclosing the citations for the published articles relating to Akavar’s efficacy. [Lieberman, H.R., Tharion, W.J., Shukitt-Hale, B., Speckman, K.L., & Tulley, R. (2002). Psychopharmacology (Berl), 164(3), 250–261. Andersen, T. and J. Fogh (2001). J Hum Nutr Diet 14(3): 243–50.] Any representation on your part that the published studies comprise the full substantiation for Akavar 20/50 or that the substantiation is lacking in any way would be false and intentionally misleading on your part since your [sic] were not privy to the full documentation. Again because of your refusal to sign a simple NDA. [This letter was signed by a paralegal.]

November 13: [Me] You did not provide the titles of the studies, but I easily found them. I can see why you didn’t provide the titles, and I can see why I didn’t find them when I looked before, because it is obvious that they were not studies of Akavar 20/50.The Lieberman study is titled “Effects of caffeine, sleep loss, and stress on cognitive performance and mood during U.S. Navy SEAL training. Sea-Air-Land.” The Andersen study is “Weight loss and delayed gastric emptying following a South American herbal preparation in overweight patients.” The herbal preparation was a mixture of yerba mate, guarana, and damiana. The patients initially lost a few pounds, but those who took the active drug for 12 months “maintained” their weight during that period. The abstract of the study does not say that the study participants were instructed not to alter their eating habits. And the numbers of patients do not correspond to either of the studies described in your ads.

Your ad says, “this is scientific fact, documented by published medical findings.” Are you now admitting that there are no published clinical studies of Akavar 20/50 and that the statements in your ads are false?

I never heard back from them, and I decided I had had enough fun. I reported them for false advertising. I was not the only one to complain. A class action suit was filed against the company for “fraudulent, deceptive, and otherwise improper advertising and marketing practices.” The lawsuit says, “Akavar has not undergone scientific evaluation by a team of doctors, nor has Akavar been tested in controlled random clinical trials.” The lawsuit also mentions that Akavar is identical to another of the company’s products, Estrin-D, which is also the subject of an unrelated lawsuit.

Later a friend contacted the company and signed the nondisclosure agreement to see what would happen. All he got was a written summary of some unspecified studies with no authors or publications listed.

Imagine a pharmaceutical company telling me they couldn’t divulge the title of an article about their new drug in the New England Journal of Medicine unless I signed a nondisclosure agreement! What planet are we on? Even worse, imagine if a pharmaceutical company asked the FDA to approve a new drug on the basis of two studies that had little or nothing to do with that drug, insisting they had more proof, but it was a secret!

I don’t know why I’m surprised. Quacks have to defend themselves any way they can, since they can’t defend themselves with facts.

You might be curious to know what ingredients are in this miracle product. Nothing even remotely likely to promote weight loss except for caffeine and related xanthines. Drinking lots of coffee is probably just as effective.

A recent issue of the Natural Medicines Comprehensive Database newsletter said:

Akavar 20/50 is a new supplement promoted for weight loss. It contains a long list of ingredients, including large amounts of caffeine from yerba mate, guarana, green tea, and kola nut extracts. It also contains damiana, ginger, schisandra, scutellaria, vitamin B6, magnesium, and other ingredients. Some research suggests that a few of these ingredients might help for weight loss, but this is preliminary. There is no proof that this specific combination of ingredients is effective. Product advertising says, “Eat all you want and still lose weight. . . .” Remind patients that if it sounds too good to be true, it probably is.

And remember, the Natural Medicines Comprehensive Database could say that in print if it weren’t true—but they wouldn’t!

Harriet Hall

Harriet Hall, MD, a retired Air Force physician and flight surgeon, writes and educates about pseudoscientific and so-called alternative medicine. She is a contributing editor and frequent contributor to the Skeptical Inquirer and contributes to the blog Science-Based Medicine. She is author of Women Aren’t Supposed to Fly: Memoirs of a Female Flight Surgeon and coauthor of the 2012 textbook Consumer Health: A Guide to Intelligent Decisions.