Diet fraud has a long history in the United States, full of colorful American character types: confidence men, hucksters, shady doctors and fly-by-night entrepreneurs. People have been peddling phony weight loss elixirs since before the turn of the century. No sooner had fashion declared that women should be thin than advertisements appeared in magazines proclaiming quick weight-loss cures. "Weigh what you should weigh!" advised one 1896 ad for a diet remedy, "Get Rid of Fat!" Some of the early promoters, uncertain about whether losing weight was necessarily going to be very popular for long, hedged their bets by advertising that their products would either help you add weight or reduce, depending on what you needed.
A few of the early diet preparations were quite dangerous, especially Marmola, Corpulin, and Kellogg's Safe Fat Reducer, which contained thyroid. Physicians also prescribed thyroid, a drug derived from animal glands that can stoke the body's furnace so high it starts to burn up vital organs. Woods Hutchinson, a medical professor who wrote for women's magazines such as Cosmopolitan, wrote in 1894 that physicians didn't have any idea how thyroid, often prescribed with potassium (and sometimes arsenic), worked:
"Both cause, in some curious manner which we do not as yet understand, such an interference with the normal metabolism of the body as to cause the burning up and elimination of considerable amounts of body fat." But, Hutchinson noted, if patients lost more than 10 percent of their body weight -- the "movable 10 percent," he called it -- the results would be injurious. "The appetite becomes impaired, the sleep broken, and the heart's action irregular." If prolonged, the drug would set up a "serious and obstinate disturbance of the nervous system, and particularly of the nerves controlling the heart, accompanied by palpitation, sweating, weakness, and intense nervousness."
Other early diet preparations contained strong laxatives or purgatives, or arsenic and strychnine. Most, however, consisted of simple washing soda, Epsom salts, or other innocuous ingredients. By 1914, Good Housekeeping printed an expose on obesity cures, "Swindled Getting Slim." Written by Harvey Wiley and Anne Lewis Pierce, the muckraking article could have been written today. "As the rage for slimness grows apace, with apparently no limit in sight, the number, audacity, and unadulterated foolishness of the alleged obesity-cures and flesh-reducers keeps step with the demand," they wrote. "Some are merely picturesque and amusing; some are dangerous; all are misleading, and no little ingenuity is shown in presenting simple old-time frauds under new names and new auspices, with marvelous scientific explanations as to how they work, and new assurances of harmlessness and effectiveness."
In their article, Wiley and Pierce described the techniques, some of which are still used today, that diet hucksters used to sell their products and escape the scrutiny of regulatory agencies. A few products, such as Manhattanite Jean Downs' "Get Slim," which contained pink lemonade, were outright fraud. Others, such as Berledet tablets, claimed their product "makes you thin without dieting," with the caveat in small print that the user should avoid all fatty foods and take long walks every day. Others took a multi-faceted approach to weight loss, such as Marjorie Hamilton's Quadruple Combination, which combined recommendations for enemas, long walks, exercise, no liquids at meals, and no white bread, pastry, or potatoes with instructions on daily use of the diet powder, which turned out to be ordinary bath powder (you bathed in it, rather than ate it).
A few diet remedies contained some of the same herbs used in contemporary herbal formulas. In 1921, for instance, the American Medical Association's compendium Nostrums and Quackery listed bladderwrack, kelp, and poke-berry as common ingredients in obesity cures. "There seems to be no explanation for the popularity of this species of seaweed as a remedy for obesity," the authors wrote about bladderwrack. "In fact, it is said that this particular seaweed is used in some localities as a food for hogs in the belief that it makes the animals fat!"
Diet quacks used the mails to sell obesity cures, moving from state to state after being indicted for fraud, or simply changing the name of their cure to launch a new ad campaign. One particularly enterprising man, Walter Cunningham, purveyor of Marjorie Hamilton's Obesity Cure, frequently changed his state, obesity remedy, and wives. After having been jailed in Minneapolis for fraudulent real estate deals in 1906, Cunningham moved to New York, where he sold mail-order beauty creams under his wife's name. In 1909, he transferred to Chicago, sold the Evelyn Cunningham bust-developer and wrinkle-eradicator, then, after some legal trouble, changed the name of the products to "Della Carson." In 1911, he divorced his wife, married Marjorie Hamilton, and sold the Marjorie Hamilton mail-order fat reducer. When that received bad publicity, he promoted the Texas Guinan fat reducer. In the testimonial ads, Texas Guinan distinguished her product from previous "frauds," which the public never knew were sold by the same company. "It is not like the Marjorie Hamilton treatment --as absolutely different as day from night," Guinan advertised.
As they do today, turn-of-the-century diet aid promoters took advantage of the frustration people felt toward the medical establishment for failing to come up with an effective treatment for obesity. Actress-turned-diet promoter Texas Guinan ("I was a sight in tights at 204 pounds!") and others ridiculed physicians' treatments in order to sell more of their own products. Guinan--whose cure, for $20, consisted of a solution of water, alcohol and alum, along with the advice to take a hot tub twice a day, and avoid bread, potatoes, sweets, and starchy foods--described how she squandered her money "trying the various fat-reducing treatments so heavily advertised by charlatans of the American Medical Association." Like diet guru Susan Powter today, who rails against "the boys at the AMA," Guinan didn't mince words about doctors to would-be weight reducers. "Tell the quack AMA doctors and specialists to go hang," she advised her followers.
Many of those quack doctors were busy selling their own, often more dangerous, diet cures. One of the early ones was dinitrophenol, the first synthetic drug used for weight reduction. During World War I, observers noted that fat men who worked in munitions plants and came in contact with the chemical lost a substantial amount of weight. After the war, physicians lost no time in prescribing it to dieters. Dinitrophenol, which is still used as a powerful insecticide and herbicide, is a metabolic poison that is toxic to all forms of higher life. In humans, it speeds up the metabolic rate until eventually the body burns itself up. By 1935, over 100,000 Americans had taken this drug, advertised in newspapers and magazines as a "new and safe way to lose weight."
It wasn't long before severe side effects and fatalities were reported. Twelve women in the San Francisco Bay Area had been temporarily blinded by the drug, prompting the dean of Stanford University's Medical School to condemn its use. One physician who experimented with a large dose of dinitrophenol was, as writer Carl Malmberg put it, "literally cooked to death." By 1938, dinitrophenol had largely been discarded because of its ill effects, and the AMA announced it would withhold its approval of the drug.
Another strange obesity cure that was popular among physicians for a time was human chorionic gonadotropin (HCG), a type of growth hormone that was injected into patients. This treatment became popular in 1957, when Harper's Bazaar printed a diet -- "Slimming: A Roman Doctor's Treatment" -- that consisted of 500 calories a day for up to 40 days, plus daily hormone injections. In the article, the physician, British endocrinologist A.T.W. Simeons, claimed his patients weren't hungry as long as they took shots of HCG, which is produced by the placenta and derived from the urine of pregnant women (variations on this treatment used the urine of pregnant rabbits and mares). It's the very hormone, in fact, that turns the stick blue on a home pregnancy test.
Human chorionic gonadotropin was legitimately used at the time to treat a condition called Frhlich's syndrome, a hormonal imbalance that affects young boys, disturbing their sexual development, appetite, and sleep, and causing them to accumulate fat on the hips, buttocks, and thighs. Simeons reasoned that if the drug worked to melt away the fat on those boys with a rare genetic disorder, then it ought to do the same thing on normal, healthy women. The hormone, he wrote, would cause a "normal distribution" of fat on the body and would correct a "basic disorder in the brain." His diet book -- Pounds and Inches: A New Approach to Obesity -- included other gems of pseudo-medical advice, warning readers to eat no breakfast whatsoever, except for coffee, and to abstain from using any cosmetics or lotion on the body because it will be absorbed and added to the existing fat deposits in the body.
Simeon's treatment became all the rage; for a time, it was the most widespread medication given in the United States to lose weight, and was the main treatment used in 80 Weight Reduction Medical Clinics in California. Unfortunately, it didn't work: None of the mainly female patients seeking treatment, it turned out, were suffering from Frohlich's syndrome. The medical establishment only started to become suspicious of the drug when reports surfaced that part-time doctors were being offered as much as $100,000 a year by weight-loss clinics to spend one afternoon a week sitting and writing pads of prescriptions for the drug.
In 1962, the Journal of the American Medical Association warned against the Simeons diet, saying "continued adherence to such a drastic regimen is potentially more hazardous to the patient's health than continued obesity." In 1974, the Food and Drug Administration required producers of HCG to label the drug with a warning against using it for weight loss or fat redistribution. In Canada, the Task Force on the Treatment of Obesity warned that the use of the hormone "touches on possible malpractice." Nevertheless, a few diet doctors continued with the treatment -- it is legal, after all, for physicians to prescribe medications for purposes that are not approved by the FDA -- often handing the patients the drugs and injection equipment so they could administer it themselves.
In 1981, a physician and an entrepreneur joined forces for another dangerous diet scheme: The Cambridge Diet. [Note: The Cambridge Diet sold today is not the same version that was sold in the 1980s.] Jack Feather, who originated the idea, was a Walter Cunningham type who built a fortune in the 1960s with his wife Elaine selling women the bodies they wanted to have. They peddled figure salons, Mark Eden bust-developers, Trim-Jeans, the Sauna Belt, and then in the 1980s, the Cambridge Diet. In the 1960s and 70s, romance and true story magazines were filled with Feather's fabulous promises for his products: "Astro-trimmer the most astounding waist and tummy reducer of all time!" Many featured lovely young women with enormous breasts, who swore their bustlines were the result not of nature or silicone, but a hand-held exercise contraption. "The very first time I used Mark II, I saw my bust line become rounder and fuller and actually grow three full inches right before my eyes!" one testified. For 15 years, the U.S. Postal Service battled with the Feathers to stop making outlandish claims. Finally, in 1981, they were indicted on 13 counts of mail fraud, and made a deal with the government to pay $1.1 million and to stop selling bust developers, Astro-Trimmers and other diet aids. But by that time, they were ready to move on to their biggest scam.
In 1979, Feather had come across a copy of the International Journal of Obesity, which described University of Cambridge nutrition researcher Alan Howard's work putting patients on very low, 320-calorie-a-day diets. Feather decided he wanted to add a diet to his line of figure-enhancing products, and made a deal with Howard to put the diet on the market.
By this time, the very low calorie diet had already proven itself to be disastrous, since 58 people had died from being on the commercial liquid diets that were popular in 1976 and 1977. The amount of protein in these drinks was insufficient to keep the body from feeding on its own stores of protein, including lean muscle tissue and vital organs. The Cambridge Diet, however, advertised that it was "the perfect food," and "provides you with scientifically balanced nutrition," and backed its claims with assurances from Dr. Howard, who was hardly an unbiased scientific observer, but continued to defend the product in scientific journals without revealing he'd been paid for his services. It took journal articles by other well-known obesity researchers to bring to light the fact that even Howard's own research showed that the extreme diet burned up the body's muscles and organs.
After two months, the U.S. Postal Service and the FDA forced Feather to stop mail-order sales from ads that claimed that the Cambridge Diet would produce "no harmful side effects," was "metabolically balanced," and that people could stay on the formula for an "unlimited amount of time." Feather stopped selling the product through the mail, and instead created a wildly profitable multi-level marketing plan. The diet sold by word-of-mouth, with counselors who served as cheerleaders and spiritual advisors for their clients. The diet counselor who sold the liquid formula not only got a profit from each can sold to his own customers, but a percentage of the sales of each counselor he recruited into the Cambridge "family."
This pyramid scheme was so successful that some counselors were earning more than $150,000 a month. Successful counselors-turned-executives were rewarded with BMWs, Mercedes-Benzes, solid gold pens, and glitzy, celebrity-ridden hotel extravaganzas. Eventually, more than 3 million people had tried the diet, which Feather marketed as "an Ultimate Truth." For some, it was the ultimate diet: Some people died from heart attacks before the FDA forced the company to stop selling nutritionally inadequate diet drinks.
The Cambridge Diet debacle shows just how dangerous weight loss marketing schemes can be. The problem with most weight loss products sold over the years is they don't work, except to make the promoter wealthy. The problem with the rest is that they do work, temporarily, by promoting unhealthy weight loss through starvation, as in the case of the early version of the Cambridge Diet, or by stimulating the nervous system, as in the case of over-the-counter diet pills containing phenylpropanolamine (now banned in the United States), which not only cause unpleasant side effects such as dizziness and irritability, but can lead to heart attacks and stroke. If money were the only thing people lost in diet scams, it would be serious enough. But many people have lost their good health or their lives trying to lose weight. No matter what the claims, no quick-acting obesity cures to date really work to help people lose weight permanently. At best, they only make your wallet thinner.
Disturbingly, even after many of these schemes have been proven ineffective or dangerous, they persist. Even the poisonous dinitrophenol made a comeback. In 1987, the Texas Board of Medical Examiners tried to revoke the license of physician Nicholas Bachynsky, who owned a $10-million-a-year chain of diet and smoking-cessation clinics, for using dinitrophenol in his weight loss treatments. Sold under the name Mitcal, and advertised with the promise, "Never Be Fat Again," patients were charged $1,000 per treatment of the poison. Bachynsky testified in a 1986 trial that he'd prescribed the drug to some 14,000 Texans. Jurors found Bachynsky guilty of using the toxic chemical on his patients, he was fined $86,000, and his medical license was revoked.
State District Judge Juan Gallardo overturned that order, finding that the medical board's claim that dinitrophenol is "a chemical compound with no proven therapeutic value and usually has a number of harmful and dangerous side effects upon persons who take it" was "not supported by substantial evidence." Bachynsky went back to practicing medicine. It wasn't until 1990 that the Board of Medical Examiners was successful in taking away the diet doctor's license, after he pled guilty to a $60 million insurance scam that put him in federal prison for a 10-year term.
And human chorionic gonadotropin is still being peddled at conventions of diet doctors. In the exhibit hall at the American Society of Bariatric Physicians conference, I picked up a bottle of HCG and read the package insert. HCG, it said, "has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction." I asked the vendor whether the physicians buy it for weight loss. He shrugged. "They buy it," he said. "It's up to them what they use it for."
Woods Hutchinson, MD. "Fat and Its Follies." Cosmopolitan (1984), p 395.
Dr. Harvey W. Wiley and Anne Lewis Pierce. "Swindled Getting Slim." Good Housekeeping (January 1914), p. 109.
Arthur J. Cramp, MD. Ed. Nostrums and Quackery: Articles on the Nostrum Evil, Quackery, and Allied Matters Affecting the Public Health: Reprinted With or Without Modifications from the Journal of the American Medical Association, Vol. II (Chicago: American Medical Association Press, 1921), p. 659.
Paul Ernsberger and Paul Haskew, "Rethinking Obesity: An Alternative View of Its Health Implications." Journal of Obesity and and Weight Regulation, Vol.6 (1987), 45.
Robert A. Kilduffe. "The Weight of the Transgressor." Hygeia (September 1938).
Theodore Berland, Consumer's Guide to Rating the diets: Everything You Should Know About the Diets Making News (Skokie: Ill.: Publications International, 1980), p 223.
Thomas Wadden, et al. "The Cambridge Diet: More Mayhem?" Journal of the American Medical Association, vol. 250 (1983), 2833.
Testimony from "Juvenile Dieting: Unsafe Over-the-Counter Diet Product, and Recent Enforcement Efforts by the Federal Trade Commission." Hearing before the subcommittee on Regulations, Business opportunities, and Energy of the Committee on Small Business, House of Representatives, 101st Congress, Washington, D.C.,Sept. 24, 1990 (Washington, D.C.; U.S. Government Printing Office, 1990).
Texas State Board of Medical Examiners orders and complaints dated 1/26/90, 1/31/87/ 5/16/86, 3/7/86, and 2/1/86.
Hillel Schwartz, Never Satisfied: A Cultural History of Diets, Fantasies, and Fat (New York: Free Press, 1986).