Our Bodies, Their Solutions

In the parking lot of a Jack in the Box on Glendale Boulevard a few months ago, I got my body fat tested. We did it at the Jack in the Box because the Winnebago with the testing equipment in it needed a power source, and the manager at the Jack in the Box let us use an outlet in the back of the store.

As I walked over to the Winnebago, a 6-foot-plus, partly bald man in squarish sunglasses approached me. This was Dr. Gil Kaats, who ran research projects for Body Solutions, the company that was about to test my fat. He had a gray-and-white beard and was in dark pants, a white shirt and a tie. We shook hands. We‘d talked on the phone but hadn’t met in person yet.

It was a perfect, sunny Los Angeles afternoon, way before the Federal Trade Commission announced that it was suing Body Solutions over those “Lose Weight While You Sleep!” ads you probably heard on the radio at some point. If you never did hear them, you missed out. They were brilliant. Body Solutions got hundreds of DJs around the country (30-plus in Los Angeles) to use their diet products and do these chatty ads-that-don‘t-sound-like-ads about how much weight they lost. In the commercials, DJs marveled at how easy it was to follow the no-fuss Body Solutions plan: Eat whatever you want, don’t worry about exercising, and then just stop eating and drinking three hours before bed and take one tablespoonful of Body Solutions‘ Evening Weight Loss Formula with a glass of water right before you go to sleep. Watch the pounds melt off.

“I’m Nancy,” I said to Dr. Kaats.

“With the smiling face,” he said.

“Nancy With the Smiling Face” is a Sinatra song, if you didn‘t know. It’s not one of his better songs, but it‘s one you’d know if your name were Nancy. In my experience, it usually signals the start of a conversation that will be, overall, more jokey than the situation warrants.

A technician sat at a computer in the Winnebago, and a Body Solutions PR guy stood in the doorway, as Dr. Kaats (pronounced Kates) put me on a machine called DEXA (Dual-Energy X-Ray Absorptiometry). It‘s an 8-foot-long box hooked up to a computer. I lay on the box, face-up, and a mechanical arm inched over me doing a very low-level X-ray. Dr. Kaats told me it would measure my bone density as well as my body fat. Body Solutions, at the time, was very into bone density. Dr. Kaats had been driving the Winnebago around to different cities for the last several months, offering to test people’s body fat and bone density and start them on Body Solutions.

Once I finished on the DEXA machine, Kaats kindly shooed the technician and Body Solutions‘ PR guy away to tell me my body-fat level (an acceptable 22.8 percent) and to give me the good news that I have “the bones of Godzilla.” I got so caught up in the process -- what woman doesn’t want to talk endlessly about her fat content and osteoporosis risk? -- that I almost forgot to ask my question: What does Body Solutions‘ Evening Weight Loss Formula have to do with bone density, again?

Dr. Kaats’ voice took on a mystified tone.

“I don‘t know,” he said, shaking his head. “When we did the study of the Evening Weight Loss, people who took it at night on an empty stomach increased bone density. If you say, ’Come on, Gil, how can that happen?,‘ I don’t know how it could happen. I can‘t explain it.”

Dr. Kaats had the same response in an earlier telephone interview, when I asked him how Evening Weight Loss managed to fulfill its claim of reducing fat while maintaining muscle: “I can’t explain that.”

Dr. Kaats smiled throughout the conversation and seemed utterly unfazed by his own lack of answers. What kind of company, I wondered, would deliberately steer reporters to this man?

When I started this story, Body Solutions filled me with an odd mix of curiosity and dismissiveness. The promise of losing weight while sleeping seemed absurd. I wasn‘t surprised to find out that, even before the FTC got involved, Body Solutions’ Texas-based parent corporation, Mark Nutritionals, was being sued in five states -- California, Texas, Florida, Ohio and Michigan -- for false and deceptive advertising. I did wonder about the people suing, though. Who could possibly say with a straight face, “I bought a product that told me I would lose weight while I slept and I didn‘t lose weight and now I want to sue”?

All diet products, in my opinion, are either a placebo or speed; either way, they’re a scam. That‘s why every story about every diet product, including Body Solutions, ends with the official reminder that there is no magic bullet when it comes to weight loss, just a lifetime of exercise and eating right. But all of that skepticism just begs the question: If everybody knows weight-loss products are scams, how did Body Solutions manage to grow, in four years, from an unknown product being sold out of a storefront in a strip mall to a multimillion-dollar corporation with 300 employees?

Now that Body Solutions not only is being sued by the federal government and several states, but also is struggling to survive its recent Chapter 11 bankruptcy filing, it’s easy to shrug and say that these are just some very unsurprising chickens coming home to roost. But is Body Solutions the problem, or are we? Americans keep getting into the same kind of mess, over and over. Body Solutions, like so many diet products before it, somehow overcame its inherent preposterousness and became a product that many people believe in. That‘s not the same as being a product that actually works, but when it comes to weight loss, isn’t believing half the battle? For instance, here‘s a proven weight-loss plan: Walk two miles every day and eat more vegetables than anything else. Are you motivated yet? Very few people with weight to lose are energized by the idea of getting up an hour early every day and going for a brisk walk, but lots of people seem to find it easier to get motivated for a walk if there’s a magic potion waiting for them.

The central fact about weight loss, the one that we as a nation are constantly realizing and then promptly forgetting, is that losing weight is really, really hard. It‘s time-consuming, discouraging, uncomfortable, disruptive and endless. If you’re overweight, you are dying to cut the ordeal of losing weight down to size, maybe put some sparkle in all the drudgery. You grasp at straws. You throw money at the problem. You try things that you know sound crazy: “Crazy, yes, but maybe just crazy enough to work!” Thousands of companies are competing to build an empire out of those impulses. Body Solutions succeeded.

Before we return to Dr. Kaats, some background. Body Solutions and Mark Nutritionals were created by a former tabloid photographer named Harry Siskind. Siskind was a very successful tabloid photographer, which is to say, hated by many. The actor Kelly McGillis sued Siskind after he and a reporter appeared at a private showing of her house and started asking her husband about his recent arrest for solicitation of a prostitute. A British television star threw a brick at Siskind‘s head. Pete Rose punched him in a parking lot. Christopher Reeve no doubt wanted to go after Siskind too, for lurking in the bushes outside a rehab facility and getting the first picture of Reeve as a quadriplegic.

Siskind did not get rich taking pictures, however, and he and his wife filed for personal bankruptcy in 1997. They moved to San Antonio and began working at a company called Texas D’Lites, a mail-order business selling a cookie that was supposed to help people lose weight. The Siskinds chose San Antonio because, as Siskind would later tell a group of San Antonio business people, he‘d heard it was the fattest city in America. But even surrounded by fat, Texas D’Lites went bankrupt by the end of 1998.

Undaunted, Siskind, less than a month later, started what was then called Mark Pharmaceuticals. He changed the name to Mark Nutritionals in 1999 when the Texas Department of Health informed him that the word pharmaceuticals was misleading. The Health Department also cited the company for “unapproved drug claims” in the labeling of its daytime formula, called “Atomic Energy.” Promotional materials for the product declared that one of its ingredients, chromium picolinate, “may lower blood cholesterol levels and optimize blood sugar.”

From the beginning, Body Solutions has been obsessed, like every other diet supplement in the country, with promoting the scientific basis for its products. Its Web site proudly proclaims that the company is an “industry leader in clinical trials and research.” The first thing you see on the back of a bottle of Evening Weight Loss Formula is a paragraph about how much research Body Solutions has done. Body Solutions‘ customers all cite how natural and well-tested its products are.

This is where Dr. Kaats comes in. He’s done most of the 30-plus studies that Body Solutions has commissioned, at a total cost of a million dollars. Even though the San Antonio--based research company that Dr. Kaats heads -- the Health and Medical Research Foundation -- is independent of Body Solutions, Dr. Kaats signed a contract to be Body Solutions‘ official spokes-scientist. That contract almost immediately placed him in the middle of the worst publicity the company has ever had.

“You must regret signing that contract every single day,” I said.

“Sometimes more than once a day,” he laughed.

I almost felt bad for him, but Dr. Kaats made his own uncomfortable bed to lie in. His degree is in psychology, not medicine, yet he volunteered to defend the quasi-medical claims of Body Solutions’ products -- namely, that they reduce fat while retaining muscle mass and building bone density.

Here is a portion of our conversation regarding the weight-reducing properties of aloe vera, one of the ingredients in Evening Weight Loss:

Dr. Kaats: “The aloe vera extract appeared to act as some sort of carrier.”

Me: “Carrier of . . . ?”

Dr. Kaats: “Some of the people in the aloe business say that the aloe vera extract serves as a way to make the product more bio-available.”

Me: “What does that mean?”

Dr. Kaats: “That means that whatever you take, you‘re going to get into the system. But remember, this is all theory stuff.”

Me: “Right.”

Dr. Kaats: “On the aloe vera.”

Me: “Right.”a

Dr. Kaats has been doing research into obesity and fitness for almost 20 years, but the lawsuit against Mark Nutritionals is the second time his research has been associated with weight-loss companies being investigated by the FTC. In 1997, a Kaats study of the supplement chromium picolinate was cited in a Federal Trade Commission complaint against companies selling products that claimed chromium could significantly reduce body fat without dieting or exercise. The FTC found that there was no “reasonable basis” for such claims. Kaats said his research was misused.

Dr. Kaats also ended up doing research, rather than private practice, partly because of a serious ethical breach in his career. His license was revoked by the Texas State Board of Examiners of Psychologists in 1982. He initiated a sexual relationship with a client who had come to him -- with her husband, at first -- because of sexual problems in her marriage. Dr. Kaats specialized in sexual dysfunction at the time.

Dr. Kaats told me he deeply regretted the transgression and said he’d been going through a divorce and had been at the lowest point in his life.

I met Sheena Metal, a Los Angeles DJ who has a show Saturday nights on KLSX 97.1 FM, at an early-morning call-in show devoted to plastic surgery. She lost so much weight using Body Solutions that she‘s thinking of having surgery to tighten the folds of skin she now has on her stomach, arms and breasts. She started using Evening Weight Loss Formula almost two years ago and has lost more than 100 pounds.

Evening Weight Loss is by far Body Solutions’ most popular product, even though Body Solutions bills itself as a “3-Phase System.” Evening Weight Loss is a sweet, viscous, golden liquid made up of aloe, chromium, collagen, chicory, amino acids, and conjugated linoleic acid, which is an essential fatty acid found in beef and milk fat. Basically this is a compendium of the most hyped weight-loss substances around. If you enter those words into a search engine, you will find claims of fat burning, immune-system boosting, intestine cleansing and insulin regulating. But if you do a search on Medline, the main database used by doctors, you will find that most of the studies supporting the weight-reducing properties of these substances have been done on mice and rats, not humans. The human trials that have been done are inconclusive.

After the plastic-surgery show, Metal and I went for breakfast at the Radisson Hotel across from the radio station.

“I used to walk through malls and kids would follow me because I was fat,” Metal said. “I remember one Christmas, right before I lost weight, these kids were following me around and just being horrible, and I‘m thinking, ’I‘ve got to get this weight off. Here I am, this local celebrity -- this radio talent -- and I’m in the mall and nobody knows who I am and kids are chasing me through the mall like I‘m the freakin’ Elephant Man.‘”

Metal told me about doing a radio show with a guy who wanted her to pretend she was a skinny blond. He even put up a picture of a skinny blond on the show’s Web site and said it was Sheena. She‘d get crazed letters and e-mails from fans who said they were in love with her. Metal said she’d show up at live events for the radio show, meet these fans in person, and they would freak out.

Metal is 5 foot 8, has long, straight brown hair and pale skin, and weighs 215 pounds. She weighed 340 pounds when she started taking Body Solutions almost two years ago. At first she did it without telling anyone except the sales rep at the station, who got her free Body Solutions products.

She said she lost 45 pounds in the first two months, just by taking Evening Weight Loss. She didn‘t exercise or change what she ate.

Metal said she still eats pretty much what she wants. For breakfast on the day we met, she had eggs, ham, cottage cheese and French toast. She said she’s been fat since she was 5 years old, and before she lost weight she thought she‘d be fat forever -- “a lifer,” as she put it.

“I’m from a family of big, fat Irish people,” she said. “I think my mom was 45 when she got type 2 diabetes. I knew I was borderline diabetic, and I knew once I got on medication [for diabetes], I‘d never lose the weight.”

Metal probably added years to her life by losing weight. Besides diabetes, she faced a significant risk of heart disease, stroke, and breast, cervical and ovarian cancer. Now she’s at a weight where she can exercise, and she does.

Metal is convinced that the ingredients in Body Solutions, rather than the three-hour fast at night, helped her lose the weight. I asked her if she would care if she found out, at some point, that the ingredients in fact had nothing to do with her weight loss.

“Does it matter why it works, as long as it works?” she shrugged.

I have the same question. As long as it‘s not speed -- then who cares why it works? Lots of Americans have the bad habit of eating their worst, most unnecessary calories after dinner. It’s such a problem it‘s been given its own name -- Night Eating Syndrome. To break this habit, people need to start a new habit, like fasting for three hours before bed. If Evening Weight Loss helps people stick to the new habit, why is that bad, and why shouldn’t it cost money? Every diet is both a product and a behavior plan, and part of what you‘re paying for is the plan, even if the plan part is something you could separate out and do on your own, for free. The fact is, most people won’t do the free part on their own.

Of course the DJs were lucky enough to get the products free, and get paid to do the ads, but a month of Evening Weight Loss is only $48 to $60, depending on what discount they give you. If you resist the sales pitch to buy the total three-month package at $158.96 plus shipping, Body Solutions can be a relatively inexpensive way to train yourself out of some bad eating habits.

But Body Solutions may not work for you, as Body Solutions would be the first to tell you. Its disclaimer is that not every diet works for every person, and everyone loses weight differently. Both of those statements are true.

“I have a patient who says she can only eat carbs in the morning and protein in the afternoon, and another who eats absolutely the opposite, and both swear the way they‘re eating is causing them to lose weight,” said Dr. Lisa Sanders, who is on the faculty at Yale Medical School and is developing a curriculum to teach doctors about weight loss and nutrition.

Contradictory advice based on personal success stories is the way of the world when it comes to losing weight. For every person who’s dropped a few pounds, there‘s a friend trying to lose weight based on whatever scheme that person recommends. What else are they supposed to do? It’s not as though most doctors are any help.

“If you ask a doctor, ‘How do I lose weight?,’ he does not know the answer,” said Sanders. “When a doctor says, ‘Eat less and exercise more,’ that‘s all they know.”

The dietary-supplement industry has eagerly filled the void left by the medical community’s neglect. Over the last 10 years, as the country has fattened up, dietary supplements like Body Solutions have become a $4.6 billion industry. Ten years ago, the biggest category of diet products was meal replacements, like Slim Fast. Now it‘s supplements. And the more money there is to be made, the more aggressive the advertising gets.

Richard Cleland, the Federal Trade Commission’s legal expert on deceptive advertising in the diet industry, started laughing when he told me that he brought his first case in 1985.

“Why are you laughing?” I asked.

“You‘d think that if you’d spent that much of your professional career fighting something, you‘d have solved it by now, instead of watching it get worse,” he said.

After a monthslong, 12-state investigation, the FTC last month, along with state attorneys general in Texas and Illinois, filed suit in federal District Court in Texas against Mark Nutritionals, Harry Siskind and Mark Nutritionals’ co-founder, Edward D‘Alessandro. The FTC is suing to get consumers’ money back, and it‘s suing to ban both the corporation and the individuals from making false and deceptive claims, now or in the future, about not only Evening Weight Loss Formula but also any other food, drug, supplement or product having to do with weight loss or health. The company has denied any wrongdoing.

Cleland said the number of deceptive weight-loss ads has exploded in the last decade. Since 1990, the FTC has filed 93 cases against weight-loss products making unsupportable claims. That’s as many cases as it filed in the previous seven decades combined, said Cleland.

“It‘s a supply-and-demand problem, not totally different than the problem with drugs,” he said. “There is high demand for magic-bullet-type products that don’t require consumers to make any lifestyle changes, and it‘s relatively easy for companies to get into the marketplace and sell products without much government oversight.”

That oversight should come from the Food and Drug Administration, but the FDA has not reviewed diet supplements since 1994, when Congress passed a law, largely at the behest of the vitamin industry, to exempt food supplements -- including diet supplements -- from FDA rules. All the FDA can do is go after the very worst cases, when people’s health is at risk.

But it‘s not just safety testing we’re missing without FDA scrutiny. FDA approval means a product has been shown to be effective in the majority of cases. Without FDA tests for diet supplements, consumers have no idea what the odds are that a product will work. Because there‘s still so much we don’t know about how and why different people lose weight, there is a remote chance that Body Solutions -- or some other product out there -- actually works, somehow. But Body Solutions‘ disclaimer -- that not every diet works for every person -- doesn’t give the whole picture, because there‘s no way to know whether it works for one out of three people or one out of 30,000.

I asked Cleland if he thought the 1994 law was a mistake and needs to be amended.

“That kind of conclusion is beyond my pay grade,” he said dryly.

Even without FDA oversight, the public has managed to learn a few hard truths about diet supplements. The speedy stuff -- amphetamines, ephedra, caffeine -- can be dangerous and will not keep weight off over the long term. Laxatives are also a bad way to diet. Losing weight too quickly means you’re probably going to gain it all back. Body Solutions positioned itself as the alternative to all that. The Web site declares that “Body Solutions is NOT a ‘lose 30 pounds in 30 days’ program. It‘s NOT a laxative. It’s NOT a diuretic.” All good, but the message turns vague when it gets to what Body Solutions IS: “A weight loss program designed to work just like the doctor ordered; nice and slow, so that you lose the right kind of weight.” How clever to work the word doctor in without actually claiming that the products are doctor-approved. Body Solutions even changed its slogan to match the “nice and slow” message: “Lose Weight While You Sleep!” was replaced by the laughably circumspect “Give Us 90 Days and Watch What Happens.”

Dr. Kaats said the company wasn‘t hedging, just evolving as it did more research and tried to distinguish itself from all the copycat “lose weight while you sleep” products that have piggybacked on Body Solutions’ success.

“The whole theme of the road they‘re trying to go down is to say, okay, what’s unique about our company?” he said. “One, clinical trials. Two, healthy weight loss.”

Let‘s look at Body Solutions’ research. Hearing that it has done more than 30 studies, and spent a million dollars, you might think, wow, that‘s a lot of research. It is. Perhaps too much.

“They wouldn’t have to do all this hand waving and put out so many pages of studies if the stuff worked,” said Dr. Sanders, the weight-loss expert at Yale, after she looked through the summaries of the studies.

The studies are short on details. The phrase “highly significant reductions in body weight” comes up a lot, and nothing is said about who the participants are or how overweight they are -- either of which could skew results. None of the studies have been published in peer-reviewed journals, which is how other researchers know a study is significant. Dr. Kaats said he‘s submitted some of the studies for publication, but he couldn’t tell me which studies or which publications. Most importantly, none of the research tests Evening Weight Loss Formula against a placebo. To settle the key issues -- whether significant numbers of people are losing weight on Body Solutions, and whether the ingredients in Body Solutions are the cause of that weight loss -- Body Solutions would have to do a randomized (the researchers can‘t choose who gets what), double-blind (neither the researchers nor the participants know who’s taking what), placebo-controlled trial, preferably done by a university with a good reputation in medicine, by researchers who have no financial stake in the outcome. Then we could know for sure if there‘s magic in the bottle or just in the heads of the people using it.

I called the woman suing Body Solutions in Florida, and we talked for an hour and a half. Janet Makinen seemed so sensible that I was confused. Why did she buy Body Solutions?

“Well, I’ll say it for you, ‘How stupid can we be?’” she said, referring to the other potential plaintiffs in her lawsuit. “If I had been thinking and relied on what I know is real, I never would have thought it would work. I just thought whatever magic mix was in Body Solutions was something I didn‘t know about.”

Makinen (pronounced MACK-in-nen) said she felt desperate and trapped in her own body. She’d been thin her whole life, and over three years she put on 20 pounds, which is a lot if you start out at a size 1. She‘d moved to a new house, and it was on a huge, unpaved hill that made it hard even to go for a walk for exercise. She almost never saw her friends, because her new house was an hour away from her old one. No one was around to kid her out of buying a “magic mix.”

As we talked, I found myself becoming more sympathetic to Makinen’s case as I realized that I‘ve spent thousands on magic mixes myself -- not for weight loss but for skin care. I simply cannot resist skin-care products, and the more incredible the claims they make, the more irresistible they are to me. I’ve bought skin-care systems from stores and from cosmetologists and from infomercials. Most of them made no difference whatsoever.

But, as I told Makinen, I never thought of suing anyone when these skin products didn‘t work. I just thought I was an idiot for buying them in the first place.

Makinen said she didn’t think of suing either, at first. But she kept hearing the ads.

“Every time I heard that commercial, it bothered me more and more,” Makinen said.

Since filing the lawsuit, she‘s lost 7 pounds -- the hard way. She walks for an hour every morning and eats oatmeal for breakfast, lentil soup for lunch and chicken breast with steamed vegetables for dinner.

This routine is in stark contrast to the three months she took Evening Weight Loss Formula. She spent every day then baking and eating pies and cakes and brownies with her granddaughter. How was a tablespoonful of anything going to fight that?

But that was Body Solutions’ message -- through the DJs who pushed the product, and through the company‘s sales staff. I had a friend call Body Solutions, and the salesman she talked to said he ate mostly fast food and didn’t exercise, and he was losing weight with Body Solutions.

I asked Makinen if she really, in her heart of hearts, ever thought Body Solutions would work, with her eating all the brownies and everything, or if she just wanted it to work.

“Maybe subconsciously I didn‘t want to stop baking pies and cakes with my granddaughter,” she admitted.

There is a collaboration of sorts between many people who want to lose weight and many of the companies that sell weight-loss products: They both desperately want to believe that these products work. If they work, everyone wins. Everyone is happy. Who but a few un-American naysayers could be unhappy if people lose weight and someone finds a way to make money in the process?

The words weight loss are now banned from Body Solutions’ Evening Weight Loss Formula, due to a preliminary injunction obtained by the FTC. Mark Nutritionals‘ headquarters has been sold to Goodwill Industries. Sheena Metal’s radio station, KLSX, has filed a claim against Body Solutions for $171,145 in unpaid advertising bills. Dr. Kaats is no longer employed by Mark Nutritionals and has been named, along with Siskind, D‘Alessandro and Siskind’s wife (former executive VP of the company), as a defendant in the Texas lawsuit filed along with the FTC case. Dr. Kaats declined to comment. Mark Nutritionals, ever hopeful, has brought in a new CEO to turn things around and has started selling Body Solutions at Sav-On, Walgreens and several other stores.

I asked the private lawyers who are suing Mark Nutritionals on behalf of Janet Makinen, et al., whether they‘ve ever tried to lose weight. Everyone said pretty much the same thing.

“I really don’t think the personal experience of the plaintiff attorney is relevant,” said Mark Baumkel, one of the lawyers in the Michigan case.

I also asked if they expected Mark Nutritionals to put a bunch of people on the stand who say they‘ve lost weight on Body Solutions. Of course not, they said. Each side will have to present evidence and experts, not a parade of unhappy fat people followed by a parade of happy thin people.

“You can have people eat dog poop and say it makes them strong and thin, but you’ve got to have a scientist bring admissible scientific evidence,” said Baumkel.

I understand why, legally, people‘s experiences of weight loss or weight gain are meaningless in these cases. Courtrooms are not rap sessions, they are for holding companies accountable for what they make, do and promise. Still, experts talking about lipids cannot convey what it means to be fat, or what it takes to get thin.

I’m happy for Sheena Metal and anyone else who‘s lost weight on Body Solutions. I think, on a case-by-case basis, it really doesn’t matter why something works, as long as it isn‘t harmful. But when you get into thousands of people and millions in profits, it does matter. Body Solutions isn’t a friend giving you diet advice over a cup of coffee. When a weight-loss strategy is hooked up to a giant marketing machine, that strategy has to have more going for it than “Hey, it worked for me.”

The bankruptcy proceedings have put Makinen‘s lawsuit and the other private cases on hold, but she says she’s not going to let it go. She and four other plaintiffs, from California, Michigan, Ohio and Texas, have filed a new complaint, this one in U.S. Bankruptcy Court, going after Mark Nutritionals for deceptive trade practice and breach of implied warranty.

“I keep the bottle [of Evening Weight Loss Formula] in my fridge, just to remind myself never to listen to anything like this again,” she said. “My husband keeps saying, ‘Why don’t you just throw this away?‘ Nope. I will throw it away when the lawsuit is over and done with.”


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