Julie Deardorff of the Chicago Tribune counts Dr. Phil’s chickens as they come home to roost:

When television pop psychologist “Dr. Phil” McGraw first teamed up with the lucrative weight-loss supplement industry, you could almost see Oprah Winfrey shaking her head in disapproval.

Oprah, his show-biz mentor, consistently has refused to endorse diet products. So when Dr. Phil told her he might vouch for Shape Up! drinks and nutritional bars, Oprah said it wasn’t necessarily a decision she would make for herself.

Dr. Phil should have listened. Now the man whose macho shtick is dispensing “Get Real” advice is facing a possible class-action lawsuit filed by three disgruntled dieters. Their main charge is that– surprise!–the products he endorsed are useless.

I’d love to be part of a jury trial to help decide which party was more foolhardy. Was it the dieters, who should have known better than to purchase weight-loss supplements, especially those endorsed by a celebrity?

Or was it irreproachable [sic - “irrepressible”?] Dr. Phil, who isn’t a medical doctor or registered dietitian (or, dare I say, even thin) but bragged that he would give his fans “scientific-based, usable information about the [obesity] epidemic”?

“I do enjoy a level of trust with a lot of people who understand and appreciate that I do my homework before I start talking,” he said last year. In hindsight, Dr. Phil seems to have opened his yapper a bit prematurely. CSA Nutraceuticals, the company that made the Shape Up! supplements, shakes, bars and multivitamins, stopped making the products early last year in the face of a Federal Trade Commission investigation into complaints of false advertising.

It was a goofy diet plan to begin with. Consumers first had to figure out whether their body resembled an apple or a pear. The “apples” downed one set of supplements and vitamins, while the “pears” took another. In addition, Dr. Phil recommended swallowing 10 more “Intensifier” pills to “take your weight-management efforts to the next level.”

The whole process involved popping 22 pills a day at $120 a month. It’s a small price to pay, I guess, if the supplements really did “contain scientifically researched levels of ingredients that can help you change your behavior to take control of your weight,” as the literature promised.

But not surprisingly, there’s no real scientific basis behind the “apple” and “pear” theory. Meanwhile, the plaintiffs’ attorney charges that there were no real clinical trials and no real testing of the products.

She goes on to point out that “dietary supplements” exist in a carefully-crafted loophole in regulatory law - they are not required to be tested for safety or efficacy in any degree. The FDA can regulate them only by conducting its own testing at its own expense, and the burden of proof is on the FDA in those cases - so almost no such products are tested. Congress explicitly created that carve-out at the “request” [$$$] of the supplement industry.

Like Deardorff, I wonder about the distribution of responsibility here. Yes, you do have to be an idiot to take untested products that occupy the woo-woo margins of scientific theory, and to take a TV huckster’s word on it even if he does refer to himself as “Doctor”. (You have to be a bigger idiot to use products advertising “no animal testing” - great: they’re testing it on you - but I digress.) And you have to be a schmuck to endorse bogus health-related products in areas in which you have no expertise, especially by making explicit prescriptions regarding their use, as “Dr. Phil” seems to have done; playing fast and loose with other people’s safety for financial gain is unforgivable. The real wrongdoing, though, is on the part of the companies marketing these worthless products, or marketing any similar products without a sound scientific grounding and thorough safety testing - which would encompass almost the entire diet supplements industry. With that much blame to go around, it’s hard to know who should bear final responsibility for the harm that is caused.

The issue is analogous to lawsuits over smoking or unhealthful fast foods - everybody knows they are bad for you, but they are produced in abundance and aggressively marketed, with minimal regulation, using the most sophisticated tricks of the advertising business (often to consumers who are addicted or otherwise have low ability to make other choices). You can hardly blame people for reacting as they have been manipulated into doing, and you can hardly absolve industries from blame for creating and marketing deadly products deliberately. But there is a necessary element of personal choice involved in using them, too.

The problem, I think, is that in a country that treats actual medicine as a consumer good in a competitive market, quasi-medical goods like food supplements fall even more obviously into the market model, in which companies have no (legal) responsibility for not harming their consumers as long as they can claim the consumers made the final choice to expose themselves to the danger. We impose relatively minimal safety requirements on prescription or OTC medications and devices, but otherwise offer no consumer protections at all regarding their use or marketing; it’s not surprising that “supplements” would be treated like Big Macs: “Here’s a warning label, you’re on your own”.

The problem is not that the supplement scammers, the unscrupulous Dr. Phils, and the bewildered and credulous consumers are all busy passing the buck round and round - the problem is that we don’t take the people’s health seriously in this country. We don’t regard health needs as important enough - in and of themselves - to make them a legislative priority: we don’t provide healthcare except in the most extreme cases; we have minimal public-health programs (which, predictably, have frequently been scaled back to accomodate religious extremists); we allow the medication and medical-device industries largely to regulate themselves; we put industry hacks in policy-making positions in government; we have large swaths of government with official policies of preventing citizens from exercising healthcare rights they are supposedly guaranteed under the Constitution. Having health needs, or having your health threatened by someone else’s malfeasance, is not justification for government’s acting to protect your interests against those of the profit-making industries that stand in opposition to it (or, increasingly, against the religious extremists who simply disapprove of your values).

That companies are killing citizens gullible enough to use their products - and that influential public figures are encouraging citizens to take significant risks on completely bogus information - are not reasons for the law to act if there’s a buck to be made in it somewhere.

Hat tip: Kristin Nelson of Women’s Bioethics Blog; she has some good things to say about the lack of testing for supplement products.