By Jeff Lewis
It used to be that if you wanted to drop a few pounds ahead of an important event, you’d hit the gym. Some people prefer to jog, jump on the rowing machine or maybe lift some weights. But if you’re Beyonce Knowles looking to trim your waistline in preparation for a starring role in a Hollywood movie, you reach for the cayenne pepper. Throw in some lemon juice and a dash of maple syrup. Mix it all together in a glass of water and you’re left with what’s called the Master Cleanse – the gold standard of “detox” programs that seem to be everywhere online these days but rarely show up in medical textbooks.
Knowles reportedly used the program in the run-up to her appearance in the 2006 movie Dreamgirls, and she is far from alone. A growing legion of everyday dieters have followed the path set by the famous songstress, shunning the simple practice of regular exercise and healthy eating in favour of esoteric herbal remedies and strange concoctions that promise to accelerate weight loss and alleviate health problems in several quick, though not necessarily tasty, gulps. “It’s almost like bloodletting, where there’s something in your body that’s toxic to the system so you have to release it,” says Dr. Arya Sharma, a specialist in bariatric medicine at the University of Alberta.
Proponents of the sort of cure-all cleansing regimens promoted by the likes of U.S.-based nutritionist Ann Louise Gittleman share a common trait. “They spend a lot of money,” Dr. Sharma says. “Not that there’s any evidence whatsoever in medical literature showing that anybody who’s ever been cleansed is living happily longer than anybody else.”
That hasn’t stopped the business of purification from thriving like bacteria in a Petri dish. The programs, which boast sunny names like “Renew Life” or “Blessed Herbs,” typically involve fasting, nutritional supplements, food restriction or some combination of the three. More often than not, practitioners seek to cleanse their gastrointestinal system of unsavory chemicals and substances believed to cause allergies, exhaustion and even certain forms of cancer. Websites for programs like Gittleman’s “Fat Flush Plan” advertise self improvement in the most literal of terms. “Cleanse your colon,” one boasts. “Discover your body’s inner harmony,” implores another.
Ms. Gittleman’s “Fat Flush Plan,” to take one of the more popular detox programs, itself made famous by a New York Times bestseller of the same name, makes bold promises. It targets the liver, which Gittleman believes is less able to metabolize fat because of toxins in the body. One of her detox regimens (there are now several incarnations) consists of a low-carbohydrate, high-protein diet worth about 1,200 calories a day. No alcohol, caffeine, sugar, grains, bread, starch-rich veggies, dairy products, fats or oils are allowed. Instead, participants drink a special brew of diluted cranberry juice throughout the day, followed by a helping of ground flaxseeds in the evening.
While it won’t scintillate anybody’s taste buds, the regimen promises to break through “the stubborn weight loss plateau every dieter faces,” Gittleman’s website says. Bollocks, Dr. Sharma counters. “I don’t even know what they’re trying to clean,” he bristles. He attributes the popularity of cleansing and, more broadly, quick-fix weight loss programs to a general ignorance about the inner workings of the human body. A healthy liver is quite capable of processing compounds and chemicals on its own. Unwanted stuff gets channeled to the intestines or else to the kidneys, where it’s excreted as either stool or urine. “Most people don’t understand how the human body works,” Dr. Sharma says, “and most people have no idea how energy metabolism works.”
The knowledge gap has created a lucrative market for savvy – some would say opportunistic – entrepreneurs. Health Canada defines natural health products as those items “made from natural sources, often sold in dosage form” and “designed to maintain or promote health; to restore or correct human health function; or to diagnose, treat or prevent disease.” In Canada, there were more than 17,600 distinct natural health products on store shelves in 2007. The industry was worth a whopping $3.7 billion that year, Statistics Canada says, basing its figure on a survey of more than 600 retailers that sell any number of common natural products like Echinacea or Witch Hazel. “Remember we’re talking about a massive industry here,” Dr. Sharma says. “This is not some Mom-and-Pop operation where some guy is making some herbal thing in his basement. These are huge, multimillion-dollar companies.”
It’s not clear that Statistics Canada tracks sales of so-called cleansing “kits” like those proffered by the likes of Ms. Gittleman. Indeed, one of the difficulties in assessing the size and reach of the more esoteric dieting programs is that, unlike purveyors of natural health products, who traffic in recognizable items like St. John’s Wort, over-the-counter vitamins, minerals or other homeopathic remedies, cleansing “kits” exist on the fringes of Health Canada’s regulations, Dr. Sharma notes. The federal agency “does not have the manpower to police the millions of concoctions and programs and things that are being offered and claims that are being made,” he says.
It’s easy to see why. Type “weight loss” or “detox” into Google and it returns with millions of hits – 232 million and 35.2 million, respectively. (Among the top results presented in a mid-May query for “weight loss” were advertisements for “Dr. Bernstein Weight Loss,” which assured visitors they could “safely” lose up to 20 pounds per month, and the “No Hunger Diet,” whose website asks, perhaps a bit mysteriously, “Why are Japanese Women So Skinny?”)
The smorgasbord of search results reveals another difficulty in health management. In a hyper-connected age, ensuring patients have access to accurate and credible information has never been so hard. Dr. Sharma says acute medical conditions yield radically different search results than their more generic counterparts. Query “diabetes” and the Canadian Diabetes Association ranks among the top links; search for “weight loss” and you get any number of programs, replete with images of bulging waistlines or trademarked diet plans. It’s not as though credible information doesn’t exist, Dr. Sharma notes. “But if I’m a little dietician who specializes in obesity management or I’m a psychologist who specializes in obesity management, I’m not going to have a $50,000 website that is search engine optimized to show up as No. 1 on Google,” he says. “You’ll never find me.”
The information vacuum is one reason the U of A professor, in conjunction with the Canadian Obesity Network, is launching COACH, short for the Canadian Obesity Awareness and Control Initiative for Health. The goal is to develop a sort of online clearinghouse of credible information where would-be patients can access reliable facts, figures and numbers. While primarily focused on mitigating obesity – a “chronic disease” Dr. Sharma says affects some 16 million Canadians and costs the country untold sums in lost productivity and health care expenses – the COACH initiative could easily serve as a model for regulating the purple-monkey-dishwasher business of “detox” diets. “I don’t know of a cleansing diet that actually helps you lose fat,” Dr. Sharma says. “It might clear what’s in your gut, and that may be a couple of kilos, but that’s not fat.