Amaze Rx Has Been Marketed with Deceptive Claims

Stephen Barrett, M.D.

Amaze Rx is a meal-replacement drink that has been claimed to produce weight loss of "up to a pound a day"—or even more. In 2007, its 30-minute infomercial [1] and Web site were loaded with testimonials from users who say they have lost close to this amount.

The most dramatic case was that of "Charles W.," who was said to have lost 32 pounds in 26 days. He was one of several people whose statistics appeared in both the infomercial and the Web site's home page. The image to the right came from the top of the home page that I viewed in February 2007. Inside the site, there is a videotaped interview in which Charles describes his experience further. The video was said to have been made a month after he began using the product.  

The infomercial was hosted by Natalie Cook, who stated that Amaze Rx enabled her weight to drop from 230 to 105 pounds. She was described as a real estate agent, "not an actress." She appeared with Richard Alan Carter, D.O., who stated that Amaze Rx was a "doctor-developed weight-loss miracle" and promised that "if you follow the program, you will have amazing results. All with no exercise." The infomercial also claimed that Amaze Rx increased people's sex drive and that losing weight was "just as easy as shaking the weight away." The Web site domain was first registered in March 2006.

Carter's Background

Carter practices surgery in Arlington, Texas. In 2007, the Amaze Rx Web site stated:

Dr. Rick Carter earned the title of America’s Weight Loss Doctor by building one of the most successful Bariatric Surgery Practices in America. Dr. Carter is recognized as one of the most experienced and talented weight loss surgeons in the United States and he has helped—through weight loss surgery—over 1200 morbidly obese American’s save their lives with his pioneering work.

Dr. Carter graduated from University of Nevada in Reno in 1972, and from Kirkville College of Osteopathic Medicine in 1976. He had an internship at Tripler Army Medical Center in Honolulu, Hawaii from 1976-1977. His surgical residency was at Walter Reed Army Medical Center in Washington, D.C. from 1977-1981. He also served as Chief of General Surgery at the 130th Station Hospital in Heidleberg, West Germany from 1981-1983. Dr. Carter served as Chairman of the Department of Surgery at the Medical Center of Arlington from 1997-2004 and has had a solo general surgery practice in Arlington, Texas from 1983-2005. He was certified by the American Board of Osteopathic Surgery in 1984 and recertified in 1996 [2].

Carter's special interest is in lap-band surgery, a procedure in which an FDA-approved adjustable elastic silicone band is placed around the smaller part of the stomach to create a small stomach pouch that can hold only a small amount of food. The lower, larger part of the stomach is below the band. The two parts are connected by a small outlet created by the band. Food will pass through the outlet from the upper stomach pouch to the lower part more slowly, which prolongs the feeling of fullness. Once the band is in place, patients are advised to eat only three small meals a day and to exercise regularly [3].

In 2006, the Texas Medical Board and Carter entered into an agreed order under which he paid an administrative penalty of $1,000 and was required to complete 10 hours of continuing medical education in the area of medical records and charting. The action was based on allegations that he had failed to meet the standard of care by leaving a sponge in the abdomen during an operation in which part of a patient's intestine was removed [4].

Misleading Claims

Amaze Rx is a protein powder that, when mixed with water, will yield a shake that contains 160 calories per serving. It could not possibly do what its marketers claimed. To lose a pound of weight, it is necessary to metabolize (burn off) 3,500 more calories than are consumed. Substituting two 160-calorie shakes for two meals might cause a deficit of 1,000 to 1,500 calorie deficit if the user does not increase intake at other times of day—which many people will do. These numbers would translate into a maximum loss of 2-3 pounds per week, which is considerably less than the infomercial suggests.

The most important consideration, however, is that the enormous weight-loss results do not appear to have been caused by using the product. The 2007 infomercial began with this announcement:

Losing weight has never been so fast and so easy. Watch his lap-band bariatric recipients talk about the amazing work of America's weight-loss doctor. And learn how people from coast-to-coast are using an amazing new product to lose up to a pound a day. But as with any weight-loss program consult your doctor. Results were accomplished on a two-a-day meal-replacement program. Your individual results may be different.

Most segments of the program did not make it clear that the testimonial-givers were lap-band recipients, which meant that people who began watching after the first minute might not realize this. The infomercial containrd occasional text messages that the participants used Amaze Rx to "maintain" or "accelerate" lap-band results. Some of these messages lasted about 5 seconds and were large enough to read. But others lasted only 2 seconds and were too small to read without pausing the video. During the eighth minute of the infomercial, Carter says, "You have seen some of the amazing results results of lap-band procedure recipients, and you have seen other men and women other men and women, just like you, losing weight and inches daily." The phrase "just like you" suggests that the product alone would bring about the pictured results.

Amaze Rx was said to cost only $1.99 per meal, but the Web site also promoted a "complete" liquid vitamin, created by Carter, which cost $59.95 for a month's supply. The site stated: "Many people don’t get the proper nutrition and as Dr. Carter tells his patients, when you're overweight, your body absorbs less nutrition than it should. Dr. Carter has created Amaze RX - CLV (Complete Liquid Vitamin) to give your body those nutrients." The idea that obese people need to worry about nutrient absorption is preposterous. Vitamin supplementation might be advisable for some people who are dieting, but the cost need not exceed $2 per month [5].

The infomercial offered a "free" trial of Amaze Rx, but when I called the toll-free number, I learned that the trial was not completely free. The purchaser had to pay $29.95 plus $9.95 for shipping for a one-week supply. The $29.95 was said to be refundable, but the shipping cost was not.

Ironically, my copy of the Amaze Rx infomercial was recorded from the Oxygen Channel, whose co-founder, Oprah Winfrey [6], struggled for many years until she finally achieved weight control with a sensible diet-and-exercise program.

Further Considerations

In the early 1990s, a Consumer Reports survey found little evidence that meal-replacement products are effective [7]. Most respondents who used them replaced one meal a day or less, but one out of six used them for more than half their meals. The average weight loss was only 4% of starting weight for men and 3% for women. Two-fifths lost less than 5 pounds, and one-fifth gained 5 pounds or more. More than one-third said they were “always hungry” while using the drinks, and nearly as many reported that they started to regain weight as soon as they stopped using the products. However, a subsequent study found that experimental subjects who used one program over a 4-year period had lost an average of 20 pounds, whereas similar subjects who did not use the product lost an average of 9 pounds [8]. All of the subjects had dietary counseling that included personalized menus. The researchers cautioned that the results might not reflect what happens to people who decide to initiate a self-help program that includes regular purchase of the meal-replacement products. It is also important to consider whether weight-loss that occurs when using meal-replacement products will last. Sooner or later, most people who use the products will return to regular food. Without lifestyle modification, the lost weight is likely to be regained.

Putting all of this together, if meal-replacement drinks can help people lose weight, the amount involved is likely to be small and far less than promised for Amaze Rx. Proving that Amaze Rx has practical use would require a study of at least a year—and ideally several years—showing that people who had not undergone lap-band surgery lost considerable weight and kept it off. No such study has been done.

Carter Gets Disciplined for False Advertising . . . and More

In 2009, in response to a complaint from me, the Texas Medical Board ordered Carter to pay a $5,000 administration and refrain from making misleading claims about himself and AmazeRx. The order prohibits statements or claims that (a) he is "America's weight loss doctor," (b) he is one of the most successful bariatric surgeons in the nation, and (c) the product will cure fatty livers and/or nutritional cirrhosis." Carter is also prohibited from making any other misleading claims about immediate results or long-term sustainability or how post-bariatric surgical patients compare to the general population [9]. In 2011, Carter and the board entered into an agreed order requiring him to pay a $1000 administrative fine and complete continuing medical education that includes 5 hours in medical record-keeping, 5 hours in risk management and 10 hours in physician/patient communication. The Board found Carter did not adequately document his rationale for the timing for removal of a patient's lap band or that he had counseled the patients [6].

What Should We Conclude?

I believe that many people who watched the infomercial—especially if they viewed only part of it—would not realize that the testimonial-givers did not use the product without surgery. The one obvious question is why dramatic pictures of lap-band patients were used to promote a product to the general public? The most probable answer—I believe—was to trick viewers into thinking that they might have similar results.

References

  1. Amazing Transformations. Infomercial broadcast on Oxygen Network, Feb 16, 2007.
  2. About Dr. Rick Carter. Amaze Rx Web site, accessed Feb 17, 2007.
  3. Lap-Band System Web site, accessed Feb 17, 2007.
  4. Agreed order. In the matter of the licensure of Richard Allan Carter, D.O. before the Texas Medical Board. Oct 6, 2006.
  5. Barrett S. Dietary supplements: Appropriate use. Quackwatch, Nov 12. 2010.
  6. Oxygen founders. Oxygen Media Web site, accessed Feb 17, 2007.
  7. Losing weight: What works. What doesn’t. Consumer Reports 58:347–357, 1993.
  8. Heymsfield SB and others. Weight management using a meal replacement strategy: Meta and pooling analysis from six studies. International Journal of Obesity 27:537–549, 2003.
  9. Agreed order. In the matter of the license of Richard Alan Carter, D.O. before the Texas Medical Board, Feb 6, 2009.
  10. Agreed order. In the matter of the license of Richard Alan Carter, D.O. before the Texas Medical Board, Aug 26, 2011.

This article was revised on October 20, 2011.

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