Saturday, February 20, 2010

Apatrim - Scam or Science?

Here's the latest from the Universal Media Syndicate and its partner company Patent Health: An appetite suppressant named Apatrim. Their full-page ad in yesterday's Star Tribune had all the usual UMS trappings (it looks like a newspaper page, has lots of quotes from possible experts, and dangles an act-now! deadline to get a special deal):

Full page ad for Apatrim

My analysis:
If you're looking for a weight-loss supplement that seems somewhat promising in two very small studies that have not been reviewed by the FDA, and you want to pay more than you would have to for another product that has the same active ingredient, go right ahead.

Apatrim's active ingredient (not mentioned in the ad, although it does tell us that it's "all natural," of course) is from a succulent plant called Caralluma fimbriata, which is native to the Indian subcontinent. The vague and under-referenced Wikipedia page about the plant says that it is well-known as a food to eat during starvation times because it will suppress the appetite.

I believe there are several serious questions about the Apatrim ad, the product in general, and its pricing.

Product

The ad says the product is made from a "patented process to make sure that the pill has the same effects as the plant." According to Sybervision, another website that reviews supplements:

there is only one type of patented caralluma fimbriata and that is Slimaluma. Now, because Apatrim chooses not to show you their product label on their official website I had to go digging around the internet to find one. This is what I found:

Close up of ingredients, saying it contains 500 mg of Caralluma fimbriata extract
If Apatrim really contained Slimaluma, it would have to be on their label - But it isn't. And that makes me wonder if Apatrim really contains Slimaluma at all. I would venture to guess no. Slimaluma is patented and has been clinically tested. If Apatrim is claiming the same results of the Slimaluma studies they are pretty misleading.
Slimaluma has been tested twice, once in India with 60 subjects taking the product over 6 months, and once in the U.S. with 26 subjects using the product for 4 weeks. Both claim to be double-blind, placebo controlled designs; the Indian study split its subjects between the two groups evenly; the U.S. study had only 7 people in the placebo group.

On slimaluma.com, the Indian trial is reported in general and a publication citation is given. There is a PDF on that page that adds a little more detail ("Statistically significant reductions were recorded in all key indicators of weight-loss") without data tables. The PDF refers to Exhibits, but they are not included.

Importantly, though, the abstract of the Indian study, provided on two other credentialed medical sites, gives a different impression of the results. While it's clear there were some statistically significant effects of the supplement, weight loss was not one of them:
Waist circumference and hunger levels over the observation period showed a significant decline in the experimental group when compared to the placebo group. While there was a trend towards a greater decrease in body weight, body mass index, hip circumference, body fat and energy intake between assessment time points in the experimental group, these were not significantly different [emphasis added] between experimental and placebo groups.
So the people taking the supplement said they felt less hungry, and for some reason their waists got a bit smaller, but they didn't actually lose weight significantly more than the placebo group.

The U.S. study, conducted over just 4 weeks with 26 people (only 7 in the placebo group), appears to be the one that's mentioned in the Apatrim ad. The ad includes graphs that indicate 83 percent of the subjects taking the active ingredient lost weight, and that the average weight loss was 4.5 pounds, vs. about .4 for the placebo group:

Graphs from the ad, showing the numbers described above
Wow, that sounds good, even though the study is small, right?

What's the catch? There's no citation of where the study was done, who did it, or a chance to review it to see if the ad is reporting it accurately, or if it even exists. As the site, dietpillcritic.com puts it,
First off, the clinical study cited on Apatrim’s website done on Apatrim appears to have been an in-house study. They mention a doctor’s name, but no reference to the actual study so that we, or anyone, can verify those claims and the viablility of the study. Real studies will be well documented to be referenced later by others (and hence have to pass the scrutiny of others).
Perhaps we should assume it's the same U.S. study described on the Slimaluma site as being conducted at the Western Geriatric Research Institute in Los Angeles, which has the same number of participants. This research was presented at a conference in 2004; no accessible version is linked. The summary of results says "every patient taking the active ingredient lost significant weight" although, again, no statistics are given. The doctor supervising this test, Ronald M. Lawrence, appears to be working for Slimaluma, because he makes presentations on their behalf at product exhibitions.

Based on the information provided about both the U.S. and Indian studies, I would say that neither Apatrim nor Slimaluma meets a reasonable standard of evidence for their claims of weight loss (where reasonable means significant results in a study that is peer-reviewed and replicable).

Pricing

Slimaluma can be bought many places, including amazon.com for prices like $14.98 (or less in larger quantities). Apatrim is more expensive:
  • $24.99 for 60 capsules at my local Walgreens. This would be subject to sales tax, which would add a bit under 7 percent to the price, for a total of $26.74 per bottle.
  • I was quoted a similar base price when I called during the advertised 48-hour deadline: Buy one bottle at $29, get two bottles for $19 each (totaling $67 for the three bottles), plus shipping of $7.85 = $24.95 per bottle. Thanks for saving me the sales tax, I guess; glad I called in before the deadline! (Of course, if I wanted to buy just one bottle like I could at Walgreens, it would cost me $36.85.)
  • On the website, I found the same three-bottle price of $67 plus $7.85 shipping with no deadline... and the website helpfully adds a 3 percent up-charge to get a BuySafe Bonded money-back guarantee. (When I called about pricing, I was told there was a money-back guarantee without any extra charge.)

    BuySafe Bonded added another $2.01 to my bill, making the per-bottle price $25.40. The BuySafe Bonded up-charge is actually optional, but I didn't realize that when I looked at the shopping cart:

    Screen snapshot of the Apatrim shopping cart, showing the BuySafe Bonded logo and a box with a green check mark, accompanying a charge of $2.01

    Would you realize that green checkmark was something you could unclick? It looks like a graphic to me. In my opinion, it adds an extra touch of sleaze when options like this are set to "opt out" instead of "opt in."
All of this reinforces my initial thoughts:
  • Apatrim and Slimaluma look, at best, promising in the two very small trials, which have not been reviewed by the FDA.
  • Apatrim is significantly more expensive (about 60 percent more) than the Slimaluma supplements available online.
Like they say, if it sounds too good to be true, it probably is, unless there's real proof to the contrary.
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For a list of my past writing on the Universal Media Syndicate, Arthur Middleton Capital Holdings and their many partner businesses, check out this post about the cease and desist letter I received from them.

3 comments:

elena said...

Thank you for your continuing scrutiny of UMS. This post should be required reading in Consumer Beware! classes everywhere. The amount of pseudo-science bandied around in advertising is alarming, and you show readers how to go in there and deconstruct the claims in a reasonable and responsible way. It's a kind of reading practice that we all need.

Ms Sparrow said...

There will always be those with the mindset that if it costs more, it's better.
I don't fault the Strib for publishing these scam ads. Most of those ads seem to scream "sucker" with their with their over-the-top
claims and in-your-face placement.

Vivian Carolina Barahona said...

Just work out and eat healthy... i am very lazy when it comes to exercice but i do it with my husband 3 times a week... makes u feel good! And try to eat as healthy as our time let us...