Supplementing their income: how celebrities turn trust into cash.

"Millions of Americans swear by the alternative medicine of Dr. Andrew Weil," says TIME Magazine of the soothing, cherubic medicine man. Yet now many admirers know that Weil, his company, and his foundation are guaranteed $14 million through mid-2008 from the sale of vitamins and other supplements he recommends?

Dr. Phil McGraw seems in command when talking about relationships. Yet now many fans know Weil his Shape Up multivitamins were pulled from the market, reportedly n one face of a Federal Trade Commission investigation into complaints of false advertising?

No talk show host is more trusted than Larry King. Yet how many viewers Know that many of the supplements he has recommended are backed by questionable evidence?

There's something wrong when the people we trust use their status to line their Dockets.

(Repeated requests to interview Andrew Weil, Phil McGraw, and Larry King about their supplement endorsements went unanswered.)

Andrew Weil

He's been called "America's doctor," a "pioneer in the medicine of the future."

Andrew Weil is the Philadelphia-born, Harvard-trained physician who migrated to the Arizona desert 30 years ago to champion what he calls "integrative medicine," which, he says, melds the best of modern science with alternative healing.

Weil's (mostly sensible) advice and his focus on the body's natural healing powers is a one-two punch that's hard to resist. And he has used his popularity to sell books (5 of his 10 titles were New York Times best-sellers), CDs, and online advice (more than a million people a month visit drweil.com and drweilselfhealing.com, which is now owned by Martha Stewart Living Omnimedia).

He even sells cosmetics (Estee Lauder is producing his mushroom-based line of anti-aging face serum) and dog food ("Pet Promise is the first commercial pet food I have found that truly supports my commitment to their nutritional Weil-being").

But it's the vast sums of money Weil is being paid to promote supplements that would raise consumers' eyebrows--if they knew about it.

Doctor, Sell Thyself 

Weil offers himself to the public and the media as an informed, sensible authority on supplements. In September. he appeared on NBC's "Today" show for three consecutive days "to help us navigate through the nutritional maze and the role vitamins can play," as host Katie Couric explained to the audience.

In October, TIME Magazine put him on its cover and featured his advice for aging gracefully with healthy food, exercise, and supplements.

Millions of people go online to seek Weil's advice about whether to take supplements. His "Vitamin Advisor," a staple on drweil.com for a decade, offers his "personalized" recommendations "based on your specific health concerns."

But Weil is hardly an objective expert. He markets his own brand of supplements--18 products ranging from multi-vitamins to B vitamins to high doses of vitamins C and E.

"How can we trust we're getting the straight skinny from you when you're obviously pushing your own vitamins?" Couric asked him point blank during his appearance last September.

Weil gave her his standard disclaimer, which is similar to the one displayed prominently on his Web site (but not mentioned in the TIME Magazine cover story or in the chapter on supplements in his new book, Healthy Aging).

"I don't get money from the vitamins that I make," he told Couric. "My after-tax profits go to a foundation that supports integrative medicine."

Weil seems to be saying that people should trust his advice because he has nothing to gain when they buy the vitamins he recommends. Not exactly.

In 2003, Weil signed a blockbuster five-year deal with the giant online pharmacy drugstore.com. It seems to give him a lot to gain from recommending supplements. According to their contract, which runs through the middle of 2008, drugstore.com has agreed to pay:

* To Weil directly: monthly honoraria that will let him pocket a total of $1.6 million;

* To Weil's foundation: a "donation" of 1 percent of all supplement sales from Weil's Web sites and his section of drugstore.com;

* To Weil's company (Weil Lifestyle): commissions of up to 30 percent on supplements Weil sells on his and drugstore.com's Web sites. Together with the "donation" to the foundation, that will mean at least $12.4 million.

Bottom line: the contract with drugstore.com guarantees Weil, his company, and his foundation at least $14 million through June 2008, even if his commissions add up to less. If Weil sells more supplements, the total could be even higher.

(We could find no mention of the drugstore.com deal in Weil's media interviews, books, or Web sites. The details came to light last summer when drugstore.com sued Weil for breach of contract for "failing to use commercially reasonable efforts to promote" his products and his site on drugstore.com. (1))

With those kind of sums passing hands, and with Weil saying "I get no money from the vitamins I make" because his after-tax profits go to a foundation, that foundation must be rolling in dough.

Nope.

Underfunded Foundation

The Weil Foundation received nothing from Weil or his company in 2003 and 2004, according to the most recent tax returns the foundation filed with the Internal Revenue Service. Yet during that period, drugstore.com was contractually obligated to pay Weil and Weil's company some $2.S million.

Maybe the money was swallowed up in expenses before the after-tax profits were computed. Or maybe when Weil says "I don't get any money from the vitamins I make," he's not including any salary or consulting fees his company may pay him. Or perhaps Weil is saving it all up to make a lump-sum donation later.

We tried to find out, but Weil didn't respond to repeated requests to his publicist, public relations firm, and foundation to talk about his marketing deals.

In any case, Weil could have been more forthcoming about the foundation with the "Today" show audience. When he said that "my after-tax profits go to a foundation that supports integrative medicine," he could have mentioned that the foundation's "primary beneficiary" is Weil's own program at the University of Arizona.

Since it was launched in 2002, the Weil Foundation (which was originally

known as the Polaris Foundation) has announced four grants totaling just $60,000. Half the money went to Weil's Program in Integrative Medicine.

So despite Weil's disclaimers, the more supplements he can persuade people to buy on his and drugstore.com's Web sites, the more Weil, or his company, or his foundation, or his Integrative Medicine program benefits.

Ironically, Weil himself makes an excellent case against listening to his advice on supplements. Here's what he writes in his book Healthy Aging about finding objective advice on human growth hormone (HGH):

"It is hard to obtain unbiased information on the benefits, dangers, and appropriate uses of HGH, because most of the doctors and other experts who talk and write about it are in one way or another involved with its distribution and marketing."

To get "an objective view from an unbiased expert" on HGH, Weil turned to an acquaintance who had "no financial interest in promoting any anti-aging product."

In other words: beware of doctors who sell what they recommend.

Consider the Source

Given his lucrative contract with drugstore.com, it must be tempting for Weil to downplay or ignore news that some of what he's selling may not be worth buying.

Take vitamin E. For years, Weil has recommended that people take 400 IU a day--one of the dosages he happens to sell. (The Daily Value for vitamin E is 30 IU.) Yet recent studies have found no evidence that large doses prevent heart disease, cancer, cataracts, or dementia.

The subject came up during Weil's appearance on the "Today" show last year, when Katie Couric asked him about the two latest vitamin E trials, the Women's Health Study and the HOPE-TOO trial. Neither found that vitamin E prevented heart disease or cancer. (2,3) "So both these studies say, 'why take it?'" said Couric.

Weil dismissed the two trials:

* "These were populations of sick people on multiple medications," he charged. (Half wrong. While the HOPE-TOO trial looked at middle-aged men and women with heart disease or diabetes, the Women's Health Study looked at healthy women.)

* "These were statistical analyses of previous studies." (Wrong. They were original studies.)

* "They didn't actually give vitamin E to people to see what happened." (Wrong. Both studies gave people vitamin E for up to 10 years.)

"I took my vitamin E this morning," Weil told Couric. "I recommend that other people do."

Other instances where the research doesn't match Weil's sales pitch:

* Coenzyme Q10. "It increases oxygen use at the cellular level, improving the function of heart muscle cells and boosting capacity for aerobic exercise," says Weil in his book Healthy Aging. "I take it myself, frequently recommend it to patients, including those with cancer, diabetes, and gum disease, and think its benefits outweigh any risks."

But in a 2003 review funded by the federal government, experts concluded that "the available scientific studies offer little evidence that supplementation with vitamin C, vitamin E, or coenzyme Q10 has any benefit on cardiovascular disease prevention or treatment." What's more, researchers in California, North Carolina, Ohio, Australia, and Finland have all failed to find that people who take CoQ10 can exercise aerobically harder or longer than people who take a placebo.

And the evidence that CoQ10 can help people with cancer, diabetes, or gum disease is "contradictory, insufficient, or preliminary." That's according to Health-notes--the pro-supplement encyclopedia that health food stores, vitamin shops, and Web sites use to help boost sales.

A 30-day supply of Well's Cardio Support Formula, which contains CoQ10, costs $40. (Well's cut: $S.60 to $10.)

* Evening Primrose Oil. EPO is a natural source of a fatty acid called GLA (gamma-linolenic acid), which "promotes healthy growth of skin, hair, and nails," according to Well. "I frequently suggest evening primrose oil for skin conditions (including brittle nails and hair), arthritis, autoimmune disorders, and premenstrual syndrome," he says on drweil.com.

Yet according to a recent meta-analysis that pooled the results of 19 trials, GLA was no better than a placebo at treating dermatitis or eczema caused by allergies. (4) What's more, the two good studies that tested GLA on psoriasis came up empty, as did the one good study on brittle nails. And EPO was ineffective in the two best-controlled studies on premenstmal symptoms. (5)

As for autoimmune conditions like rheumatoid arthritis, one study found that evening primrose oil helped reduce tender and swollen joints, but at a dose 28 times higher than Well recommends. In two other studies--using 10 to 12 times what Well suggests--EPO was no better than the placebo at relieving pain or easing movement in the joints.

A two-month supply of Well's Evening Primrose Oil capsules sells for $14. (Well's cut: $1.96 to $3.50.) If you want to take the amount that seemed to help relieve swollen joints in one study, you'll have to shell out $196 a month.

* Energy Supplement Formula. Feeling tired? Run down? Need a boost? Try Well's "exclusive blend of tonifying herbs formulated to support healthy energy levels." That's the way drweil.com describes his Energy Support Formula--a mix of eleuthero, cordyceps, and ashwagandha, "all traditional herbs which may give those energy levels the boost you need."

Well says that all of his products "are based on stringent scientific research."

What's the research behind the three herbs in the Energy Support Formula? Ashwagandha: there's not a single good study on energy levels. Cordyceps: in the only three good studies, it was no better than a placebo at helping people exercise harder or longer. Eleuthero (also known as Siberian ginseng): it was no better than a placebo at improving cardiorespiratory fitness or endurance, according to a recent review of five well-controlled studies. (6)

A 30-day supply of Weil's Energy Support Formula costs $30. (Weil's cut: $4.20 to $7.50.)

"Current, valid studies (published in peer-reviewed scientific journals) are the basis of our formulations," says Well.

Do profits also qualify as a basis?

The Vitamin Trap

Who is your vitamin advisor? If you want it to be Andrew Weil, click on the "Vitamin Advisor" box at drweil.com to get a free "personalized" vitamin recommendation "based on your specific health concerns."

The clicking may be free, but the results aren't. No matter how we tried, we couldn't get the Advisor to stop recommending that we buy supplements galore.

The first time we worked our way through the Vitamin Advisor's 48 questions, we were a non-smoking, non-drinking, 60-year-old woman in tip-top health who eats a stellar diet--at least five servings a day of fruits and vegetables and three servings of dairy, plus fish at least four times a week. Weil's recommendation: $48 a month worth of multivitamins, fish oil, and calcium pills.

A 30-year-old woman with the same profile? $48 a month. A 25-year-old male? $45 a month.

And if you're not a paragon of good health? When we went back as a 55-year-old man with an enlarged prostate, high blood pressure, high total cholesterol, and low HDL ("good") cholesterol who doesn't exercise and is under stress, who has at least five alcoholic drinks a day, and who eats little or no vegetables, fish, or dairy foods, the Vitamin Advisor told us we'd need to take supplements totaling $98.70 a month.

Ordering the supplements that Weil recommended was as simple as checking the box next to each. Every month a package would arrive, the order form told us, with each day's pills shrink-wrapped in their own CustomPak.

Why was it so easy to spend so much money? A cynic might conclude that it's because drugstore.com is paying Weil's company a 14 to 25 percent commission on every CustomPak or Weil-brand supplement he can persuade visitors to his or drugstore.com's Web sites to buy. The online pharmacy handles the transactions, according to a contract signed in 2003 that guarantees Weil, his company, and his foundation at least $14 million through the middle of 2008.

Weil also gets a cut from any supplement sales that come from subscribers to "My Optimum Health Plan," his online customized program intended to "help you address your health issues."

My Optimum Revenue Plan sounds more like it. According to the drugstore.com contract, "It is anticipated that vitamins, herbs, minerals and/or supplements, together with advice from Dr. Weil, will be sold in connection with the My Optimum Health Plan Assessment."

Dr. Phil

Psychologist Phil McGraw was working as a jury consultant in Texas in 1998 when Oprah Winfrey hired his firm to help defend her against a "food defamation" lawsuit by the cattle industry.

In April 1996, during a segment on how mad cow disease could spread, Winfrey told her TV audience that the way dead cows are rendered into feed for other cows "has just stopped me cold from eating another burger." After the broadcast, beef prices plummeted.

Oprah, impressed by McGraw's shrewdness and candor, invited him to appear on her show. That gig turned into regular appearances, which "Dr. Phil" parlayed into a syndicated talk show that featured him as an expert on families, marriage, and relationships. (McGraw has a Ph.D. in psychology from the University of North Texas.)

In 2003, McGraw branched out into the weight-loss business with a best-selling book plus a line of shakes, energy bars, and supplements.

But Dr. Phil's Shape Up pills, which cost $120 a month, couldn't live up to their labels' claim: "These products contain scientifically researched levels of ingredients that can help you change your behavior to take control of your weight."

In a 2003 interview with USA Today, McGraw boasted that "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." Yet in a 2003 internal e-mail message discussing promotional copy for his Shape Up supplements, McGraw wrote: "... They need to redo the one that says I created these products b/c I have no expertise."

The e-mail is part of the court record in a 2004 suit by three California consumers who charged McGraw with making false and misleading statements about his supplements, according to the New York Daily News, which made the e-mail public in December. (1)

In March 2004, facing a Federal Trade Commission investigation into Shape Up's claims, McGraw pulled his supplements off the market and the FTC dropped its probe, according to the Los Angeles Times.

Soon after, McGraw showed up in the first weight-loss milk moustache ad, telling magazine and newspaper readers to "Get Real" about losing weight by eating three servings of dairy foods every day.

In 2004, the U.S. Dietary Guidelines Committee said there was "insufficient evidence" to link dairy to weight loss. And several studies published since then dispute the milk moustache ads' claim.

That's doing your homework before you start talking?

(1) The consumers are seeking to turn their suit into a class action. A copy of their complaint has been posted at casewatch.org/civil/drphil/classactioncomplaint.shtml.

Larry King

Larry King has been fixture the airwaves for more than 30 years, the last 20 of them interviewing celebrities and newsmakers on CNN.

After suffering a near-fatal heart attack 19 years ago, he started a foundation to provide financial help for heart patients who can't afford adequate medical attention.

While King's talk show appears only on TV now, he hasn't given up doing those supplement commercials that are familiar to his longtime radio listeners. Either he has a knack for picking weak products to pitch, or manufacturers seek him out to lend credibility to supplements that could use some.

In the 1990s, for example, King promoted the Ginsana brand of ginseng to boost energy levels, even though the best research overwhelmingly shows that ginseng doesn't help people feel more energetic. (Ginseng-pill takers aren't able to exercise longer or harder than people who take a placebo. (1))

In 1998, it was Garlique brand garlic pills. "Garlique's a world leader in product potency," King said in one radio ad. "And since garlic has been clinically shown to maintain healthy cholesterol levels, for me, that makes Garlique dietary supplement the one to trust."

This time, the Better Business Bureau asked that the ads be changed or pulled because none of the research had been done specifically on Garlique. (Garlic supplements lower cholesterol by around 5 percent in some short-term studies, but the impact seems to disappear after about six months. (2))

Next came coral calcium, which self-labeled scientist Bob Barefoot claimed could prevent and cure cancer, heart disease, and other degenerative diseases.

"Coral Advantage has changed my life and could change yours," King said in his radio ads for Barefoot's product. Since switching to Coral Advantage, "I sleep more soundly, wake up with more energy than ever. Bottom line: Your body needs calcium for good health and good health means Coral Advantage. So look for my signature on the bottle."

King probably didn't sleep as well in 2004, when the Federal Trade Commission halted Barefoot's infomercial, charging that its claims about coral calcium were "false and unsubstantiated."

Then there was Welch's Grape Juice. "Studies have shown that because Welch's 100% Grape Juice is made from antioxidant-rich Concord grapes with no added sugar, it's actually good for your heart," says King in one spot.

In fact, the research is still in its early stages and is far from definitive. (Last summer, Welch's replaced King as their spokesperson with Regis Philbin, another celebrity who has suffered a heart attack.)

King's latest gig? He's the national spokesperson for Ester-C, an over-hyped brand of vitamin C that's twice as expensive as regular vitamin C, even though there's no good evidence in people that it's any better.

Got an iffy supplement to sell? Have your people call Larry's people.

(1) Nutrition Reviews 59: 91, 2001.

(2) www.ahrq.gov/clinic/epcsums/garlicsum.htm.

(1) The text of drugstore.com's complaint is at casewatch.org/civil/weil/complaint.shtml. A copy of the 94-page contract is at casewatch org/civil/weil/contract.pdf.

(2) J. Amer. Med. Assoc 294: 56, 2005.

(3) J Amer. Med. Assoc 293: 1338, 2005

(4) Brit. J. Dermatol. 150: 728. 2004.

(5) Control Clin Trials 17: 60, 1996.

(6) Int J. Sport Nutr. Exer. Metab. 15: 75, 2005.