George L. Blackburn, M.D.
This is going to be a two-part post. Today’s post will be the history. Tomorrow’s post will be the outrage.
Last year I initiated the Reckless Award named for Dr. John Reckless, the British physician who suggested that statins should be put in the drinking water. The award goes to the person who makes the most outrageous recommendations for statin drug use. Now comes the second such award, the Blackburn Award given to the person who makes the most feckless, stupid, dogmatic nutritional statement imaginable. The award is named after Harvard associate professor George L. Blackburn, M.D. Dr. Blackburn is the Chief of the Nutritional/Metabolism Laboratory, and Director of the Center for the Study of Nutrition Medicine, which are affiliated with the Beth Israel Deaconess Medical Center in Boston, Massachusetts.
Benjamin Franklin said that “we are all born ignorant, but one must work hard to remain stupid.” George Blackburn has not just worked hard to remain stupid, he’s made it his life’s labor. Before I get to Dr. Blackburn’s latest outrage, I need to make a disclosure. I’ve had personal experience with him that probably colors my judgment a little, but tomorrow I’ll post his latest so readers can make the call themselves. But first, the personal history.
In the early to mid 1980s I was working as a family physician. I had gained a bunch of weight and stumbled into the low-carb diet by trial and error. I had started many of my own patients on my version of the low-carb diet (which later morphed into the Protein Power diet) and was in the process of moving from a general medical practice to one more specialized in the treatment of obesity and related disorders. In about 1986 or so the physician-supervised, protein-sparing, modified fasting (PSMF) programs were becoming popular. Two companies – Optifast and Medifast – were the largest promoters of these programs: the Optifast program was generally conducted through hospitals and the Medifast program through individual doctors’ offices. I sent off for the materials on Medifast looking to see if I could make it a part of my obesity-treatment practice.
When I got the materials and read through them I was struck by a couple of things. First, all the documentation for the benefits of the PSMF were the same medical papers I had found substantiating the effects I was seeing in my own patients on low-carb diets. And second, the makers of Medifast were using the PSMF to get patients down to goal weight, then switching them to standard low-fat, high-carb, reduced calorie diets for maintenance. At the time these fasting programs were much in the news, and one of the complaints was that although subjects lost weight rapidly on the PSMF part of the program, they just as rapidly regained it once they went on maintenance. To my way of thinking, it didn’t take a rocket scientist to see why.
I decided to start using the Medifast program in my clinic to help patients rapidly lose weight, but I used my own low-carb program once they reached goal weight and started maintenance. I cranked along for a couple of years using this protocol with great success.
All of the information provided me by Medifast was soaked and cloaked in the idea that the PSMF was fraught with danger and consequently required a lot of hands-on physician supervision to ensure that patients stayed out of trouble. Me experience was that it was anything but dangerous. By the time I had supervised a couple of thousand patients on the program I realized that it was really pretty safe. And I realized that it could be made even safer if one whole-food protein meal were added to the regimen. I began putting my own patients on four shakes per day and a meat and green vegetable meal instead of the five shakes and nothing else. My patients did fine on this regimen and had zero problems. It dawned on me that such a regimen could be made available to the public at large who couldn’t afford a medically-supervised program that cost a couple of thousand dollars that insurance didn’t cover.
I wrote up my idea in a proposal form, sent it to a number of publishers, and ended up with a book contract with Warner Books to write the book Thin So Fast.
As I was nearing the end of writing the first draft of the manuscript William Vitale, M.D., the founder and owner of Medifast, somehow got wind of the fact that I was writing a book on the PSMF. He came to Little Rock, and he and his very lovely wife took MD and me to dinner. He alluded to the book I was writing and said that he would love to write the foreword to it. I assumed he knew what the book was about, so I didn’t really elaborate. We had a wonderful dinner and parted the best of friends.
Dr. Vitale called a few times and dropped me a note or two asking about the book’s progress. When I was finally finished and had the manuscript turned into the publisher, I had my editor send Dr. Vitale a copy to read before he wrote the foreword. When he realized that the book wasn’t a history of the PSMF, but was a do-it-yourself manual for people to go on without physician supervision, he went ballistic.
He called me and had the company’s lawyer on the phone with him. He told me that under no circumstances should this book ever be published. He said that I would be responsible for the deaths of thousands of people. He begged me not to publish. It was all in his economic interest, of course, but he couched his plea in terms of patient safety. I refused and told him that his best bet was to write the foreword so that his company’s name would be out there. I told him that it was simply a matter of time before someone wrote such a book, and that if it weren’t me, it would be someone else. And soon. He said not just No, but Hell No to the idea of writing the foreword, and we ended the call unpleasantly.
A few days later I got an emergency call from my editor. She told me that Medifast’s lawyers had written a letter to Warner Books’ legal department pointing out that if Warner persisted in the publication of my book they would end up having the blood of thousands on their hands. The legal department wanted me to respond. Which I did. The decision was made to continue with publication.
Shortly, the folks at Warner got another letter of warning. This one came from Harvard professor Dr. George Blackburn. It was one of the most inarticulate letters I had ever seen. The letter echoed the one from Vitale’s attorneys, and stated in no uncertain terms that Warner was treading on dangerous ground with the publication of this book. Blackburn detailed all the dangers associated with the PSMF, and said that such a program absolutely required physician supervision. A book such as mine, so he said, would give people a blueprint for their own destruction.
Once again I had to write a rebuttal, and once again Warner decided to go through with the publication. The book Thin So Fast was on the shelves in December, 1988.
It’s difficult to believe now what with the plethora of ready to drink protein shake products available, but when I wrote this book there were no such products. The only ones available were the Medifast and Optifast shakes. I had to instruct readers on how to make their own protein powders out of non-fat powdered milk and a number of other products available at the time. Before my book and the ready-made protein shake products it inspired, the only way people could really do a PSMF was by using the Medifast and Optifast programs, which were out of reach cost-wise to the majority of people. Also, as an historical note, this book was the first mention anywhere of the idea of net effective carbs, although I didn’t call them that at the time. And it was the first to lay out for the layman the idea that the metabolic syndrome existed and that insulin resistance and too much insulin could be the cause of heart disease, high blood pressure, obesity and diabetes. I proposed some mechanisms that since have turned out to be pretty much correct.
Had the Blackburn letter been merely an effort by a friend to help out another friend (Blackburn and Vitale were buddies) it wouldn’t have gotten under my skin so much. But later events proved just what a snake Blackburn really is.
Thin So Fast came out in December 1988, and in September 1989 MD and I attended a NAASO conference in Bethesda, MD. In going through the book of abstracts for the various presentation, I noticed one by George Blackburn. He was giving a presentation on how he had developed a program on which patients went on a self-monitored (NOT physician-monitored) PSMF program that he ran out of Harvard. His presentation pointed out that the program was safe and that the patients made it through without problem. (And although he didn’t mention it, somewhere along the way he became affiliated with Slim Fast and even appeared in a video news release prepared by that company. Not only that, he has consulted for Novartis, the company that makes Optifast.)
So, Dr. Blackburn, who in late 1988 condemns me and my book as being potentially lethal to readers who might follow the PSMF on their own, comes out with his own similar program within a year. Which is why he’s not at the top of my list of friends, and which is why I might have a little bit of an axe to grind. But at least I’ve disclosed it.
Interestingly, now Medifast is sold as a self-monitored PSMF. You can order their meal replacements and go on it without physician supervision. And, the good folks at Medifast have published their own book showing how to use their supplements. And in a bizarre twist of fate, Medifast is recommended for use with Protein Power and other low-carb programs.
Today you get my personal history with Dr. Blackburn, tomorrow I’ll post on what he’s done (most recently) to have the Blackburn Award named after him.
The Blackburn Award I