The Tapeworm Diet

Hi everyone, I’m Becca.

S: & I’m Sarah! And you’re listening to Unsavory. 

Today we are covering one of the more questionable dieting methods in the history of dieting. But this is one method that surprisingly doesn’t encourage restriction. Advocators actually promote this diet with the claim that you can eat whatever you want on it. But only because you have live worms living inside of you consuming your food for you.

We’re talking about the tapeworm diet.

S: I already feel nauseous. Just thinking about people purposely eating a worm… I’m going to have nightmares tonight.

I don’t think there has never been a widespread fad diet as gross as this one. It’s very much not doctor recommended and is actually illegal in some countries like the US, where the FDA has banned tapeworm pills. As well as in Australia, where it is illegal for the pills to be imported into the country. So this diet isn’t as accessible as it once was…which is a really good thing. 

S: Wait, tapeworms come in pill form? 

B: Yep, I’m going to tell you all about it! 

S: Okay :S let’s do it.

Intro music

Shout out to my sources for today’s episode which are all listed in the show notes at unsavorypodcast.com. I used sources from the CDC and Cleveland Clinic, as well as articles by De Baets et al, Mickelson and Mickelson, Kesa & Whitfield. There were a lot of sources since it was difficult to find information on this  story all in one place.

And a quick trigger warning. We will be discussing weight loss and historic weight loss methods in this episode. So if this is something that you find triggering or that doesn’t fit within your recovery journey, please feel free to skip this one. 
What are tapeworms?
Let’s start with a brief rundown of what tapeworms are…because this is obviously critical to the story. So tapeworms have been around much longer than even humans, with the first indication of their existence found in fossilized shark feces from over 259 million years ago (De Baets et al, 2015). 

They are flat, parasitic worms that are very adaptable to their environment. Meaning that they can infect a wide variety of different host species - but particularly meat-eating hosts, like cats and dogs, humans, and some livestock. Once the worms are mature, they do need a host to survive…because they attach their heads to the insides of the host’s intestines and feed off of the nutrients being digested by their host.

S: This is disgusting. 

A well nourished tapeworm will grow larger, keeping their elongated tape measure appearance, and they may even lay eggs. These eggs will exit the host’s body through their feces, where they will then start looking for new hosts to infect. 

The tapeworm's body has three different parts - the head that attaches to you, as well as the neck and the lower body. Each of these sections can produce eggs, and in some tapeworm species, the sections can break apart. These sections may end up in the host’s feces, which is often the first sign of a tapeworm infection. So like these little wiggly things show up in your poo that kinda look like white rice.

A healthy tapeworm can grow up to about 30 FEET (!!!) - although recently one man had one that was almost 60 ft - and they can live up to 30 years. (S: OMG) As long as the infection goes untreated and the tapeworm doesn’t kill its host. The infection is often referred to as “taeniasis” (tee-nai-uh-suhs), which comes from the taenia genus, and is the most common species of tapeworms to infect humans.

S: Okay wait, 30 feet? Do they coil or kind of stretch out in the intestines? I feel like at some point you’d have either a bowel obstruction or some tapeworm coming out the other end :S

One source mentioned that they coil up like a ball…but I am sure they can stretch out if they want to. And as for bowel obstructions…we’ll get to that.

So that’s all info for intestinal tapeworms, but in some instances a young tapeworm may leave the intestines and enter the bloodstream or other organs. This causes what’s called an invasive larval infection. And this can be pretty serious. When the larvae are in different parts of the host’s body, they will cling on and create cysts - so pockets of fluid with the tapeworm inside. These cysts can be harmless; but they can also disrupt the functioning of organs…and if they stick to the host’s brain or spinal cord, it can cause neurological issues, such as seizures (Cleveland Clinic, 2022). 

When the neurological system is involved, the infection is called “neurocysticercosis” (neuro-cyst-is-er-cosis). And this is wild…but in certain areas of the world, such as Asia, parts of Africa and Latin America, neurocysticercosis causes up to 29% of cases of epilepsy in humans. And in some countries, the number is closer to 50%. This makes neurocysticercosis the leading cause of acquired epilepsy in these areas (CDC, 2021). 

The worst thing about tapeworms is that you can have them in both your intestines as well as a cystic infection throughout your body, which is like a double whammy of bad luck. And this bad luck usually starts when someone eats undercooked meat or contaminated feces - so like manure that’s used as produce fertilizer but that has tapeworm eggs in it. Meat like beef and pork usually get a bad rap but large freshwater fish like salmon can also become infected with the larvae (Cleveland Clinic, 2022). This is why you should exercise caution when eating any raw animal products.

S: Okay, so it’s already exceedingly clear that getting a tapeworm should be avoided at ALL COSTS, not intentionally ingested for weight loss. There are serious medical consequences (in addition to being just freaking disgusting)

Exactly. And fun fact - well not really fun, but interesting - it’s theorized that humans actually gave tapeworms to livestock, and not the other way around. So about 2.6 million years ago when humans started to eat meat and bone marrow, it was not uncommon for game meat like antelope in areas like Africa to be infected with tapeworms. Humans then caught the infection but there was no real treatment so they would live with it and pass it on to other community members. Then about 10,000 years ago when humans began domesticating animals, they too caught the tapeworms. And there’s no real evidence of them having tapeworms before this (Whitfield, 2001). So we really can’t blame beef and pork.

S: The tapeworm circle of life. 

So we’ve established that this is NOT something you want. Tapeworms are harmful and potentially even life threatening. So how and why did they make their way into diet culture?
History of tapeworms in diet culture
I’ll tell you. 

As we likely all know, female beauty standards have always been pretty extreme. Throughout history and in most areas of the world - from foot binding practices in imperial China to bathing in arsenic for weight loss in countries like England. Popular quotes like “pain is beauty” perpetuated the painful and unrealistic expectations that women tried to achieve…and in many cases, continue to try to achieve. 

The tapeworm diet originated in the mid-1800’s. It’s kind of hard to believe but the concept of a “diet influencer” already existed at this time. And the first influencer is often referred to as Lord Byron. Lord Byron was a famous poet and an avid dieter known to try new weight loss techniques such as eating only biscuits and soda throughout the day and in wearing layers of wool to sweat off water weight (BBC, 2012). He actually launched the apple cider vinegar trend in 1820 by encouraging people to consume the vinegar in water for weight loss. 

S: Oh wow, so the ACV trends have been around for a while! 

Because of his celebrity status, people were fascinated by his lifestyle and diet methods. While Lord Byron never directly endorsed the tapeworm diet, he can be credited with pushing the new Victorian beauty standard - tuberculosis chic. The gaunt weak look associated with the respiratory disease was the latest hot trend. (S: I hate that). I really wish I was kidding. But women began trying to achieve this look by using makeup to look more pale with rosy cheeks and crimson red lips, as well as by implementing intense weight loss methods and wearing corsets to get the quote unquote “ideal” 16-inch waist that was associated with looking ill (Zapata, 2016). 

Before the 1800’s corsets were typically made out of different types of fabrics, whale bone, wood or metal to give it that stiff look in the front…and then laces to tie it closed. But with the invention of pliable, moldable rubber by Charles Goodyear, women realized it was much more effective in holding in excess flesh AND - as a bonus - it would make you sweat in the process. Leading people to believe that it was also contributing to weight loss while they wore it. However, what it actually did was create a moist environment where it would wear the skin down, causing friction wounds and making the area more susceptible to infection (Winterman, 2013). The shape of the corset would also displace organs often pushing intestines down lower, which I can only imagine did a number on digestion.

S: That sounds so incredibly painful and uncomfortable. 

It seemed like there was no limit to what these fashionable Victorians would do. And there really wasn’t. Which is exactly how the tapeworm diet - a parasitic infection - became popular. Victorians saw people across the world withering away after contracting these worms and figured they could use it to their advantage. Women would consume the larvae which would migrate to the women’s intestines, mature and live there, consuming a significant portion of their caloric intake (Mikkelson & Mikkelson, 2014).

S: I’m so curious if the tapeworm dieters feel full or not. Like if you’re not getting the nutrition you need, this is clearly not a healthy weight loss, but at the same time there is a large forein body in your stomach that might be making you feel more full than you are? 

In 1912, reports of the diet being adopted in the US began popping up. And this is where tapeworm pills came into the picture. You might remember that I mentioned that tapeworms need a host to survive, so it was almost impossible to transfer a live worm to a new host. This meant that people would need to consume infected food products in order to get the “benefits” they were after. And this was a tricky practice - especially since tapeworm infection wasn’t as common in North America as it was in other areas of the world. But you might also remember that while the worms need a host to survive, the eggs and larvae do not.

S: I wonder if people would travel to other countries to get a tapeworm like some people will travel to get a more affordable gastric bypass surgery or plastic surgery. 

So an unknown genius had the idea of freeze drying beef tapeworm cysts with the tapeworm larvae inside to create a pill for easier transport and a better shelf life. The idea was that the dried larvae would be consumed, the tapeworms would then mature in the intestines, absorb food & nutrients and result in the desired weight loss (Winterman, 2013).

So basically the same concept as sea monkeys.

S: Except you don’t keep it as a pet in a tank, you keep it as a pet in your stomach. For up to 30 years!

There was such little regulation around diet pills at this time, that they could almost promote or say anything to sell them. One such promotion claimed “tapeworm has been a NATURAL part of human intestinal flora for millions of years, protecting from obesity and stimulating immunity” (Kesa, 2018). First of all, this is the perfect example of why we shouldn't trust the “all natural” claim. Because it’s true, but the reason they were a part of human intestinal flora at all was because people were contracting and dying from this infection before there was a way to get rid of them. It’s ridiculous.

S: Classic appeal to nature fallacy, the sneakiest one of all. 

These “miracle diet pills” were so sought after that even in the book Seabiscuit, author Laura Hillenbrand mentions that many horse jockeys would try to get their hands on the diet pills to lose and maintain weight for racing (Kesa, 2018).

Side effects & complications
However, in many cases, weight won’t be lost until the worm is removed. Unless you are also experiencing diarrhea and vomiting, the worm grows larger but remains inside the host. So the mass or weight of the worm weighs down on the digestive tract and isn’t removed until the worm itself is removed. 

S: Disgusting. So body composition overall might be changing, but you’ve got a giant growing worm in your GI tract. 

Yep. Some other side effects and complications of an intestinal tapeworm include persistent hunger or loss of appetite, nausea, fatigue, stomach cramps or even allergic reactions to the larvae; with even more serious issues occurring over time, like nutrient deficiencies such as anemia, obstructions in the intestines, appendix and bile ducts; or if the infection leaves the digestive system, cysts in the lungs, liver, heart, eyes, or brain leading to possible seizures, meningitis, brain swelling and dementia (Cleveland Clinic, 2022)

https://www.medicinenet.com/eating_tapeworms_for_weight_loss/views.htm 
How to get rid of them
Eventually, anti-parasitic medication became available on the market to kill off these tapeworms - but of course the meds were created more so for those who contracted tapeworms from infected food stuff and not for people willingly ingesting them. The most important thing in treatment is that you must dislodge the tapeworm from the wall of the intestines. Because its body can regenerate.

So before medication was available, there were two more popular methods of removing tapeworms from the colon. Neither of which sound very pleasant. So for both of these methods, once a person reached their desired weight, they would starve themselves for a few days so that the worm was hungry. The first treatment method, created by a Dr Meyers, involved placing a cylinder stuffed with food on a string and lowering it down the host’s throat. This would entice the worm, who was hungry, to follow the food in the cylinder as it made its way back out of the host’s mouth. But one HUGE issue with this method was that many people would choke on the cylinder and die.

S: Did that actually work?!

The second method, and my personal favorite, involved starving the worm then placing glasses of milk at both the mouth and anus and to wait for the worm to wiggle its way out. Now I’m not sure how effective either of these methods were, so thank goodness for medication. But at one time, these were the main options (Kesa, 2018; Zapata, 2016).

S: I’m speechless. 
The diet today
With the severe consequences and pretty morbid treatment methods, it is shocking that anyone would want to try this diet. And to this day it continues to be brought up as a “quick fix” for weight loss, while the legitimacy of these claims remain questionable. One thing that pushed the narrative was celebrity endorsements or at least perceived endorsements. Women like Claudia Schiffer and Maria Callas, a famous opera singer, were rumored to have tried the diet. However, with Maria, it was later found through her biography and personal communications that she had a love of steak tartar and had actually contracted the infection by eating raw beef. But headlines would make an attempt to glamorize the diet, making it seem purposeful and effective. Even the Kardashian’s have mentioned wanting to try it. In 2013, one woman in Iowa purchased and consumed tapeworm pills, forcing the state’s department of public health to issue an official warning of its dangers (Kesa, 2018; Mikkelson & Mikkelson, 2014). As I mentioned earlier, many countries have banned the distribution of these pills.

But historians disagree on whether true tapeworm pills were actually ever distributed at all. Or if there was a placebo effect on those desperate enough to consume them. We have access to vintage ads promoting them to prove their presence in the market, but with no proof that the products actually produced the effects they promised. So there is the question of whether this diet (in pill form) was an actual fad beyond the Victorian era or if it is complete fiction. 

But perhaps the scariest thing about this diet is that it refuses to die. It continues to linger in pop culture enforcing the idea that female bodies are subject to trends.

S: What’s so insane about this “diet”, if it is true, is that it literally takes nutrition from you and makes you sick, and I bet if someone was trying it, it’s not like they would look healthy and glowing and like they were making positive lifestyle changes. They would look depleted and ill, becuase they are. It reminds me of that New York Post headline that’s been going around that says “Bye Bye Booty: Heroin Chic is back”. Society is really twisted if people want to look like they opioid use disorder or tuberculosis. 

B: .. 

The good news for us never wanting to try the diet, cooking food to its proper internal temperature does kill off live tapeworms. So let this be your sign to get a meat thermometer.

S: I’ll never eat tartar again. 

Byeeeeeeeeeeee