Mazel had tried and failed to lose weight with existing programs, and developed the diet plan after spending six months working together with a nutritionist in Santa Fe, New Mexico.
After completing development of the program and returning to Los Angeles, she opened a weight-loss clinic whose clients included a number of celebrities.
[9] Nutritionist Theodore P. Labuza noted that the diet is unbalanced with potential hazards such as diarrhea, potassium deficiency and heart arrhythmia, thus should be avoided.
[10][11] A report published in the Journal of the American Medical Association in 1981[12] criticized the diet, noting significant inaccuracies that could result in physical harm to those following the regimen.
The report, written by Dr. Gabe Mirkin of the University of Maryland, College Park and Dr. Ronald Shore of Johns Hopkins University, pointed out that there was no evidence supporting the scientific validity of the program and that it stood in opposition to established knowledge in the medical profession about nutrition, calling it "the latest, and perhaps the worst, entry in the diet-fad derby".
The article expressed concerns about the combination of large amounts of fruit with little salt, noting that significant water loss from diarrhea could produce fever, muscle weakness, and a rapid pulse, and that blood pressure could drop low enough to cause death.