The Internet is a wonderful new medium for communicating ideas and information in a rapid and interactive way. Many articles are followed by a “comments” section. Like so many things in this imperfect world, comments are a mixed blessing. They can enhance the article by correcting errors, adding further information, and contributing useful thoughts to a productive discussion. But all too often they consist of emotional outbursts, unwarranted personal attacks on the author, logical fallacies, and misinformation. They provide irrational and ignorant people with a soapbox for promoting prejudices and false information.
To illustrate, let’s look at the responses to something I wrote about a weight loss product called Isagenix that is sold through a multilevel marketing scheme. To quote the website,
The Isagenix cleanse is unique because it not only removes impurities at the cellular level, it builds the body up with incredible nutrition. Besides detoxing the body, Isagenix teaches people a wonderful lesson that they don’t need to eat as much as they are accustom to and eating healthy choices are really important and also a lot of the food we are eating is nutritionally bankrupt. [errors are in the original]
I didn’t set out to write an article about this. It started when I received an e-mail inquiry about Isagenix. I posted my answer on a discussion list and it was picked up and published on the healthfraudoz website. Sandy Szwarc approved of it and kindly reposted it on her Junkfood Science blog.
As I write, the comments on the healthfraudoz website have reached a total of 176. A few commenters approved of what I wrote, but the majority of commenters tried to defend Isagenix. Their arguments were irrational, incompetent, and sometimes amusing.
It was as if no one had actually read what I wrote. No one bothered to address any of my specific criticisms. No one even tried to defend Isagenix’s false claims that toxicity accounts for most disease, that the body protects itself from toxins by coating them with fat, and that internal organs become clogged and deteriorate if you don’t “cleanse.” No one offered any evidence that “detoxification” improves human health. No one tried to identify any of the alleged toxins or show that they are actually removed. No one tried to provide any rationale for the particular combination of ingredients in Isagenix products (242 of them!). No one questioned my assertion that “no caffeine added” was inaccurate because green tea was added and it contains caffeine. No one commented on my observation that the amount of vitamin A in the products was dangerous and went against the recommendations of The Medical Letter. No one offered any evidence that more weight was lost by adding Isagenix to a low calorie diet and exercise. I offered some alternative explanations that might account for people believing it was effective when it wasn’t; no one commented on that. The medical advisor on the Isagenix website argued that at $5 a day Isagenix is less expensive than open heart surgery. I pointed out that that was a laughable false dichotomy: it’s not a matter of choosing between open heart surgery and diet supplements. No one commented on that. Instead of rational responses, we got …
The greatest number of comments were testimonials: “I took it and I lost weight.” They claimed not just weight loss, but a variety of improvements. It allegedly cured fibromyalgia, osteoarthritis, and hemorrhoids. It facilitated getting off sleeping pills and caffeine, balanced brain chemistry (what does that mean?), improved focus and mental clarity, allowed running longer marathons with less fatigue, saved a failing marriage, stopped irritability and crankiness, kept arm from getting sore after pitching, “Made my son interact appropriately with peers, take care of himself, and want to be hugged and kissed,” and “I made money selling it.” One said, “My out of control Irritable Bowel Syndrome disappeared and I had the healthiest BM in about 6 years! … you can’t brainwash POO!!” Two commented that the Isagenix program provides motivation; one said he needs “structer” (structure?) to stay on a diet.
The plural of anecdote is not data. Two commenters appropriately objected to all this testimonial evidence. They pointed out that testimonials are unreliable and subject to post hoc ergo propter hoc errors, that all the “it works for me” comments can be attributed to low calorie diet and exercise, and that the testimonials are almost exclusively from people who are selling the product.
Quite a few commenters reported that they had tried it and it either didn’t work or caused side effects such as 5 days of violent diarrhea. One reported gaining a lot of weight while taking it; many reported losing weight just as well without it. Several reported credit card disputes with the company and failure to get their money refunded. One reported that his parents are using it and it seems to be slowly killing them: they have decreased energy, declining health, mood swings, and poorer control of diabetes.
Rebuttals to Negative Testimonials
Supposedly the people it hasn’t helped haven’t been following the program right.
Apparent bad reactions are just signs that it is working: “When one is cleansing out years of accumulation of toxins, chemicals, jet fuel, gasoline, arsenic, heavy metals, radiation poisoning – one will have reactions.”
“Evidence” that it works:
One commenter heard a doctor speak who cited all kinds of studies to support the theory behind Isagenix — environmental toxicity, depletion of nutrients in the food supply, malabsorption, our incessant food cravings, and how Isagenix cleansing could supposedly solve these problems.
A former Hare Krishna was impressed by the array of nutrients in the products and believed that the doctor on the website had integrity and cared about her patients.
Several people claimed that we need nutritional supplements because the ground has been depleted of nutrients.
“There have been many valid scientific research [sic] to back the claims of Isagenix.” [I couldn’t find any, and they provided no clues as to where to look.]
Lots of MDs are recommending Isagenix, and they can’t all be quacks.[Apparently they can. And lots of MDs recommend homeopathy, and some of them believe in astrology.]
Isagenix has paid for independent studies [Where are they? What did they show? If Isagenix was paying, were they truly independent?]
Mainstream physicians are starting to realize cleansing is important.[Not any of the ones who practice science-based medicine.]
Cleansing makes sense because one of the main ingredients of pesticides and insecticides is estrogen. It makes women fat and causes ED in men. Toxicity is a bigger cause of obesity than most people realize.
These products are “designed and formulated by professionals and advocated by professionals.”
One MD commenter claimed “I have the before and after pictures and the lab tests to prove it.”
“Most people only absorb 8% to 12% of what we eat – the rest is waste which we flush down the toilet. With Isagenix we can absorb up to 94% of what is ingested with less waste going down the toilet. Isagenix is full of good probiotics which help rebuild our digestive systems, fights candida. Isagenix also helps the body become alkaline, which is a healthy body. John Hopkins 2008 Cancer Report stated that cancer cannot live in an alkaline body only acidic bodies. Processed food makes our bodies acidic — thus the epedemic [sic] of cancer and diabites [sic] in the USA along with heart disease.” [This is all nonsense.]
Isagenix is food. Regular food is from depleted soils. Organic food made children behave better at lunch in a school study. Genetically modified food is lacking in nutrition. “The majority of people fill their stomachs with foods void of natural nutrition and the evidence supports that they behave poorly, learn less, mis-behave more and commit more crimes than those who fill their stomachs with highly nutritious organic produce and meats.” [Wow! Instead of the Twinkie defense, criminals can claim their non-organic lunch made them do it!]
“Isagenix is a divine blessing in this toxic sick world.”
These people apparently expect us to believe unsubstantiated assertions. They have no concept of what constitutes scientific evidence or why controlled studies are needed.
Defense of Multi-Level Marketing
“MLM is not a scam, but one of the last bastions of free enterprise.” MLM is good because FDA products don’t work. MLM is “the most legitimate business out in the world today.” All corporations are a pyramid, anyway.
But one commenter called it an “exploitative business model” and pointed out that the average yearly income for Isagenix distributors is only $116.87. And another pointed out that 97% of MLM schemes fail.
Personal Attacks on Me
“A Dr Harriet Hall wrote a very funny one sided arguement [sic] against it (Isagenix) but omitted to inform the world how much money she has made conning patients into taking drugs she should know are harmful to you.”
I am arrogant: “If it were up to know-it-all MDs like Harriet Hall, I’d still be in chronic pain.”
“To [sic] bad when you look up Dr. Hall in Washington no such person is licensed to practice medicine. Sad day when you have to lie to get people to pay attention to anything you say…” (It took me about one minute to locate verification of my license at https://fortress.wa.gov/doh/providercredentialsearch/SearchResult.aspx.)
One commenter questions whether I am really a doctor and says I have a small brain and a big mouth.
I only write to feed my ego.
I shouldn’t make comments without doing any research.
I should try it for myself.
I should have learned more by attending a meeting for the product, talking to company representatives or talking to the press.
Instead of writing for the public I should have contacted the doctors at the company and discussed my concerns with them.
Don’t try to convince us, Dr. Hall, that you necessarily have “the answer.” [Did I say I did?]
One alleges that I came to a conclusion without any research whatsoever: this from a doctor who says “Cleansing is now my first choice for my patients.” One wonders what research he did to reach that conclusion.
“Going out of her way to trash Isagenix this way is pathetic.”
“PS ‘Dr.Hall’ your little family practice designation really doesnt buy alot of cred.”
“Real doctors don’t waste their time sitting on the internet making bogus posts about different health products….I could sign as doctor and no one would know.”
“this article is and the author is full of crap. I know it and he knows it.” [I know I’m not a “he.”]
I don’t know anything and I should just shut up.
“This is just another doctor that stands to loose [sic] their income by the masses becoming healthy.” “What ever Dr. Harriet Hall is selling, I’m not interested.” [For the record, I’m retired and the only thing I’m “selling” is critical thinking. Profit margin? Low.]
I probably drink Diet Coke and eat at McDonald’s.
Just because I went to medical school doesn’t mean I’m a smart person.
A few commenters offered agreement and praise, pointed out that no one had actually addressed any of the points I made, much less offered any evidence that what I wrote was wrong, and reprimanded other commenters for resorting to ad hominem attacks.
Attacks on the Medical Profession
Doctors know nothing about nutrition. They put band-aids on problems. They sell pills that mask symptoms and wreak havoc on your body instead of treating underlying causes. There are lots of malpractice suits. They only want to make money. They want to keep people sick so they won’t lose their kickbacks. [What kickbacks? Where are my kickbacks?!]
“Most MD’s will not even take the death dealing treatments they inflict upon the rest of the population.”
If evidence showed it worked, conventional medicine still wouldn’t adopt it because of competition from drugs. Many doctors are out of shape. The majority of ER doctors are lacking the skills in emergency procedures.
MD’s keep American’s addicted to drugs! MD’s also fancy themselves as God like. They think that being an MD allows them to keep American’s [sic] from seeking nutrition.
Doctors are typically overweight.
Our medical doctors have failed us.
“So sad that people in our medical profession have no idea what they are talking about!!!”
Attacks on Science
Instead of listening to science, one should listen to one’s own body.
Even if it’s only a placebo, why not use it?
Western medicine is trying to squash Eastern Medicine
“Things work for different people. Chiropractic and acupuncture work. If you ask for everything to be backed by studies, they just tailor the studies to benefit industry. Research things for yourself and don’t be a sheep taking pills from an MD.”
Two commenters attacked the scientifically impeccable website Quackwatch, asserting that Stephen Barrett is paid by Big Pharma and the AMA and the FDA to say those things, literally funded by them to produce dis-information aimed at discrediting alternative health. [He has no ties to any of those organizations.]
“See how herbs can treat people, not drugs.”
“Did any of you see Sicko? If you did how could you possibly take one physicians [sic] ‘opinion’ about something she didn’t even try over the many testimonials.”
I choose to observe how my own body feels and reacts to what I ingest.
If you think it’s going to help it will.
The real answer is to integrate Eastern with Western medicine.
It is unfair to say Isagenix is making unsubstantiated claims and then to make the unsubstantiated claim that it doesn’t work. [I didn’t claim that it didn’t work: I said there was no evidence that it did, and no reason to think it would.]
Attacks on FDA and Big Pharma
The FDA disclaimer is meaningless.
We shouldn’t take FDA warnings seriously: “it is a terrorist organization that lies, cheats steals, and intimidates anyone who stands between them and the targets of their wrath.”
Dr Hall if you think the FDA is doing a good job you must love some of the poison they approve, such as Aspartame.
Doctors get commissions for prescribing drugs.
A conspiracy of JD Rockefeller is behind the pharmaceutical industry: many prescriptions are made from manipulation of petroleum.
People die from drugs.
“My doctor wanted me to start beta blockers, after much investigation I decided that I was to [sic] young to have my liver contaminated by these pills…”
Natural remedies work just as well and are safer than prescriptions.
Pharmaceuticals are the ultimate money-making scam.
Off-the-Wall False Claims
“The FDA (yes, those great friends of ours) just recently put a new advisement out there [It did not!] that we will soon be required to irradiate ALL raw vegetables and fruits. Do you all know what irradiation does to food? It not only kills “bad” things like e. coli, but it kills nutrients from your foods as well.”
Try It for Yourself
Numerous commenters seemed to think the best way to determine if a treatment works is to try it yourself. But one commenter rightfully pointed out that the try it yourself argument was fallacious and condescending. “One does not have to experience snake venom to know to stay away from snakes.”
Haven’t Tried It But Plan To
Several were planning to try it after reading the article and comments. One of these said he knows firefighters who use it and he “would rather have one of the firefighters doing brain surgery on me, than let the average physician tell me what is going on in my body.” [Wow! Does this guy even have a brain to operate on?]
It’s a Scam
Quite a few people agreed with what I wrote. Several were outspoken in calling Isagenix a scam.
“People would rather rave about this crap than admit that they were fooled into wasting their money.”
“Without even considering the science, common sense helped me spot this as bullshit.”
“Isagenix is a freakish cult perpetrated on the uncritical, by the unscrupulous, using the desperate search for the ever-elusive ‘easy solution.’”
One reported that a cousin and her boyfriend are “making a TON of money selling this stuff to all of you morons stupid enough to buy it and make them rich. ISAGENIX only “works” for the people selling it. Diet and exercise WORKS for everyone!”
A few commenters expressed concerns about the product. The Isagenix rep couldn’t answer questions about origin of ingredients and quality control. There have been no controlled studies. Where is the evidence? How do we know it is safe? Long-term results remain to be seen. How many can maintain this restrictive lifestyle for years? Why isn’t it being regulated by the FDA?
“I am a little concerned about the way some people discuss this product in almost cult-like fashion. It makes me wonder if there are mind-control drugs in this stuff.”
“I got a refund check from IRS after starting Isagenix.”
“I have some magic beans for sale. Try eating right and exercising instead.”
Funny, Unhelpful, and Bizarre Comments
“Who cares whether it works or not. This stuff tastes like 9-day old garbage mixed with water from a sewer.”
One man took it on the recommendation of his chiropractor; he now distrusts both Isagenix and his chiropractor. “I have been feeling better ever since I stopped having my head wrenched and being put on a rack and practically decapitated week after week, except for the apparently permanent click in my neck that wasn’t there before.”
“We fertilize our soil with fake nutrients and usually do not replace with all 60 nutrients the plants need to be healthy so they are prone to diesease [sic – a disease that they die from?] and incests [sic].” [Gotta watch out for those incestuous plants!]
“I never hear anything from the medical field about elevating the PH level in the human body to keep in from being to acidic. That study was done by Dr Lioness Paulings medical reseacher and nobel prize winner.” [Yet more amusing errors in original. Lioness?!]
“Whoever started this blog is an idiot.”
“I am amazed at the amount of ingnorance [sic] on this Blog. Whom [sic] ever allows this should be ashamed.”
My favorite comment of all was “Dr Harriet Hall is a refrigerator with a head.” I don’t know what that means, but its whimsical imagery appeals to my sense of humor.
In looking back at this whole kerfuffle, it became clear to me that there had been a colossal barrier to communication. The person who originally asked me about Isagenix and the blog owner and I were all operating in the arena of science and evidence. Most of the commenters were operating in a whole different universe of discourse based on belief, hope, hearsay, and personal experience. Science is like a foreign language to them, and they were incapable of understanding my points. Pearls before swine…
This article was originally published in the Science-Based Medicine Blog and later appeared in in Skeptical Inquirer.