Dr. Aviva Romm: Distancing herself from Goop after defending it [Respectful Insolence]

It’s been over a month now since I started paying real attention to that wretched celebrity hive of scum and quackery founded by Gwyneth Paltrow known as Goop. It was a long time coming, and I feel a bit guilty for not really paying much attention to the “wellness,” “lifestyle,” and, of course, expensive quackery being sold by Paltrow and her minions through Goop. It began when Goop caught flack for selling pricey magic energy healing stickers. Well, it wasn’t so much for that as much as for the amusing intervention of NASA, which slapped down Goop’s claims that these stickers were made with a carbon compound that was developed for use in spacesuits used by astronauts.

Then it was a mere three weeks later that Goop decided to strike back against Dr. Jen Gunter, one of its most persistent and effective critics. Basically, Goop’s editors published a tag-team article introduced by an unnamed editor and then featuring “rebuttals” by two of Goop’s doctors, Dr. Steven Gundry and Dr. Aviva Romm. While Dr. Gundry’s response was condescending as hell and full of tone trolling and appeals to his alleged authority based on his history (like Dr. Mehmet Oz, he was once a respected academic cardiothoracic surgeon before he turned to woo), Dr. Romm’s response was a bit more low key. Unlike Dr. Gundry, in her defense of Goop she didn’t directly attack Dr. Gunter, and, to be honest, she basically admitted that a lot of what Goop publishes isn’t based in science but invoked this excuse:

In a time when women are desperately hungry for safe alternatives to mainstream practices that too often fall short of helpful for chronic symptoms, and in the setting of a medical system that is continually falling short of providing lasting solutions to the chronic disease problems we’re facing: I prefer, rather than ridiculing vehicles that are actually highly effective at reaching large numbers of women who want to be well, to seek to understand what women are looking for, what the maintstream isn’t providing; and how we can work together to support those vehicles in elevating their content so that women are receiving the meaningful, and evidence-based answers, they want and deserve, whenever possible.

This would have been well and good if Goop ere actually producing evidence-based answers to anything. In any case, I bring this up because yesterday an interview with Dr. Romm by Megan Thielking was published by STATNews, entitled Goop promoted her as one of ‘our doctors.’ But Dr. Aviva Romm is concerned the site is becoming a caricature. When I saw the title, I couldn’t help but wonder if maybe, just maybe, Dr. Romm is figuring out that Goop has gone so far down the rabbit hole of quackery that it might just be rubbing off on her. Her statements sure read that way, but they also read as a doctor who is trying to have it both ways. Clearly Dr. Romm is trying to put some distance between her and the unsavory expensive pseudoscience being peddled by Goop and Paltrow while not alienating Goopies (my new name for Goop fans who are happy to hand Paltrow their money for such ridiculous nonsense.). Hilariously, Dr. Romm claims that she doesn’t even read Goop, that she’s shocked—shocked, I say!—that there’s quackery being sold there:

But one of those physicians, Dr. Aviva Romm, told STAT that she doesn’t see herself as Goop’s doctor at all. She hasn’t read most of the content on the site (which promotes things like goat’s milk cleanses, energy healing stickers, and “brain dust” to “align you with the mighty cosmic flow”). She can’t give it a scientific stamp of approval. And she’s wary of anyone who automatically endorses products or therapies simply because they’re branded as “natural.”

In fact, she said she’s advised Goop that if it wants to be more than a “caricature of everything alternative health for women,” the editors need to do an audit of all their content, in consultation with physicians.

“I don’t think everything in there is necessarily evidence-based or effective,” said Romm, who lives in Massachusetts and runs a small practice in New York City.

She added: “I’m not one of these integrative doctors who basically just because it’s alternative thinks it’s safe and good. I try to keep my doctor thinking cap on as well.”

I laughed out loud when I read one statement there. “I don’t think everything in there is necessarily evidence-based or effective”? Ya think? What was your first clue, Dr. Romm? In fact, I was chuckling heartily throughout large swaths of this interview. For one thing, Dr. Romm is correct to characterize Goop as a caricature of everything alternative health for medicine. No, wait, on second thought, no she isn’t. This is what “alternative health,” be it for men or women, is. It’s some uncontroversial advice on diet and exercise, with a whole lot of woo, quackery, pseudoscience, and mysticism slathered on liberally. Goop isn’t a caricature. It’s the epitome of “alternative health,” and Dr. Romm helped make it that way.

Particularly amusing was her claim that she’s an integrative doctor who tries to keep her “doctor thinking cap on as well.” She really, really could have fooled me. Remember. I perused her website. Remember how I not infrequently say that a very good indication that you’re dealing with a quack is if that doctor advocates “detoxing.” Well, Dr. Romm’s blog is full of articles with titles like How to Detox Every Day: Top Ten Foods & Herbs, Detox Immunity, The Easiest, Most Effective Spring Detox Ever, and Detoxing Before Pregnancy. (That last one sounds like a really, really bad idea to me.)

Here’s a taste of what I’m talking about:

So you can imagine by the time you hit your 20s and beyond, our bodies have been steeped in environmental chemicals!

These chemicals come from herbicides, pesticides, antibiotics, hormones, and artificial ingredients in our foods. They exist as pollutants in our air, water, cosmetics, medications, vaccinations, household cleaners, furnishings, cars – there are literally tens of thousands of them.

Not only that, we create toxic chemicals in our bodies from the process of breaking down the hormones and stress chemicals that our own bodies produce.

This is nothing more than a variant of a very old idea that isn’t science-based, namely autointoxication. The idea behind autointoxication is that the colon is leeching “toxins” into our body that must be purged for optimal health. Of course, as I’ve pointed out before, by the time a colon becomes “toxic” because of what’s in it, it’s called toxic megacolon, and it’s a surgical emergency, usually associated with sepsis. No, the colon is quite capable of eliminating all the “toxins” thrown at it, as is the liver. Dr. Romm has just changed the source of the “autointoxication” from teh colon to the body “breaking down hormones and stress chemicals.” This is just as nonsensical an idea as the idea that “death begins in the colon” because the poo in it is slowly poisoning us.

At some level, Dr. Romm even appears to realize this:

The good news is that your body is amazingly equipped with detoxification systems that have been evolving and improving over millions of years. Most of these are in your liver, but also require that you keep your bowels moving well each day to “take out the garbage” that the liver has processed. Your body has the mechanisms in place to keep you healthy – vibrant, in fact.

The bad news is that never before in the history of humanity have we been exposed to so many different individual and combinations of chemicals at once. You know how you can feel overwhelmed by life sometimes? Well, our bodies are overwhelmed by toxic loads and need some extra daily detox help.

How do I know this? As a Yale-trained MD and an environmental health scientist, one of my key areas of research is women’s and children’s health and environmental toxicity.

Oops. I spoke too soon. She did indeed invoke a more direct variant of the old idea of autointoxication. Of course, it’s utter nonsense that never before in history have we been exposed to so many different individual and combinations of chemicals at once. Anyone who studies history and understands how much more polluted our world was throughout the industrial revolution will realize that. Indeed, if anything, the environment we live in is almost certainly much cleaner, with many fewer environmental threats than even 50 years ago, although Donald Trump is sure enough trying to take us back to the bad old days. (If you’re a Trump supporter and don’t like me injecting politics here, guess what? I don’t care!)

I also love Dr. Romm’s invocation of her authority. She’s not just an MD. Oh, no. She’s a Yale-trained MD. Well, Yale is, unfortunately, a bastion of quackademic medicine. Remember Dr. David Katz and his more “fluid concept of evidence“? I sure do, and Dr. Romm strikes me as the epitome of what Dr. Katz was talking about someone so open-minded that her brains fell out. As for Dr. Romm being an “environmental health scientist,” I searched Medline for her publications resulting from environmental research. To my surprise, I found one article in the New England Journal of Medicine. Actually, it wasn’t an article. It was a letter to the editor questioning an article about prepubertal gynecomastia linked to lavender and tea tree oils. (Gynecomastia is abnormal breast growth in males.) The letter is ten years old, and the only thing I could find in the peer-reviewed literature by Dr. Romm on environmental determinants of health or “environmental toxicity” in children. There’s also an “ask the experts” article in Explore, which, as you might know, is one of the more “out there” alternative medicine publications.

And I haven’t even gotten into Dr. Romm’s embrace of functional medicine, which basically combines the worst aspects of conventional medicine with the quackery of alternative medicine, her “adrenal thyroid revolution,” which basically posits that Epstein-Bar Virus is the cause of Hashimoto’s thyroiditis, and also the cause of…just about every chronic health problem. Then there’s her flirtation with antivaccine ideas, which, as far as I know, she has not rejected.

So we’ve established that Dr. Romm is not nearly so evidence-based as she claims to be, which is a reason why her proposal that Goop institute a medical advisory board made up of physicians cracks me up. There’s no reason to expect that such a board would make any difference, not if it’s made up of Goop physicians like Dr. Romm and her fellow Goop doctors.

Of course, Dr. Romm can’t be too critical of Goop. After all, she got involved with Goop when her publicist thought that writing for Goop would help her “expand her audience” (translation: sell more books, supplements, and stuff), which is probably why she was willing to do it for free, while claiming she has no idea what’s published there. (I really do call BS on that last part, but maybe she really doesn’t read anything in Goop except for her stuff.)

Here’s how she came to write part of the response to Dr. Gunter:

Romm got roped into the Goop fight after Dr. Jen Gunter — a longtime critic of the site — lambasted the lack of scientific evidence behind Goop’s recommendations in a widely shared post on her blog in May.

“When the Goop hit the fan, let’s say, with the Jen Gunter piece, it was just kind of in the early stages of my writing for them,” she said.

Goop asked her to submit a quote addressing the criticism. She responded that she couldn’t endorse the site, but she could share her thoughts on women’s wellness. That’s how she came to write the open letter which Goop later published as “A word from our doctors.”

If Dr. Romm wasn’t comfortable writing the response to Dr. Gunter, then she should have politely declined. However, she knows what side her bread is buttered on; so she didn’t. And she’s still defending Goop:

But, Romm said, it’s not just celebrities and alternative medicine providers who are making money off patients. She pointed to the billions drug companies spend on TV ads.

“Let’s not be misled here,” she said. “Those drug company commercials are making lots of people millions. So it’s not just one isolated situation with Goop.”

I love the smell of pharma mongering in the morning. It smells like…false equivalence! Yes, pharmaceutical companies make lots of money selling drugs. The difference, of course, between pharmaceutical companies and Goop is that pharmaceutical companies have to do the scientific and clinical studies to show their products work before they can market them. As a result, most drugs do what their manufacturers say they do. In contrast, Goop (and, truth be told, Dr. Romm) can make any claim they want to sell their product—and they do. I’d also wonder if Dr. Romm really wants to compare Goop to pharmaceutical companies. As I’m sure she’d agree, pharmaceutical companies have done some bad things over the years, and she basically defended Goop by comparing it to pharmaceutical companies.

One wondes how much longer she’ll be writing for Goop. Or maybe she’s just part of Goop’s pivoting.