Issue 1 / 16 January 2012

AFTER the overindulgence of the festive season come the regrets, the resolutions and — for some in search of absolution — an arcane ritual called the detox.

Eating healthily and getting a bit of exercise might be a more productive response, but why settle for an extra serve of leafy green vegetables when you could join a detox program in which a fully qualified something or other will oversee the elimination of the pariah foods of the moment from your diet?

With the added benefit of various expensive nutritional supplements, of course.

The Dietitians Association of Australia has been valiantly arguing against such fads in recent weeks, saying there’s little evidence detox diets actually remove so-called toxins, and people should abandon the “magic powders, awful tasting drinks and starvation diets” and instead … well, you know the rest.

Diets are, sadly, only the tip of the iceberg when it comes to shamanistic rituals designed to remove the unnamed toxins that supposedly blight our modern lives.

An aqua detox, for example, will detoxify and rebalance your body by soaking your feet in salty water that has an electric current running through it. (Yes, the water turns a rather icky shade of brown but, as the wonderful author and doctor Ben Goldacre has pointed out in his book Bad science, you don’t even need to put your feet in the water for electrolysis to produce that effect.)

Another way to suck all the toxins out of your feet (apparently gravity makes them accumulate there) is through an adhesive patch containing a whole swag of miracle-working substances that wouldn’t be out of place at Hogwarts: tourmaline, chitosan and pearl stones are among the promised ingredients in one product.

If you don’t have a foot fetish — and are not too concerned about the risk of rectal perforation — another detoxifying option is to get somebody to stick water up your bottom. This has many benefits including, apparently, helping with migraine, arthritis and diabetes. (I’m not making this up.)

The specific “toxins” being eliminated by any of these rigmaroles never seem to be identified by the commercial providers, though there’s a lot of worried talk about “chemicals” and “our modern lifestyles”.

The businesses are careful too about the promises they make. They may preface the eulogy for their product with something like, “Suffering from irritable bowel, depression, stomach ulcers?”, but they’re too savvy to make actual undertakings about effects on any of these conditions.

Instead, they promise improved wellbeing, relaxation, lower stress levels — essentially unmeasurable outcomes that many customers probably will experience. After all, if we know anything about the placebo effect, it’s that it works a whole lot better when there’s a bit of theatrical enhancement and money changing hands.

Evidence-based practitioners, like the dietitians, will no doubt continue to argue against such hocus pocus but it’s always likely to be an uphill battle.

The ceremonial detox seems to speak to some ancient desire for purification after excess, one that perhaps resists the imposition of a more scientific view.

As Dr Goldacre puts it: “… we fill our faces with drugs, drink, bad food, and other indulgences, we know it’s wrong, and we crave ritualistic protection from the consequences, a public ‘transitional ritual’ commemorating our return to behavioural norms”.

Detox pseudoscience, he goes on, “isn’t something done to us, by venal and exploitative outsiders: it is a cultural product, a recurring theme, and we do it to ourselves”.

Jane McCredie is a Sydney-based science and medicine writer.

Posted 16 January 2012

9 thoughts on “Jane McCredie: Detox temptations

  1. Chris Richardson says:

    Unfortunately our pharmacist colleagues have to bear their share of responsibility for the rise and rise of shamanism in our society. Their shelves are loaded with homeopathic sugar pills and lolly water. They often allow naturopathy advocates space on their floor to peddle their shameful idiocy. I went into a pharmacy to get a dressing for my wife’s finger after she had slammed it in a car door – and was offered a homeopathic product! Pharmacists need to decide whether they are science-based health professionals, or merchants of witchcraft. They can’t have it both ways.

  2. john buchanan says:

    Absolutely agree with Jane and Chris; pharmacists appear to have sold their soul stocking unproven remedies on their shelves, and advertising on radio as ‘naturopaths’ on some occasions. Detox seems to have entered the popular culture of many young people; perhaps it is partly to do with the culture of taking some personal responsibility for one’s own health – which is good – but sometimes using wrong-headed methods for which there is no basis. I wish the TGA would require manufacturers to provide evidence of effectiveness for products, instead of the usual ‘this may help’ labels being sufficient.

  3. Frank McLEod says:

    The pharmacists aren’t by themselves in promoting doubtful products.

    The TV is awash with adverts suggesting your liver needs some assistance that will be supplied by a particular product carrying the same name as a ‘high profile’ medical practitioner. It certainly raises some questions. Has anyone seen the evidence behind the claims in this advert?

    Curse me for being a cynic, but I have my doubts.

  4. Max King says:

    Quackery sells itself. Very clever advertising campaigns have glamorous desperates in glamorous surroundings preaching the benefits, the miraculous cures, of fatuous products or practices. These poor darlings were put in the “too hard basket” by modern medicine, but Company X “really cares” and, at great expense, developed a better type of snake oil. If you don’t believe Company X, then read some of the testimonials from “those-who-had-given-up-hope”.

    Easy money for pharmacists – strategically placed displays of the quackery hypnotise the unsuspecting consumer, who snaps up the panacea. By crikey, it contains anhydrous hydrogen hydroxide and cyclomethane so it must be good.

    Does the pharmacist or the pharmacy assistant strongly advise against the purchase? No.

    Will governments/political parties dare to take on quackery? I suspect not.

    By the way, I have some Dihexachlorobenzoylactinate for sale – great for halitosis and deafness – on special @ $48 per picolitre.

  5. Sue Ieraci says:

    The other related issue is the apparent lack of ethics of those “alternative practitioners” who market remedies from their own websites. Homeopaths typically do this. FOr all the criticism of orthodox practitioners apparently being in the pocket of “Big Pharma”, at least we are at arms length from retailing drugs. I agree with others, though, that retail pharmacists who market scam remedies have something to answer for.

  6. Chris Richardson says:

    I disagree Sue. Don’t worry about the ethics of the “alternative practitioners”. Orthodox professionals must get their own houses in order.

    I’ve banged on about this before and it’s certainly well summarised over at Science Based Medicine (http://www.sciencebasedmedicine.org/), which I’m sure you’re aware of. You either take a science-based approach to the understanding and management of human health and disease, or not. The homeopaths, and the naturopaths, the faith healers and the spoon-benders – they are all doing what they’ve been doing for hundreds of years. With the rise of scientific thinking and its application to human health, great gains have been made, and outmoded and implausible theories had been progressively, rightly, marginalised.

    Then something happened during the 80s – medical schools started to include nonsense in the curriculum. I know – I was there. Hats were doffed to acupuncture. Homeopathy was touched upon as a modality that patients were seeking, therefore doctors should know about it! The tone gradually changed from awareness to advocacy – from “this is lunacy” to “this is an alternative”. The logic? I’m not entirely sure but it was along the lines of “if you can’t beat ’em, join ’em”. There was a fear that because some patients sought this kind of treatment, doctors should offer it or advocate for it. Was there a fear that patients would abandon Western medicine in droves? How did advocating alternative nonsense either stop that occurring or improve the legitimacy of science-based medicine?

    Now we have “alternative” treatment quacks doing what they’ve always done, and the institutions of Western science-based medicine trying to walk a middle road that legitimises the quackery as fast as it destroys their own credibilty. How can the lay public be expected to be able to make a clear choice, when the professions that they should be able to rely on have de-legitmised themselves? From pharmacists, to medical school deans, from the College of General Practitioners, to the toothless apathy of the TGA – the blame lies entirely with the professions. We need to get our houses in order. This “hedging of our bets”, whatever the motivation, must end before we lay the blame on the consumers and their Providers of Nonsense.

  7. Sue Ieraci says:

    Interesting comments, Chris. I see this as a phenomenon of our current society, which appears to give all points of view equal validity, and always seems to require a presentation of “the other side”. I see this as showing also a tinge of anti-intellectualism – that professional knowledge and skills somehow are seen to invalidate those who don’t have them. The tightrope we now need to tread is to assert the value of training, knowledge and professionalism without being dismissed as being arrogant and self-serving.

  8. Chris Richardson says:

    Well I absolutely agree with you that there are a few issues in play here; anti-intellectualism is rife, the issue of ‘false balance’ also. I guess my beef is that the traditional health professions have helped, and continue to help contribute to the rise of these issues. When GPs dabble in acupuncture, then acupuncture is seen, quite reasonably, by reasonable people, to be a modality that must have some validity. We know from the studies that it doesn’t. When some of my very intelligent, but non-medical friends ask why does a pharmacy assistant recommend homeopathic treatments if they don’t work, I’m unable to defend the integrity of a system that allows this. If someone wants a homeopathic experience and goes to a homeopath to seek such, fair enough. If they go to a pharmacy and get the same recommendation, then they can only conclude that homeopathy is a perfectly reasonable modality that will “treat” their illness, a modality that has the imprimatur of mainstream science-based “Western” medicine. We must reclaim our authority over human health, an authority that is usually based upon decades of rigorous research, an authority based on the scientific method. Our patients may say to us “if you cannot provide me with the witchcraft I desire then I shall find myself a witch”. To this we must reply “So be it for you shall not find any of that here under the auspices of science-based medicine”

  9. JD says:

    Just read the article and comments about the supposed billions being wasted by Medicare, and now read this article and comments.
    It occurs to me how little most of the general population know about the scientific method and critical thinking (some doctors too, for that matter). For them, science and medicine may as well be witchcraft, and their beliefs are subject to pop culture.
    One of the things that the “alternatives” seem to offer is *time* – particularly time to listen and explain. One of the commentators, on Medicare mentioned how it penalises those who spend time on patients, and certainly, public hospitals do not encourage it.
    Medicine is not going to claw back the ground lost to quacks by emphasising its technological supremacy, medicine will need to refocus on patients and whatever it is they think modern medicine is not providing. Not all of the expectations will be appropriate, but I suspect spending more time will have benefits on both sides.

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