Offit, P. (2013). Do you believe in magic? The sense and nonsense of alternative medicine. New York, NY: Harper Collins Publishers.
Reviewed by Lori Ernsperger, PhD, BCBA-D
Autism and Behavioral Consulting
“What people believe, prevails over truth,” is a quote written over 2,000 years ago by Sophocles, an ancient Greek writer, and is exemplified throughout the book, Do You Believe in Magic? by Dr. Paul Offit. Dr. Offit is the Chief of the Division of Infectious Diseases and Director of the Vaccine Education Center at the Children’s Hospital in Philadelphia. You may be familiar with Dr. Offit’s earlier works, which include Autism’s False Prophets (2008) and Deadly Choices: How the Anti-Vaccine Movement Threatens Us All (2011). Dr. Offit has never shied away from controversy, and in this book he challenges his readers to examine the field of alternative medicine through the lens of scientific methods and peer-reviewed research. Dr. Offit fearlessly attempts to uncover the truth behind alternative treatments such as acupuncture, dietary supplements, chiropractic interventions, and various other unregulated cures for cancer, Lyme disease, heart disease, and autism. This important, and well-written book makes a case for disseminating the truth and educating the public while attempting the difficult task of combating what people choose to believe.
Dr. Offit provides readers with a detailed historical account of the Food and Drug Administration (FDA) and the pertinent federal regulations for consumer protection which began to slowly evolve in the early 1900s. At the turn of the last century, there were no set regulations governing food preparation, food handling, or the accuracy of statements made by the food industry regarding product safety and nutritional ingredients. Several laws, passed between 1906 and the 1960s, established some basic food industry standards, and stipulated that pharmaceutical companies had to actually prove that drugs did not cause serious harm, such as was the case with Thalidomide in the late 1950s and 1960s. By 1975, the FDA began regulating the pharmaceutical industry, but vitamins, supplements, and other herbal remedies were not under the FDA umbrella and thus, could continue to make false claims of effectiveness without publicly disclosing their ingredients or side effects. The Proxmire Amendment of 1975 was written specifically to prohibit the FDA from establishing standards to limit the potency of vitamins and minerals in food supplements or regulating them as drugs based solely on their potency. The passing of the Proxmire Amendment gave vitamin and supplement manufacturers carte blanche to self-regulate and create what has become a $34 billion industry over the last thirty years. Even the most recent federal law, the Dietary Supplement Health and Education Act (DSHEA), passed in 1994, has done little to change this, as all vitamins, supplements and other dietary ingredients continue to go unregulated and manufacturers are still not required to label the ingredients or provide evidence of effectiveness. According to the New York Times, the DSHEA of 1994 should be referred to as the “Snake Oil Protection Act” (p. 260 Kindle Edition).
FACT: As of 2013, in the United States, manufacturers can produce vitamins,herbal remedies, or other products and label them “dietary supplements,” which then excuses them from any testing, data, scientific evidence, clinical trials or FDA approval for human consumption.
Dr. Paul Offit details several important reasons why alternative medicine is not regulated and why Americans believe in its efficacy and are willing to pay for these expensive treatments. First, the role of celebrity endorsements has long been a tradition in supporting alternative medicines and scam treatments. Steve McQueen was an early proponent of alternative treatments for cancer. He traveled to Mexico in his final days to receive laetrile, which at the time, was being touted as an alternative cancer cure made from crushed apricot pits. Unfortunately, although his choice in treatment did not cure his cancer, it propelled laetrile into the mainstream medical community, where vulnerable cancer patients requested this treatment from traditional doctors. Dozens of other celebrities have endorsed alternative cures and treatments including Larry King, Mike Wallace, Whoopi Goldberg, Mel Gibson, Regis Philbin, Steve Jobs, and the mega-alternative celebrity, Suzanne Summers. Ms. Summers has created a multi-million dollar industry built on attempting to turn back the hands of time with anti-aging compounds, creams, and bioidentical hormone replacement therapy, despite a lack of peer-reviewed research proving these claims. Such celebrity endorsements have propelled the popularity of alternative medicine without any regulation or scientific proof of efficacy.
FACT : 51,000 supplements have been manufactured in the US over the last 10 years and yet only 0.3% have been tested and documented safe for human consumption.
In addition to celebrity endorsements, the vitamin and dietary supplement industry has political clout. Politicians from Bob Dole, Orin Hatch, Richard Blumenthal, Joe Barton, and most recently, Dan Burton, have all supported alternative medicines and have blocked any legislation from restricting or regulating this industry. Each of these political figures has taken great steps to ensure less regulation for alternative treatments without any regard to the scientific data or human sacrifice. For example, Joe Barton a politician from Texas, supported antineoplaston (urine) treatment for cancer and repeatedly stated, “FDA, go away.” This is in the face of every clinical trial proving its lack of efficacy and denouncements from the American Cancer Society. Dr. Offit details the motivations of politicians which are often financial or based on personal beliefs and anecdotal cases from their constituents.
Unfortunately scam treatments and frauds have targeted one of our most vulnerable populations, children with autism spectrum disorders (ASD) and their families. The clash of ASD treatment and alternative medicine is a perfect storm rife with celebrity endorsements and political support. Dr. Offit spends several chapters describing the various fad treatments which have emerged in recent years claiming to “cure” autism, including mega doses of vitamins, chelation, stem cells, chiropractic manipulations, digestive enzymes, secretin, hyperbaric oxygen therapy, and even coffee enemas. As Dr. Offit explains, “parents of children with autism will do anything to help their children” (p. 392 Kindle Version), and as a result, they subscribe to the unsubstantiated claims of celebrities like Jenny McCarthy who has led the charge towards alternative therapies and expensive interventions. A parent of a child with ASD who was interviewed by Dr. Offit shared, “I don’t blame the parents for being susceptible to this. The culpability lies with the quacks who are preying on desperate families” (p. 400 Kindle Version). Dr. Offit offers credible scientific evidence to refute these treatments, but this is an uphill battle, as detailed in his chapter entitled, “Charismatic Healers are Hard to Resist,” which describes the fraudulent work of Dr. Rashid Buttar (www.drbuttar.com) and his “cure” for autism.
Scientific evidence, data, conventional medicine, and clinical trials sound old and boring. Dr. Offit points out that most traditional doctors often lack the magnetic personality, sales pitch, and rapid fire charm which are sold in a bottle of vitamins or a cure for autism using “natural” remedies and creams. The charisma of Dr. Oz and others in the mainstream media who report that acupuncture is 3,000 years old and based on wise Chinese tradition is filled with intrigue and hope. Dietary supplements and alternative treatments offer a cure for some of the most awful diseases and disorders that afflict millions of children and adults. Dr. Offit explains how the marketing of alternative medicine is based on fraudulent snake oil salesmen who are not selling the truth, but rather, what people want to believe.
FACT : Natural does not necessarily mean healthy or safe. There is a myth that if something is grown from the Earth it is healthy. Conduct a quick Internet search of “Earth, Nature, Green and Vitamins” and you will find dozens of highly lucrative manufactures who propel this myth. Unfortunately, it is a fact that there are hundreds of plants which grow from the Earth but have poisonous chemicals and should not be consumed by humans in dietary supplements.
Whether you are an advocate for scientific inquiry and empirical research on alternative medicine (e.g., BCBA) or simply want the facts on taking a daily multivitamin, this book will meet and exceed your expectations. Dr. Offit provides a fascinating and accurate account of the state of alternative medicine in the United States. He compels us to examine the statement posed by Sophocles: “what people believe, prevails over truth.” As scientists dedicated to promoting the truth about effective treatments for individuals with ASD, we must continue to assist and educate families in their beliefs about traditional and conventional scientific methods. We, behavioral scientists, along with other professionals, must sell our evidence-based truth as strongly and charismatically as the charlatans who are selling a cure in a bottle. Dr. Offit reminds us not to shy away from confronting those who wish to hide the truth and asks, Do You Believe in Magic?
References
Offit, P. A. (2008). Autism false prophets: Bad science, risky medicine, and the search for a cure. West Sussex, England: Columbia University Press.
Offit, P. A. (2011). Deadly choices: How the anti-vaccine movement threatens us all. New York: Basic Books.
About the Reviewer
Dr. Lori Ernsperger is a Board Certified Behavior Analyst-Doctoral and owner of Autism and Behavioral Consulting. She has over 28 years of experience working in the public schools as a classroom teacher, administrator, and behavioral consultant. Dr. Lori currently provides professional development and conference workshops to school district professionals and parents. She is the author of three books: Keys to Success for Teaching Students with Autism, Just Take a Bite: Easy Effective Answers to Food Aversions, and Eating Challenges and Girls Under the Umbrella of Autism Spectrum Disorders.
Citation for this article:
Ernsperger, L. (2013). Book Review of Offit, P. (2013). Do you believe in magic? Science in Autism Treatment, 10(4), 4-6.
