His Quackwatch Web site has a whimsical title, but don’t let that fool you. Stephen Barrett, M.D., a retired psychiatrist, cares not a whit about amusing anybody. Rather, he is an indefatigable medical troubleshooter and B.S. detector who wants to tell the truth, as he sees it, about consumer health issues. As for the Web site (http://www.quackwatch.com), which gets more than 1,000 hits a day, its self-described purpose is “to combat health-related frauds, myths, fads, and fallacies.”
Barrett, who works out of his 1500-square-foot basement home-office in Allentown, Pa., has the credentials to prove both his intellectual weight and workaholic disposition. The co-author/editor of 45 books, including Health Schemes, Scams, and Frauds (Consumer Reports Books), and Chemical Sensitivity: The Truth About Environmental Illness (Prometheus, 1998), he received an FDA Commissioner’s Special Citation Award for fighting nutrition quackery in 1984, and two years later was awarded honorary membership in the American Dietetic Association.
Raised in New York City, Barrett received his bachelor’s degree from Columbia University, an M.D. from Columbia College of Physicians and Surgeons, and did his psychiatric residency at Temple University in Philadelphia. Married to Judith Nevyas Barrett, a physician, and the father of three (Daniel, Deborah, and Benjamin), he practiced psychiatry for 35 years. “In the late ’60s, I began taking an interest in health frauds,” says Barrett, 65. “As time went on, I began cutting down on my practice to pursue my hobby. Eventually, I just shut my door.” In 1993 he began pursuing his avocation full time.
Today quackbusting remains his passion, “It’s intellectually stimulating and publicly valuable,” he says. “I try to look at private communications. For instance, I read chiropractors’ journals. I look to see what they’re saying among themselves, which may be different from what they’re saying to the public.”
This armchair warrior has won his share of public battles. One research project into mail-order fraud prompted the passage of the 1983 Mail Order Consumer Protection Act. Another put a good many hair-analysis labs out of business. Barrett also counts among his victories “mail from people thanking me for rescuing them from one sort of quackery or another. That’s reward in itself”
Biography Magazine spoke to Barrett about issues ranging from the efficacy of alternative medicine to the validity of advice from best-selling diet gurus, and the various forms of medical quackery he says are being perpetrated on the consumer today.
Biography: Some detractors say you are simply a puppet of the American Medical Association. How do you respond to this?
Barrett: By laughing. I think the AMA provides outstanding scientific information. I happen to disagree with many of its political and marketing activities. But there is no way that it has the slightest influence over what I do. That’s standard quack propaganda.
Biography: Clearly, you seem most comfortable with traditional, commonly practiced medicine.
Barrett: “Traditional” means folk medicine. You mean standard medicine. If something has been shown to work and makes sense, it’s fine. If it hasn’t been shown to work and makes sense, it might be okay and needs more study. And if it hasn’t been shown to work and makes no sense, it’s worthless.
Biography: An article in the New York Times last spring described a touch-therapy experiment designed by a 9-year-old student, Emily Rosa. You helped write up the experiment for the Journal of the American Medical Association. The Times piece noted that her experiment “has thrown the field [of alternative medicine] into tumult.” How so?
Barrett: In Emily’s test, 21 practitioners who claimed they could feel a “human energy field” were not able to demonstrate that they could. The study that we wrote up also included a survey done by Emily’s parents over a six-year period [examining] over 800 published reports. In it they analyzed every paper and citation on [Therapeutic Touch] and concluded that there was no evidence that touch therapy had any value whatsoever.
Biography: Didn’t some of the healers involved say Emily’s study was flawed?
Barrett: Yes, but there were no flaws. One practitioner said, “Well, Emily’s too young to do a serious study.” I wanted to ask how old you have to be. After the results came in, some practitioners said that Emily’s negative attitude had influenced those results. However, none of these very same practitioners had objected to the study’s setup. Besides, the idea that the patient’s negative intention [in the study, Emily was the “patient”] can interfere is absurd. It is the opposite of touch-therapy teaching theory, which states that it is the therapist’s intention that matters and that heals.
Biography: Why do so many people have such a desperate need to believe?
Barrett: I think it’s more a matter of misplaced trust.
Biography: A number of best-selling authors have set themselves up as advice gurus. What do you think of Deepak Chopra, author of Quantum Healing and the Seven Spiritual Laws series?
Barrett: As far as I’m concerned, he promotes all sorts of ayurvedic mumbo-jumbo.
Biography: Andrew Weil, who wrote 8 Weeks to Optimum Health?
Barrett: His advice is an unsortable mixture of sense and nonsense. For example, he says in one of his books that bloodroot, a caustic herb which burns your skin, can kill skin-cancer cells without injuring the surrounding normal cells. That’s absurd. It burns everything it touches. It can’t tell the difference. On his Web site, which is owned by Time magazine, he has a questionnaire you fill out, and he’ll tell you what ten vitamin and herbal products to take. And there’s no foundation for such recommendations. Then you click on a link, mid you’ll go to an online “store” to buy them. The “Ask Dr. Weil” Web site is brought to you by The Vitamin Shoppe, a company paying over a million dollars for the privilege of placing its link next to Weil’s stupid advice.
Biography: What about Dr. Atkins’ New Diet Revolution? Robert Atkins has been around for a long time promoting his high-fat diets.
Barrett: As far as I know, Atkins has never done a systematic study of his diet and submitted the results to a recognized mainstream journal. Until he does that, his ideas should be given no credibility. Nobody knows the percentage of people who get sick or lose weight. If you go on a high-fat diet, there is a risk of raising your cholesterol and increasing your tendency toward heart disease. At the same time, his diet may decrease appetite, not necessarily in a healthy way, and cause people to lose weight, and the weight loss may have a tendency to lower cholesterol. I don’t know what percentage of his patients wind up with higher cholesterol, because he has never published a study. But he is doing a lot of very questionable approaches to health in his office.
Biography: Such as?
Barrett: Chelation therapy, which is the administration of amino acids and vitamins into the blood through a slow intravenous drip over a few hours. It claims to clean out the atherosclerosis from your coronary artery. There’s no theoretical reason to believe it would, and there’s no evidence that it does.
Biography: Is it dangerous?
Barrett: The danger is difficult to know. I’m more concerned about the way it’s marketed. In my community it’s marketed by someone on the radio saying, “If you’ve been told you need bypass surgery, come see me instead.” But if you go to chelation therapy when you need a bypass, you risk your life. Chelation doesn’t work, and many people who need bypass surgery are in considerable danger.
Biography: How do you regard Harvey and Marilyn Diamond’s best-seller, Fit for Life, which promotes food combination for weight loss?
Barrett: That is one on the list of the nuttiest books of all time. It’s based on the theory that people gain weight because they don’t digest their foods completely and have toxic sludge in their intestine. The authors say that the way to fix that is to eat fruits and vegetables and to wash ourselves out from the inside. That’s about as sensible as an astronomer who says the moon is made of green cheese.
Biography: What about Barry Sears’ diet book, The Zone?
Barrett: I haven’t studied that one closely. His diet is not outrageous or unhealthy, but it’s higher in protein than is optimal. He proposes 40% carbohydrates and 30% each of fats and protein. People should eat about 60% carbs, 25% fat, and 15% protein.
Biography: Do consumers depend much on alternative therapies? Instead of going to physicians, they go to homeopaths. If someone’s spine gets out of alignment, he goes to a chiropractor.
Barrett: Necks and spines don’t get out of alignment. That’s a nonsensical chiropractic concept. Joints tighten. Chiropractors can sometimes loosen them. The spine is held together by some of the strongest ligaments in the body, and the bones don’t change in relation to each other. And a chiropractor doesn’t change that either. Probably a chiropractor can stretch a tight area. He may make the joint looser or relieve fight muscles that are causing pain.
Biography: Do you respect chiropractors or think they’re quacks?
Barrett: Neither. Chiropractors fall along a very broad spectrum of belief and practice. A few practice in a scientific manner. I am a consultant to a national organization of chiropractors who do that. On the other hand, many do all sorts of nonsensical things. Some say they can put their hands on your body and regulate your biomagnetic field. Others think they can pull down your arm after putting some substance in your mouth like sugar or vitamins, and by the way your arm reacts — whether it gets weaker or stronger — tell whether the substance is good for you. And one out of three chiropractors, according to their own survey, practices this sort of thing.
Biography: How about osteopathy?
Barrett: Osteopathy is a form of medical practice with a slight additional emphasis on musculoskeletal problems. A small percentage of osteopaths do manipulation for lower back pain and a few other things. Another percentage regards manipulation as a general preventative that can boost the immune system and do all sorts of things. That’s not science-based.
Biography: And is there any validity to homeopathy, which often requires years of study and a long apprenticeship?
Barrett: Homeopathy is a pseudoscience based on the notion that a substance that produces symptoms in a healthy person can cure ill people with similar symptoms. Most homeopathy is simply buying products off the shelf. How long does it take to become a homeopath? Two seconds. You just call yourself a homeopath, and you are one. You could study it a lot, but so what? You can study astrology for a hundred years, but it’s not going to make it work.
Biography: What do you think of meditation? Is it useful for therapy?
Barrett: It’s a relaxation technique, one of many. I don’t think relaxation has a tremendous amount of use. Transcendental meditation is one form of meditation. It’s very expensive to learn, and it’s been closely associated with a lot of mumbo-jumbo on health-related things.
Biography: How about acupuncture?
Barrett: There are two separate issues here. One is the theory and practice. And the other is what actually happens when you go to see a practitioner. The acupuncture universe is divided into two groups. One thinks of acupuncture in terms of a physical process that causes the body to produce pain-relief compounds like endorphins, or that works by distracting a person so that when you pinch one part of the body, another might relax. And the other is the Chinese way. Practitioners talk about putting the needle in the skin to manipulate the flow of nonmaterial energy called chi. Supposedly, your chi has to be balanced. And disease is caused by imbalance. All that stuff is totally nutty. And the people who do it are not medically trained. They’re trained in Chinese medicine, which involves pulse diagnosis, where they feel the pulse for 6 or 12 or 24 characteristics, on the basis of which they tell you what’s wrong with your “chi” and what herbs and what type of acupuncture you should have. It is complete insanity.
Biography: Did you ever consult an acupuncturist?
Barrett: I did, following a lecture in my local community. After listening to my pulse, he looked at my tongue and told me I had “congestion of the blood” and “stress.” I don’t have congestion of the blood, and he had no concept of whether or not I’m under stress. As for the lady standing in line behind me, he said she had premature ventricular contractions, which is an irregular heartbeat. I then took her pulse, which was completely normal. This guy was a medical lunatic. But he represents the acupuncturist majority. The bottom line is that acupuncture may have some usefulness in relieving certain kinds of discomfort. For instance, acupuncture may be able to relieve postoperative nausea, but it may not be cost-effective. I don’t want to spend $90 and get a needle when I can take a pill for a fraction of the price that would do the same thing.
Biography: Yet we have come to regard the Chinese practices of acupuncture and herbal medicine highly. Think of the five-part Bill Moyers series on PBS, “Healing and the Mind.”
Barrett: That series was funded by the Fetzer Institute, a very wealthy organization with hundreds of millions of dollars, whose purpose is to promote mind-body nonsense. Anyone with an ounce of brains could see that it was journalism-for-hire, with a very clear point of view.
Biography: How should the consumer safeguard him- or herself against quacks?
Barrett: The first thing is to maintain an adequate level of caution with respect to claims. Second, identify reliable sources of information and follow what they say.
Biography: What or whom do you consider to be reliable sources?
Barrett: Major medical organizations — the AMA and the American Dental Association and the American Heart Association — put out reliable information. So does the Food and Drug Administration. As far as publications are concerned, there’s one that’s head and shoulders above the rest — the newsletter Consumer Reports on Health. It is a filter from the experts to the public. Beyond that, one very efficient way for people on the Internet to develop the ability to sort out fact and fiction is to go to Quackwatch. We also have a document called “How to Spot a Quacky Web Site,” which is also useful for detecting a quacky practitioner or product.
Biography: Do you think readers can rely on consumer magazines for their information?
Barrett: Most health-related magazines have only one purpose-to make money. They’re packages by which they convey ads to the public. The quality of health related material in women’s magazines varies a great deal and is sometimes influenced by advertising or political considerations; it can also be influenced by confusion on the part of the editor. Offhand, I would say that the only publications I would recommend for the general public are health-related newsletters reviewed by experts, prepublication. And very few magazines do that.
Biography: How can the FDA guide the public in making wise choices?
Barrett: The FDA is doing as much as it can. The health-food industry ran a propaganda campaign, and most members of Congress weren’t interested in the facts and simply did what their constituents asked. Consequently, Congress weakened the FDA’s ability to regulate the marketplace. Now in order for the FDA to remove a worthless product, it has to show that it’s dangerous too, and the result is that hundreds of products are being marketed that are not dangerous but are absolutely worthless.
Biography: Can you name one or two?
Barrett: Chromium picolinate for weight control. And all sorts of amino-acid products that are supposed to help people sleep better. All single-ingredient amino-acid products are worthless. Other worthless products would be animal-organ extracts — freeze-dried animal organs. They call them “glandulars,” but they have no glandular substances in them.
Biography: Recently, someone recommended echinacea as a way to curtail a bad cold.
Barrett: As with many herbs, it’s unsettled whether echinacea is useful. Also, many herbal products are not standardized as to what’s in them, so even if something is useful, you can’t be sure that the quality control or dosage that makes it useful is in the bottle. The FDA doesn’t regulate that. And few publications are dedicated to doing anything about it. That’s one of the neat things about my Web site. We answer to nobody. We can put up whatever information we want.
Biography: How has managed care affected consumer health care?
Barrett: Health maintenance organizations (HMOs) are an attempt to deal with escalating costs that would eventually bankrupt the economy. Those that are working smoothly do an excellent job. The ones that get bad press are overly restrictive. If you join a managed-care program, you are participating in an attempt to hold down costs, and one price you pay will be to give up a certain amount of choice. For some people it’s a problem. Still, most polls show that most people are happy with their HMOs.
Biography: You wrote a book called The Vitamin Pushers: How the “Health Food” Industry Is Selling America a Bill of Goods (Prometheus Books). What is the bill of goods you refer to?
Barrett: Let’s define what we mean by the “health food” industry — a network of individuals and companies that is pushing an idea that you can’t get what you need from food and presenting all the different unscientific reasons to justify that. This industry promotes a number of basic myths: that most diseases are related to nutrition, that they have a nutritional remedy, that most Americans suffer from nutritional deficiency. Also, that there are special foods which have additional powers that our food supply is unsafe, that Americans are overchemicalized, that organic is safer than inorganic … blah, blah, blah. My book is about the health-food industry’s propaganda. It took more than 20 years to collect this information. I closed my practice in order to finish it.
Biography: What does Quackwatch think of the use of vitamins as preventive medicine?
Barrett: I don’t think there’s much evidence that vitamin E helps prevent cancer. The issue of vitamin E and its effect on heart disease is unsettled. There’s no evidence either that vitamin C can prevent the common cold. Sixteen double-blind studies have been done, and none has turned up any evidence that it works.
Biography: In what instances do vitamins work as drugs?
Barrett: There are a few instances where vitamins are useful as drugs, but not for self-medication. The most significant is the use of high doses of the vitamin niacin to help regulate cholesterol. However, it is only suitable for certain people, and you need medical supervision because niacin can cause certain side effects. For one thing, you have to monitor it to see that the liver isn’t being irritated. There are also side effects that are not dangerous, but still unpleasant, like itching and burning of the skin. But niacin is a very cheap, very good drug for the right people. I have been taking niacin for high cholesterol for nine years. It’s not controversial, and it’s not New Age. It’s standard treatment.
Biography: Does a multipurpose vitamin a day do any good?
Barrett: Most people can get what they need very easily from food. People with an inadequate diet could benefit from supplements. Postmenopausal women who need 1,500 milligrams of calcium a day might need supplements even if they eat very well. Pregnant women need to be careful about getting enough folic acid. And some women who menstruate heavily need to be concerned about iron. We have an article on Quackwatch called “Dietary Supplements: Appropriate Use,” which summarizes everything.
Biography: What was your biggest triumph as a quackbuster?
Barrett: One of my biggest measurable triumphs was my 1977 study of mail-order advertising. We looked at 500 magazines and discovered that there wasn’t a single product advertised which lived up to the health claims it made. That information was published in Consumer Reports and became the groundwork for a congressional bill that passed unanimously in both houses-because crooks don’t have a constituency. The bill strengthened the ability of the Postal Service to enforce the law. And there have been fewer frauds since then. We repeated our study in 1990 and found that the amount of space in magazines devoted to mail-order health claims was one-third of what it had been earlier.
Biography: What about infomercial fraud?
Barrett: There has been a lot of it, and the Federal Trade Commission has been very aggressive and has dampened it quite a bit. Consumers should remember that truly effective products are available in drugstores, and they’re cheaper because it’s a cheaper way to market than spending a lot of money on infomercial advertising.
Biography: Tell me about your investigations of hair-analysis labs.
Barrett: In 1985 I sent identical hair samples from each of two girls to 13 labs, and I discovered that from lab to lab there were tremendous differences [in results]. What we showed was that even if hair analysis is a valid measurement of health, which it isn’t, most labs were measuring it inaccurately. As a result of my study, many labs were shut down. My advice is that if a doctor wants to do a hair analysis to judge your nutritional status, you should switch doctors. It’s the hallmark of nutrition quackery.
Biography: How can consumers spot quacky Web sites or practitioners?
Barrett: First, you should be suspicious of any site that sells a health-related product, like vitamins. You should be skeptical of the information on those sites. Second, you should dismiss anyone who says that everyone should take vitamins. Those are the cardinal signs of something being wrong. By the way, if your family doctor is selling vitamins, it’s either unethical or a sign of poor judgment.
Biography: What if he tells you that his vitamins are purer or of a higher quality than most?
Barrett: There’s no appreciable difference in quality from one vitamin manufacturer to another. Hoffman-La Roche and a few other companies make most vitamins, which are then repackaged by smaller companies for sale to the public. The way distributors for the various multilevel marketing companies often make their pitch to doctors is usually to say, “Come to a free dinner. We’ll tell you how to make the money you’re losing in managed care.” And if doctors can get 100 patients on a monthly vitamin program, they can easily pick up $20,000 to $30,000 a year for doing absolutely nothing. The same pills can be purchased in a drugstore for much less.
Biography: How can consumers safeguard their own health?
Barrett: People should adopt a healthy lifestyle, which includes appropriate exercise, food choice, and weight control, and safety behavior. Beyond that, they should have an appropriate level of skepticism toward health information in the media, Finally, they should be skeptical of anyone who says he’s practicing “alternative” or “complementary” medicine. Most of these people have bad judgment.
Biography: If people have specific questions, can they contact Quackwatch?
Barrett: Yes. We answer about 25 individual questions a day. People send e-mails. When I am logged in, about 80% of their questions get answered within ten minutes. It blows people’s minds. I have an advisory board with more than 100 experts, and within a year people will be able to contact them directly, and get an answer if there’s one available. Right now the site is completely translated into French as well. We have over 400 articles available, as well as a new referencing system with a link to the National Library of Medicine. If you click on the citation at the bottom of an article, it puts you right in the library’s system and brings up the page with the abstract of the article and related articles. It’s amazingly powerful.
This article is reprinted with permission from the October 1998 issue of Biography Magazine.