Andrew Weil: Legit or quack?

Hey, all. A friend just recently lent me a copy of Andrew Weil’s Eating Well for Optimum Health. I know it’s a national bestseller and all, but I’m wondering if his theories on food, diet and nutrition are generally considered effective or nonsense. I’m all for healthy eating, but Weil himself looks like Santa, and I don’t normally take that as a good sign.

While not a nutritionist, he seems to legit. My friend gets his newsletter. I wondered whether he was legit as well, and from reading his newsletter, he doesn’t appear to have an agenda. He also doesn’t appear to be hocking his own brand of products. He did a review of some of the popular diets (Atkins, sugar busters, South Beach) and made sure to list positives and negatives of each.

My vote is for legit.

I meant to say “I am not a nutritionist…”

Well, Quackwatch has him on its list of “nonrecommended sources of health advice.” There are several articles there about him – just search on 'Weil."

The trouble with medicine is, it’s not science. It’s informed by science, but there’s a big difference between experimenting on people, and treating them in a routine manner.

Doctors learn stuff in school, and then they use it. Some do a better job than others, once finished with their training, remaining au courant. Even still, the conventional wisdom in medicine can be, and is, overturned quite often. Nobody can even agree now whether or not it’s good to eat fat. What’s really alarming is that, often, when you dig deep into what informs the conventional wisdom, there’s no really good science to back it up. And medicine can be highly politicized. Sometimes what everybody thinks has as much to do with the person espousing a particular medical theory as the science behind the theory.

What you wind up with at the end of the day is uncertainty. Weil makes a lot of claims. Some of them are on a relatively sound scientific basis, most not at all. Trouble is, his critics often don’t have much more of a leg to stand on, when you really scrutinize their position. They just happen to be more conventional. Would you want to go back to 1970 and be treated by what was “conventional” back then, or would you rather be treated now? How did the Medical Truth™ in 1970 wind up being so false today? Is Weil a loony quack, or is he prescient Sage? Sometimes the “experts” don’t know any better than you or I. Any reasonably intelligent person can focus on their particular disorder and, after extensive research into the subject, be armed with more knowledge about a specific condition than their doctor has. You won’t know as much about medicine in general as your doctor, but still, even with your hard work, will he or she listen to you if so say “hey, Doc, you say X, but what I read from the most recent study says Y.” Maybe, maybe not. Depends on the doctor and his or her personality, doesn’t it.

It’s buyer beware, my friend. The sad truth is, that’s the reality in all of medicine, not just the fringe stuff. My guess is that Weil, being just one guy by himself with a distinct bias for a particular philosophy, is not as reliable as the “conventional wisdom”. And if he and the conventional wisdom are at odds, the probability is greatest that Weil is wrong. However, there have been plenty of instances where the entire profession has been dead wrong about the “conventional wisdom”, and you had one lone renegade championing the new theory. Like as not, this person was branded a heretic by his profession, ostracised, discredited, accused of malpractice, you name it. It will happen again too. Unfortunately none of us can predict with certainty who is the quack and who is the visionary. We can just make informed guesses, and hope like hell the information is reliable.

He quacks more then the Afleck duck.

Here’s an article from quackwatch that’s specifically about him.

Yeah, well, I don’t want my statement above to reflect a suspicion Weil is correct in his philosophy. I read about the whole “stoned thinking” thing before, and frankly thought it was a load of B.S. However, there are conventionally-trained, well-respected physicians out there who stand firmly behind their belief that prayer is essential to healing. Some even go so far as to pray with their patients in the office, or before performing medical proceedures. Even more creepy, there’s a fair amount of hard evidence out there that prayer works.

I’d bet my money that a good portion of the docs who prescribe prayer actually believe there are spiritual powers at work, rather than a physiological phenomenon at work, perhaps related to stress reduction. It would actually be unethical for these physicials to administer aid through prayer if they didn’t believe in it, unless they stated explicitly they had no faith in prayer’s spiritual powers vs. a more prosaic explanation. I don’t heart these people being called quacks. In fact, I think the AMA is behind the practice. And there’s no more sound theoretical basis for prayer than what Weil espouses.

Where Weil goes off the deep end is his suggestion that, rather than integrate mind-body healing and herbal remedies holistically with conventional medical practice in a complimentary manner, we simply regard the conventional biology that informs medical practice as unimportant or even irrelevant. That’s just absurd. There’s nothing that says, however, that Weil might not stumble upon a remedy or approach through his own “philosophy” or “research” that isn’t right on the money. Trouble is, since the feels no need to prove himself rigorously, there’s no way to know except to experiment yourself and deal with the consequences if something goes wrong. At least with conventional allopathic medicine, your chances of having something sound to fall back on are better (though certainly not guaranteed).

No, there is not. All such studies are demonstrably flawed.

Short answer:
Weil says a lot of common sense stuff (eat well, clean water/air, exercise, etc.) and is good at de-complicating wellness, but then slips past that and complicates it again with alternative medicine (anecdotal evidence, poor studies, etc.).

But would his books sell (or would anyone’s?) if they stuck to common sense?

Yeah, well…They say most clinical studies for antidepressants are demonstrably flawed as well, and that 90% of the supposed therapeutic benefit can be chalked up to the placebo effect (and, implicitly, big-pharma only asking questions that will yield positive answers or none at all, which in turn is part of the giant pharma-FDA conspiracy to rip off the American consumer). Then again, the meta-analysis techniques used to “prove” this are controversial, and thought by some statisticians to be demonstrably flawed.

Such is life in clinical research.

Yes, and those same studies say that having an animal to pet such as a dog and/or a cat will help reduce stress. I love it when people draw all kinds of conclusions when these studies come out (I am not saying you Loopydude) are drawing such conclusions…
But prayer has effect on people with cancer in many ways…and reducing stress is the main relief.
Dr. Weil teaches at U of A in Tucsan AZ. I’ve had the wonderful fortune of meeting the man, and he is as robust and entertaining a person as I have ever met. I do not think he is full of anything but good intentions backed by his theories.

I’m not a religious person at all. When somebody says “prayer heals”, I automatically assume either A) This is bullshit, or B) The observation is real, the mechanism of action is unknown, but knowable through empirical study.

Same say “Well, you’re just a closed-minded empiricist.” Maybe. But it doesn’t matter. If faith, mind-body, “stoned-thinking”, whatever has some mystical power that is out of the realm of empirical study, it’s unprovable. You have to take it on faith. Arguing the science of Dr. Weil’s approach is pointless because it’s religion. It’s like discussing the “science” of Chi, or Feng Shui. There are people who do this. They’re entitled, I suppose, to do whatever they like. Does faith heal? Who knows. I’ve seen studies published in good journals that say yes. QED says these studies are flawed. I believe QED, in that I don’t doubt the integrity of his cite. But guess what: I’d bet money in a year or so somebody else is going to publish a clinical study saying faith heals, and claim the last analysis wasn’t adequate. This shit happens in clinical science all the time. It takes years, even decades, to sort this kind of stuff out. Half the reason is it’s so hard to design studies that don’t reflect the bias of the investgators. Wanna prove something? Easy. Wanna disprove it? Just as easy. Just ask the right questions. Put all the questions together? You get no result. Half the time your mock control vs. untreated shows efficacy in the mock, such that the experimental group looks equivocable, because your negative treatment control (vs. naive) is now positive. Again, happens all the time. What do they do? Run another study, only then they change the design. Guess what, they get a different answer. Why? Because it’s a better study design, or just different? Well, that’s hard to know. Depends on if the result is what you wanted. Doctor A will say “this is a better design” because he’s pro the result. Dr. B will say “this design is flawed, the old design was better” because he’s con the result.

Happens all the time.

But Loopydude, you said there was hardevidence that prayer works in healing. Cite?

There are loads of publications like this, but here is one example that I found in about a minute, perhaps one of the better examples in that it’s a thorough literature review, which provides a good survey of the field, and cites plenty of studies that you can peruse to your heart’s content. I’m able to read the primary source just by clicking on the link. It may be because I’m at work, so if you can’t read it, I’m sorry. You could try going to a university library, or simply paying a small fee to gain access to the paper (should you feel it’s worth it):

A reference to the study published by the Beeb:

http://news.bbc.co.uk/2/hi/health/778564.stm

The review in Annals of Internal Medicine (a good clinical journal) that the article above references:

http://www.annals.org/cgi/content/full/132/11/903
Annals of Internal Medicine is a decent journal. The abstract is for a review

According to the text, the studies were of “high average quality”, and roughly half of the studies they reference showed a positive result from prayer. This was, in the estimation of the author, worthy enough an evidential basis to perform better studies to address the various methodological limitations of the studies chosen for analysis. The authors stress that these studies were culled specifically for their relatively high quality. Unfortunately, heterogenaity in study design precluded proper meta-analysis. It would have been interesting if they had been able to do that.

Maybe I shouldn’t have used “hard evidence”. However, in clinical circles, this is the kind of “very good evidence” that motivates people to design very large and expensive clinical trials. For instance, if these studies were about a drug, I wouldn’t be surprised if a company might risk a Phase II or III trial, based on the positive evidence (they would have to have a fair amount of proof-of-principle pre-clinical evidence, as well as extensive Phase I safety data, etc., so perhaps it’s not a good analogy). In other words, it’s “hard” enough evidence that somebody would throw some serious money at it to develop it further, if it could be patented.

I would actually be curious to see QED’s cite about the contrary evidence. I don’t doubt it exists, I’m just interested. I’m not surprised, actually, that I haven’t heard of it, as it’s rarely front page news when somebody discovers that “Prayer Has No Effect on Health”. I mean, duh, you would expect hard-nosed sceptical empiracists who don’t believe in anything to say that. You sell more copy when you can publish and article that says “Dr. Expert Scientist reports ‘Prayer Heals’”, primarily because the majority of Americans (sorry to non-USA citizens, I don’t want to malign you :D) believe in the healing power of prayer. People like it when science reaffirms their belief.

And when it doesn’t? Well, maybe time to run another study… :rolleyes:

Jeezus, sorry for the crap-ass writing above. I’m dashing off stuff between assays! No time to proofread!

Not quite. Only 5 out of the 23 studies included are specifically testing the effect of prayer. For these:

This particular effect is the smallest of the three groups considered - the opening paragraph of the Discussion even describes it as “small”.

Furthermore, the most recent of the studies included, which is one of those with an apparently positive effect, also shows the additional odd effect of backwards causation. As Humphrey’s notes in that link, this alone is grounds for suspicion about the validity of the result.

Cool! Thanks for the link!

Actually, it’s interesting…

Does Weil say anything about prayer, or is that Depak Chopra’s thing…