T

he headline on Gwyneth Paltrow’s wellness site, Goop, looked straightforward enough: “Uncensored: A word from our doctors.”

It featured a defense of the alternative medical practices that Goop has promoted, such as tucking a jade egg in the vagina to enhance sexual pleasure. An attack on an OB-GYN who has publicly slammed Goop’s advice. And then, open letters from two doctors who have written for Goop in the past.

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.”

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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.”

Goop said it’s considering a medical advisory board but hasn’t yet established one — and in the meantime, uses a number of physicians as “sounding boards” before publishing its articles. There may be more open letters in the future, a spokeswoman said.

Despite her reluctance to endorse the publication, Romm isn’t disavowing Goop.

She has been interested in alternative medicine since her college days, spent 20 years as a midwife and herbalist before getting her M.D. at Yale Medical School, and said she understands why women are dissatisfied with conventional medicine and searching for new paths to well-being.

And she promotes her own takes on alternative medicine — some of which have drawn sharp criticism from mainstream doctors.

Romm sells proprietary blends of nutritional supplements branded with her name and sold in formulations such as “soothe,” “nourish,” and “uplift.” She also urges women to consider seasonal detoxes, use herbal alternatives to antibiotics for some infections, and try her month-long program to revamp their adrenal and thyroid health, and in turn, boost energy and lose weight. Critics have said some of those ideas aren’t backed by evidence, either.

Here are excerpts from STAT’s recent conversation with Romm, condensed and edited for clarity. Some themes touched on more than once in the interview have been consolidated for clarity.

How did you get involved with Goop?

As she explored alternative medicine in college, Romm said her outlook shifted from being “the spelling bee, science fair kid” to being a “do-it-yourselfer hippie.”

More recently, she said, “I wrote the seminal — it’s always an odd word to put to women’s things — women’s health and botanical medicine textbook.”

That’s how she got to Goop. The publicist for her new book suggested she expand her audience by writing for publications including Goop, and put her in touch with someone at the site.

What does your role at Goop entail?

“My role with Goop is nothing formal at all,” Romm said. “I really just write my articles.”

The editors at Goop write her from time to time, looking for an article about endometriosis or polycystic ovary syndrome, or a fresh take on Epstein-Barr virus. (Goop’s first story on the virus was written by a self-proclaimed “medical medium” who claims to have been guided, at age 4, by a voice to diagnose his grandmother’s lung cancer. Romm’s own take on Epstein-Barr virus — that it can cause autoimmunne diseases such as thyroiditis and can be treated with herbal supplements such as lemon balm, licorice, and holy basil — has also been criticized by some in the medical community as lacking in evidence.)

Romm isn’t paid for her contributions to Goop, nor does she consider herself one of “Goop’s doctors.” She said she simply doesn’t pay enough attention to Goop’s content to make a judgment on it.

Does it concern you that your medical credentials might lend a credibility to other Goop posts that you weren’t involved in?

In short: no.

“I think there’s this sense that sort of by default by writing for them, I was endorsing them,” she said. But Romm said she sees that as the equivalent of assuming that every writer in the New York Times agrees with every piece published in the New York Times.

“I had a letter to the editor published in the [New England Journal of Medicine]. I certainly don’t endorse everything in NEJM,” she said.

What did you say when Goop asked you to write a response to the critics?

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.”

Romm’s key goal with that letter: pushing back against a conventional wisdom that she said “trivializes” women seeking alternative medical options “as participating in a wellness trend.”

Romm acknowledged that some women “may be choosing things that aren’t necessarily the healthiest, best, or wisest therapies, like constantly detoxing …” but said that’s no justification for “dismissing the entire arena of women’s alternative medicine in one fell swoop.”

But, Romm said, “two wrongs don’t make a right.” Just because women are searching for alternatives to conventional medicine doesn’t mean any alternative is a good one.

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And she criticized the “sea of internet noise and people wearing white coats when they’re not even doctors” as confusing women about what’s valid, what’s trustworthy — and what’s not.

“I can’t endorse Goop, in that … just because [products are] natural or organic, doesn’t mean that they’re beneficial for women,” she said. “Just because it hasn’t been proven harmful and it’s natural doesn’t mean it’s safe. We can’t just say that that’s sort of the default position.”

“You can’t just say it’s better than conventional medicine. If it’s wrong, it’s wrong.”

If a woman came into your practice with a Goop article and said she wanted to try out this health trend, whether that’s a month-long detox or the jade egg, what would you say to her?

Romm said she’d start by trying to understand why a patient felt like she needed to jump on a health trend train. Maybe it’s that she’s newly single, feels bad about her body, and wants to lose weight, Romm said. Or perhaps, it’s that she has migraines and read online that a detox might help.

“She might be being told by a rheumatologist that she needs an immunosuppressant drug but maybe there’s not great evidence for that either, and she’d rather try something more benign for 21 days before she goes on that,” she said.

“I’m really respectful of other people’s choice and autonomy if there’s nothing harmful in the plan. I’ll say, ‘Great, awesome, give it a try.’ But not if there’s something harmful in the plan, or even if it’s not harmful but it’s gonna cost a lot of money out of pocket,” she said.

Goop has been criticized for selling products for wealthy white women. How would you respond to that?

“All health care is for wealthy white women,” Romm said.

“When you look at the statistics on maternal mortality, infant mortality, mental health problems, abuse at home, drug problems, with the exception of the growing opioid problems, which are typically more in the white community, all of these have to do with lack of access to health care” — which correlates with socioeconomic status, she said.

Romm added that she understands that “Goop is certainly commercial.”

She is, too, she said: “I have to make a living, too. I sell my books and courses on my website.”

“I think Gwyneth Paltrow was a fabulous actress in her day of acting, and I’m not a sort of advocate or antagonist of her work. I understand that she is probably a very decent person, trying to do good work, and [she] does things that feel meaningful to her. And, yes, there’s a commercial aspect to it, [but] there’s nothing that doesn’t have a commercial aspect to it, unless you’re a saint doing medical work.”

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.”

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  • Seriously? Her defense of selling products geared toward wealthy white women is that “all healthcare is for wealthy white women” ???? Disgraceful. Way to try to address the problem…. She’s in it for the money only.

    • I believe she meant that all COMMODIFIED healthcare directed toward WWW. And in that, “healthcare” translates to disease management or symptom management.

  • Someone who sells pseudoscientific snake oil is upset that someone else is selling a different kind of pseudoscientific snake oil because that other pseudoscientific snake oil is hurting the credibility of her own pseudoscientific snake oil.

  • “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.”

    Good grief. Drug companies can’t run ads until the products discussed have been scientifically tested, and the ads are monitored by the FDA to ensure that they do not claim more than the labeled indication. Goop in contrast touts, well, goop — feel-good stuff usually with nothing but anecdotal evidence to back it. It is fine if you want to try these things (as long as they are not dangerous) – caveat emptor and it’s your money. But to compare life-saving medications that cure cancer or put severe arthritis into remission vs cuckoo powder to align your brain waves with cosmic rays is specious.

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