s Com a pe tm t s it i i CHRISTMAS OFFERINGS r o

h n

C

Celebrity-based medicine

Edzard Ernst and Max H Pittler

hen we went to medical school, ABSTRACT in the 1970s and 1980s in Ger- Objective: To collect contemporary accounts of celebrity use of complementary and many, we essentially had to W alternative medicine (CAM), to aid clinicians in determining which CAM treatments adhere to “eminence-based medicine”: what patients are likely to use. our teachers preached was right, no ques- tions asked. This has, of course, changed in Design: Articles published during 2005 and 2006 reporting celebrity use of CAM. a big way; today it seems everything is Results: 38 celebrities were found to use a wide range of CAM interventions. measured by the yardstick of evidence- Homeopathy, acupuncture and Ayurveda were the most popular modalities. based medicine. But there are notable Conclusions: There may be many reasons why consumers use CAM, and wanting to imitate their idols is one of them. exceptions,The Medical and complementary Journal of Australia and alter- nativeISSN: medicine 0025-729X (CAM) is4/18 one Decemberof them. It’s MJA 2006; 185: 680–681 not that2006 there 185 11/12is no 680-681evidence behind CAM — on©The the Medicalcontrary, Journalits evidence of Australia base is 1 expanding2006 www.mja.com.aurapidly — but the evidence is Reported uses of complementary and alternative medicine by celebrities usuallyChristmas ignored. Offerings In the United Kingdom, even the official patient guide to CAM Jennifer Aniston Atkins diet Madonna Yoga, herbalism avoids the evidence like the plague.2 And (actor) (singer, actor) certainly, the average consumer seems bliss- Pamela Anderson Homeopathy Sir Paul McCartney Alexander technique fully unaware of it. (actor) (singer, musician) After considering this for some time, we Boris Becker Homeopathy Demi Moore Klamath Lake algae have noticed that, in relation to CAM, con- (tennis player) (actor) sumers seem to adhere to the principles of Cherie Blair Acupuncture, gem Kate Moss Acupuncture “celebrity-based medicine”. This can be (barrister, wife of therapy, dowsing, (model) summarised as: find out what form of CAM UK Prime Minister) Ayurveda your idol currently uses, and do likewise. To ny Bla ir Homeopathy Martina Navratilova Homeopathy The media has a strong influence on the (UK Prime Minister) (tennis player) public’s view of CAM.3 An abundance of Dina Carroll Reflexology Olivia Newton-John Homeopathy research has also addressed the question of (singer) (singer, actor) why people are attracted to CAM. The rea- Charles, Prince of Magnet therapy Acupuncture, sons often provided include ideas such as Wales (Royal) (actor) cupping, herbalism “philosophical congruence” or “locus of (singer, actor) Homeopathy Brad Pitt (actor) Atkins diet control”.1 We suggest that a desire to imitate Cindy Crawford Homeopathy Sir Cliff Richard Ginseng our idols should be added to this list. Here, (model, actor) (singer) we aimed to collect contemporary accounts Sheryl Crow Eskimo diet Sarah, Duchess of York Bioenergy of celebrity use of CAM, to aid clinicians in (singer, musician) (former Royal) determining which CAM treatments patients Chris De Burgh Healing Nadia Sawalha Homeopathy are likely to use. (singer) (UK television presenter) Queen Elizabeth II Homeopathy Arnold Schwarzenegger Breathing therapy (Royal) (actor, Governor of METHODS California) To identify reports on celebrities’ use of Homeopathy Hugo Speer Yoga CAM, we searched our department’s exten- (actor) (British actor) sive data files, the Internet via the Google Richard Gere Breathing therapy Margaret Thatcher Ayurveda search engine, and the UK popular press via (actor) (former UK Prime LexisNexis (http://lexisnexis.co.uk) using Minister) the search terms “celebrity”, “alternative Homeopathy Gem therapy medicine” and “complementary medicine”. (actor) (actor) We considered articles published during Peter Hain Homeopathy Christy Turlington Ayurveda 2005 and 2006 for inclusion in the study. (UK politician) (for his son) (supermodel) Original articles are available from the Jerry Hall Homeopathy Tina Turner Homeopathy authors. (model, actor) (singer) Geri Halliwell Yoga Kate Winslet Acupuncture (singer) (actor) RESULTS Ayurveda Catherine Zeta-Jones Homeopathy We identified 38 celebrities, including 19 (actor) (actor) female singers or actors, who were reported

680 MJA • Volume 185 Number 11/12 • 4/18 December 2006 CHRISTMAS OFFERINGS to use CAM (Box). The range of reported clinical trials. For example, there is reason- these matters. Thus, while mainstream CAM interventions is wide, with some ably convincing evidence that homeopathy, health care relies on evidence-based medi- celebrities using several types simultan- spiritual healing and dowsing have no dem- cine, celebrity-based medicine seems to be eously. The most popular modality is hom- onstrated effects beyond placebo.1 On the the current approach for CAM. eopathy, followed by acupuncture and other hand, there is some evidence that, for Ayurveda. Some CAM treatments (eg, some conditions, acupuncture, the Atkins COMPETING INTERESTS Klamath Lake algae) are so “cutting edge” diet, the Alexander technique, herbalism that even we didn’t know what they were. and yoga are effective.1 For the rest of the None identified. Finally, there are several well known CAM treatments listed, the jury is still out — therapies that are noticeably absent from the either the results of clinical trials are contra- AUTHOR DETAILS 1 list — perhaps chiropractic is currently so dictory (eg, reflexology ) or not enough Edzard Ernst, MD, PhD, FRCP, Director of “uncool” that no celebrity would want to be research has yet been conducted (eg, breath- Complementary Medicine seen emerging from a chiropractor’s office. ing therapy1). The latter category of CAM is Max H Pittler, MD, PhD, Senior Research certainly the largest and probably the most Fellow interesting: for many of the treatments, all Complementary Medicine, Peninsula Medical DISCUSSION that evidence-based medicine can say about School, Universities of Exeter and Plymouth, Exeter, UK. These data suggest that many celebrities are them is, “there is no evidence”. This verdict Correspondence: [email protected] fond of CAM. This may partially explain the can easily be twisted to mean, “it might current popularity of therapies such as work — if only scientists were a little more homeopathy and acupuncture, as people open-minded to testing it”. REFERENCES strive to emulate their idols. Why should it be remarkable to hear that 1 Ernst E, Pittler MH, Wider B, editors. The desk- Of course, most, if not all, of this informa- a celebrity uses a particular form of CAM? top guide to complementary and alternative tion is based on “gossip”. Rarely do we see We do not normally read in the papers that medicine. An evidence-based approach. 2nd TM edition. Edinburgh: Elsevier Mosby, 2006. celebrities endorsing a particular therapy or an actor has taken Imodium or that a 2 Pinder M, Pedro L, Theodorou G, et al. Com- TM hear direct statements from them about singer purchased some Canesten . Yet, like plementary healthcare: a guide for patients. CAM. In terms of promotional effect, how- CAM therapies, these remedies are readily London: The Prince of Wales’s Foundation for ever, this is largely irrelevant. Perhaps more available without prescription. It is thus not Integrated Health, 2005. http://www.fih.org.uk/ unusually, denials of CAM use by celebrities the celebrity value alone that renders a Resources (accessed Nov 2006). 4 3 Ernst E, Weihmayr T. UK and German media also exist. medical treatment newsworthy. The combi- differ over complementary medicine. BMJ We are not normally told in media reports nation of CAM and celebrity seems crucial. 2000; 321: 707. what the CAM treatments in question are This highlights the fact that lay people’s 4 Kylie denies holistic claim. The Age (Mel- used for. It is thus difficult to assess whether attitudes to CAM differ from their attitudes bourne) 2005; 23 Oct. http://quackfiles.blogs- pot.com/2005/10/kylie-denies-holistic- or not the therapies are employed wisely by to conventional medicine. In a sense, CAM claim.html (accessed Nov 2006). celebrities. Nevertheless, it is remarkable seems more responsive to fashion than does that use of many of the modalities listed in conventional medicine, and celebrities the Box is not supported by data from should be more aware of their influence in (Received 28 Sep 2006, accepted 12 Nov 2006) ❏

MJA • Volume 185 Number 11/12 • 4/18 December 2006 681