Goop promoted her as one of ‘our doctors.’ But Dr. Aviva Romm is concerned the site is becoming a caricature – STAT

T

he headline on Gwyneth Paltrows 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 Goops 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 doesnt see herself as Goops doctor at all. She hasnt read most of the content on the site (which promotes things like goats milk cleanses, energy healing stickers, and brain dust to align you with the mighty cosmic flow). She cant give it a scientific stamp of approval. And shes wary of anyone who automatically endorses products or therapies simply because theyre branded as natural.

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In fact, she said shes 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 dont 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: Im not one of these integrative doctors who basically just because its alternative thinks its safe and good. I try to keep my doctor thinking cap on as well.

Goop said its considering a medical advisory board but hasnt 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 isnt 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 saidsome of those ideas arent backed by evidence, either.

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

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 its always an odd word to put to womens things womens health and botanical medicine textbook.

Thats 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.

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. (Goops 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 grandmothers lung cancer. Romms 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 isnt paid for her contributions to Goop, nor does she consider herself one of Goops doctors. She said she simply doesnt pay enough attention to Goops content to make a judgment on it.

In short: no.

I think theres 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 dont endorse everything in NEJM, she said.

Romm got roped into the Goop fight after Dr. Jen Gunter a longtime critic of the site lambasted the lack of scientific evidence behind Goops recommendations in a widely shared post on her blog in May.

When the Goop hit the fan, lets 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 couldnt endorse the site, but she could share her thoughts on womens wellness. Thats how she came to write the open letter which Goop later published as A word from our doctors.

Romms 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 arent necessarily the healthiest, best, or wisest therapies, like constantly detoxing but said thats no justification for dismissing the entire arena of womens alternative medicine in one fell swoop.

But, Romm said, two wrongs dont make a right. Just because women are searching for alternatives to conventional medicine doesnt mean any alternative is a good one.

And she criticized the sea of internet noise and people wearing white coats when theyre not even doctors as confusing women about whats valid, whats trustworthy and whats not.

I cant endorse Goop, in that just because [products are] natural or organic, doesnt mean that theyre beneficial for women, she said. Just because it hasnt been proven harmful and its natural doesnt mean its safe. We cant just say that thats sort of the default position.

You cant just say its better than conventional medicine. If its wrong, its wrong.

Romm said shed start by trying to understand why a patient felt like she needed to jump on a health trend train. Maybe its that shes newly single, feels bad about her body, and wants to lose weight, Romm said. Or perhaps, its 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 theres not great evidence for that either, and shed rather try something more benign for 21 days before she goes on that, she said.

Im really respectful of other peoples choice and autonomy if theres nothing harmful in the plan. Ill say, Great, awesome, give it a try. But not if theres something harmful in the plan, or even if its not harmful but its gonna cost a lot of money out of pocket, she said.

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 Im 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, theres a commercial aspect to it, [but] theres nothing that doesnt have a commercial aspect to it, unless youre a saint doing medical work.

But, Romm said, its not just celebrities and alternative medicine providers who are making money off patients. She pointed to the billions drug companies spend on TV ads.

Lets not be misled here, she said. Those drug company commercials are making lots of people millions. So its not just one isolated situation with Goop.

Reporter, Morning Rounds Writer

Megan writes the Morning Rounds newsletter and covers health and medicine.

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Goop promoted her as one of 'our doctors.' But Dr. Aviva Romm is concerned the site is becoming a caricature - STAT