MAHA and Me

In 2012, I wrote a book about MAHA. In my case, that stood for “Make AJ Healthy Again.”

I devoted two years of my life to trying to figure out the healthiest ways to eat, sleep, exercise, de-stress, even go to the bathroom. I chronicled my findings in Drop Dead Healthy.

Years later, my waistline has rebounded somewhat – but there’s at least one lasting effect of that project: My Quackery Detector remains strong. Not perfect, but strong.

My health project – which included years of interviewing medical experts and statisticians - trained me to spot unfounded claims and motivated reasoning. There was a lot of bunkum then. But now? We’ve got a tidal wave of hogwash.

So today I’m going to use some lessons from my own MAHA project to point out what I believe to be epistemic sins committed by the current version of MAHA.

The Make America Health Again movement – led by Robert F. Kennedy, Jr. – is not a monolith. It’s a Cobb salad of beliefs (with extra bacon for protein!)

Some of those beliefs are reasonable and helpful – for instance, I agree that we should eat less processed food and exercise more.

Some of MAHA’s claims have a grain of truth but are distorted or overstated.

And some of MAHA’s claims – such as the ones about vaccines– stand in stark opposition to the best scientific evidence available.

Instead of critiquing each of the individual MAHA claims, I thought I’d highlight what I believe are the problems with MAHA’s approach to science. MAHA isn’t problematic because it questions mainstream health advice, but because it violates the rules of good truth-seeking.

During my project, I made a list of guidelines that are useful in judging health claims. I won’t call them commandments because none is perfect. But they’re helpful heuristics. Below are four truth-seeking guidelines that I believe MAHA-heads regularly ignore.

1. Thou shalt pay heed to experts (plural) but be skeptical of any one expert (singular)

While researching my book, I attended a speech by a woman with excellent credentials – she graduated with an advanced health degree from the esteemed Johns Hopkins University.

Here is one of her suggestions: Women should spend time jumping on trampolines topless, since the bouncing of the breasts releases toxins and helps prevent breast cancer.

I have searched in vain for any double-blind studies to support this claim. If I had a conspiracy mindset, I’d think this expert was being paid off by the HTB Lobby (Horny Teenage Boy).

I bring this up because it’s an example of how well-pedigreed experts often make claims that are wildly wrong and/or lacking in evidence.

I’m a fan of expertise. But I’m not a fan of blind devotion to a single expert.

I prefer to look at the big picture. What do the majority of legitimate scientists say? It’s sort of the Rotten Tomatoes approach to judging scientific knowledge. Rotten Tomatoes is that site that aggregates movie reviews from dozens of critics. If a movie has a 90 percent rating, it means that 90 percent of reviewers liked the film. I find looking at Rotten Tomatoes more helpful than reading, say, the lone reviewer who appreciated John Travolta in Battlefield Earth.

For science, I gravitate toward meta-studies. Or even meta-meta-studies. This is when researchers look at the aggregate of studies to see what the majority says.

It’s not a foolproof strategy. Meta-studies can have biases too. And sometimes the scientific establishment is mistaken. Sometimes that maverick scientist is correct. I’m guessing Galileo would have had a low Rotten Tomatoes score when he was alive. What’s more, parts of science suffer from the replication crisis and the malign influence of Big Pharma money.

So I don’t want to fetishize this heuristic. But in general, especially now that science has become so complicated that it’s hard for a layperson to judge the merits of a particular study, it’s a decent guide. As a starting position, consensus still beats contrarianism.

RFK Jr. has frequently violated this heuristic – starting with his support of Andrew Wakefield, the discredited scientist who touted the supposed link between vaccines and autism.

2. Thou shalt have a scientist’s mindset, not a prosecutor’s mindset

Nothing against lawyers – my family is full of them – but when it comes to seeking the truth, having a prosecutor’s mindset is bad.

Psychologist Adam Grant talks about this in his book Think Again: The Power of Knowing What You Don’t Know. He contrasts the prosecutor’s mindset with that of the scientist.

A prosecutor is besotted with motivated reasoning and confirmation bias. A prosecutor looks at the evidence and cherry-picks those facts and statistics that reinforce their preconceived notion.

I believe that RFK Jr. -- a lawyer himself – sees the world through prosecutor’s glasses. When I was an editor at Esquire, RFK Jr. submitted an article for consideration about his cousin Michael Skakel. The article made an argument that Skakel was innocent of the murder of which he was accused. We Esquire editors weren’t well-versed enough in the details to refute or confirm all the claims, but it seemed clear to us that the piece included much cherry-picking. We rejected the article.

RFK Jr. applies the same approach to his favorite health claims. In fact, in 2005, RFK Jr. became a vaccine skeptic and wrote a piece about it for Rolling Stone. “He would turn in these manuscripts, and it’s barely exaggerating to say, like, eighty to ninety per cent of the facts would be incorrect, even the simple ones,” former Rolling Stone editor Will Dana told The New Yorker in a 2024 profile of RFK Jr. “It’s because he’s not a journalist. He’s a lawyer. He’s more about making arguments than about trying to communicate the truth.” You can see this in RFK Jr.’s support of ivermectin claims and his fluoride stance.

America deserves a top health official who looks at the world like a scientist. We want someone who is always open to adjusting or reversing their beliefs in light of new evidence. A great scientist and policymaker is okay with being proven wrong.

3. Thou shalt realize that “healthy” and “natural” are not exact synonyms

RFK Jr. has promoted cod liver oil as a treatment for measles while casting doubt on lab-made vaccines. It’s a more natural remedy. RFK Jr. believes we should drink natural water, not water artificially supplemented with fluoride. Health is about clean living; pharmaceutical interventions are suspect.

Some call this the “Appeal to Nature Fallacy.”

There are several problems with equating “natural” and “healthy.”

--Many “unnatural” things are indeed unhealthy. But so are many “natural” things – such as tobacco, hemlock, and snake venom.

--Some so-called “unnatural” things have tons of evidence supporting their efficacy. Vaccines and lab-created antibiotics have saved millions of lives. Artificial valves in hearts and titanium hips are boons to humanity.

--The line between “natural” and “artificial” is a slippery one that’s dependent on culture. You could argue that glasses are unnatural. Not only are they plastic, but they distort the natural light.

--The word “chemical” should not be a bugaboo. Certain chemicals can indeed be harmful, but not all chemicals are bad. In fact, the word “chemical” simply refers to the building blocks of the universe. The most “naturally”-grown apple contains glucose, quercetin, epicatechin – all of which are chemicals.

--Nature’s goal – if it can be said to have a goal – is to propagate DNA. That’s evolution’s purpose. Evolution did not design human bodies to live pain-free into their 90s. The lifespan of prehistoric humans was much shorter and their existence was full of pain. Humans have expanded our lifespans and reduced pain with “unnatural” means such as antibiotics, vaccines, and Advil Cold & Sinus pills (which I popped last week).

In short, some human inventions are indeed potentially dangerous (hello A.I.!) but our inventions should be judged on a case-by-case basis, not dismissed because they are deemed “unnatural.”

4. Thou shalt not use doubt as a weapon

I love a certain amount skepticism. As I’ve written about before, I hate absolutist statements and believe we should use Bayesian percentages when describing our beliefs.

But our skepticism should be commensurate with the evidence. You should not say “the jury’s still out” when the jury has returned, delivered the verdict, and gone home to have soup with their families.

I recently learned a new word: Agnotology. This refers to the deliberate misuse of doubt. Agnotology is when you deny there’s a broad scientific consensus when there is, in fact, a broad scientific consensus. You overstate the amount of doubt that exists.

We’ve seen agnotology’s damage all over:

How the tobacco lobby created doubt about whether cigarettes cause lung cancer.

How fossil fuel companies overstate the doubt about human-caused climate change.

How creationists claim there’s a scientific controversy over whether the Theory of Evolution is true.

And RFK Jr. testified before a Senate committee that there’s not enough evidence that vaccines are, on the whole, safe.

What makes agnotology so dangerous is that it uses science’s strength to attack it. In science, nothing is proven beyond the shadow of a doubt. New evidence can always overturn a claim. That’s why the scientific method is so glorious.

But it also means you will never have 100 percent consensus. You can always find random outlier scientists who dispute the majority. (In the above jury metaphor, a scientific jury cannot require a unanimous vote – and it can always be called back to court to consider new evidence).

We saw science’s strength/weakness in action during the Covid pandemic. For instance: Early in the pandemic, many public health authorities emphasized surface transmission and were slower to acknowledge airborne spread. (Please give me back the 80 hours I wasted scrubbing my apples and onions with soapy water.)

One reaction to this could be: Scientists don’t know their asshole from their elbow (or their intergluteal cleft from their cubital joint). A more generous reaction would be: Science tries to correct itself. It’s a messy, bumpy process. During the pandemic, scientists and health officials made errors in fact, judgment, and policy. Some even intentionally obscured the truth.

Yet despite these flaws, I remain huge fan of science. I worry about RFK Jr.’s damage to the scientific enterprise, and the millions of dollars in research he’s trying to cut, but I’m hopeful we can take science back. I believe that the arc of science is long, but it bends toward the truth.

I understand why people are attracted to MAHA. There are good reasons to distrust aspects of mainstream health industry, including Big Pharma and Big Food. But MAHA’s approach to fixing these problems is dangerously misguided. The problem isn’t skepticism. It’s wrong-headed skepticism.

FOOTNOTES:

Full disclosure: I met RFK Jr. a couple of times may years ago – one of his brothers is a college friend of mine -- and he was always perfectly nice to me. We didn’t share a lot of interests (he was really into falconry at the time), but I had no complaints about his civility. However, as I’ve come to realize as I get older, perfectly nice people can still inflict a huge amount of suffering on society. And I believe RFK Jr. falls into this category.

I do wish actress Cheryl Hines would distance herself more from husband’s unfounded beliefs. I loved her in Curb Your Enthusiasm. In fact, I’ve long thought someone should make a parody of that show with RFK Jr. in place of the curmudgeonly Larry David. They could call it “Curb Your Empiricism.”