MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Times are hard, also in the strange world of chiropractic, I guess. What is therefore more understandable than the attempt of chiropractors to earn a bit of money from people who want to lose weight? If just some of the millions of obese individuals could be fooled into believing that chiropractic is the solution for their problem, chiropractors across the world could be laughing all the way to the bank.

But how does one get to this point? Easy: one only needs to produce some evidence suggesting that chiropractic care is effective in reducing body weight. An extreme option is the advice by one chiropractor to take 10 drops of a homeopathic human chorionic gonadotropin product under the tongue 5 times daily. But, for many chiropractors, this might be one step too far. It would be preferable to show that their hallmark therapy, spinal adjustment, leads to weight loss.

With this in mind, a team of chiropractors performed a retrospective file analysis of patient files attending their 13-week weight loss program. The program consisted of “chiropractic adjustments/spinal manipulative therapy augmented with diet/nutritional intervention, exercise and one-on-one counselling.”

Sixteen of 30 people enrolled completed the program. At its conclusion, statistically and clinically significant changes were noted in weight and BMI measures based on pre-treatment (average weight = 190.46 lbs. and BMI = 30.94 kg/m(2)) and comparative measurements (average weight = 174.94 lbs. and BMI = 28.50 kg/m(2)).

According to the authors of this paper, “this provides supporting evidence on the effectiveness of a multi-modal approach to weight loss implemented in a chiropractic clinic.”

They do not say so, but we all know it, of course: one could just as well combine knitting or crossword puzzles with diet/nutritional intervention, exercise and one-on-one counselling to create a multi-modal program for weight loss showing that knitting or crossword puzzles are effective.

With this paper, chiropractors are not far from their aim of being able to mislead the public by claiming that CHIROPRACTIC CARE IS A NATURAL, SAFE, DRUG-FREE AND EFFECTIVE OPTION IN THE MANAGEMENT OF OBESITY.

Am I exaggerating? No, of course not. There must be thousands of chiropractors who have already jumped on the ‘weight loss band-waggon’. If you don’t believe me, go on the Internet and have a look for yourself. One of the worst sites I have seen might be ‘DOCTORS GOLDMINE’ (yes, most chiropractors call themselves ‘doctor these days!) where a chiropractor promises his colleagues up to $100 000 per month extra income, if they subscribe to his wonderful weight-loss scheme.

It would be nice to be able to believe those who insist that these money-grabbing chiropractors are but a few rotten apples in a vast basket of honest practitioners. But I have problems with this argument – there seem to be far too many rotten apples and virtually no activity or even ambition to get rid of them.

6 Responses to Chiropractic care for reducing body weight – or just for reducing the cash in the patient’s pocket?

  • Edzard said:

    yes, most chiropractors call themselves ‘doctor these days!

    They certainly shouldn’t be using the title ‘Dr’ in their advertising in the UK: Use of the term "Dr": Chiropractors – Committee of Advertising Practice

  • Professor Ernst wrote: “With this paper, chiropractors are not far from their aim of being able to mislead the public by claiming that CHIROPRACTIC CARE IS A NATURAL, SAFE, DRUG-FREE AND EFFECTIVE OPTION IN THE MANAGEMENT OF OBESITY”.

    Interestingly, the UK General Chiropractic Council would appear to condone that sort of claim. In its Code of Practice and Standard of Proficiency, under the term ‘care’, it includes:

    QUOTE
    “advice, explanation and reassurance − for example, explaining the kinds of activity and behaviour that will promote recovery, giving nutritional and dietary advice”

    See the Glossary here:
    http://www.gcc-uk.org/UserFiles/Docs/COPSOP_2010_for_WEBSITE_30_June.pdf

    In view of chiropractic being what chiropractors need it to be in order to earn a living, perhaps we shouldn’t be too surprised by the above inclusion.

  • If weight is an issue with a patient and contributing to their back pain then I definitely discuss it, as well as the sedentary lifestyle that is contributing to both. I also have a close referral relationship with local personal trainers, exercise physiologists, dietitians, GP’s etc and we work as a team. If I ignored the weight issue and lack of exercise then that would be unethical and sub standard care.
    As for the use of the title doctor, it is totally wrong even if used as doctor of chiropractic. It confuses the patients and pisses off the doctors. The topic often comes up in my conversations with doctors and I have written to AHPRA about it. Prior to AHPRA when there was separate state registration, chiro’s were regularly audited and fined for using the title. It needs to come back.

    • Thinking_Chiro wrote: “If weight is an issue with a patient and contributing to their back pain then I definitely discuss it, as well as the sedentary lifestyle that is contributing to both…If I ignored the weight issue and lack of exercise then that would be unethical and sub standard care.”

      That’s what should happen, but Professor Ernst seems to be suggesting that, if they could get away with it, some chiropractors might start implying that chiropractic itself – as in spinal manipulation – contributes to weight loss.

      As I pointed out, the UK General Chiropractic Council, under its definition of ‘care,’ gives the example of “explaining the kinds of activity and behaviour that will promote recovery, giving nutritional and dietary advice”. Unfortunately, that could easily be twisted by chiropractors into “keep coming to me for spinal manipulations/adjustments if you want to enhance weight loss”. Indeed some chiropractors might truly believe that their spine-cracking helps with weight loss…

      QUOTE
      So-called “straight” chiropractors (who make up an estimated 30% of all chiropractors) still adhere to the original philosophy of chiropractic invented by “magnetic healer” D.D. Palmer, which is based upon the claim that an undetected life energy called “innate intelligence” flows through the spinal cord and nerves and is responsible for health. Such chiropractors will treat any disease or ailment with spinal manipulation.”

      Link: http://www.sciencebasedmedicine.org/the-bait-and-switch-of-unscientific-medicine/

  • In reply to Blue Wode:
    “some chiropractors might start implying that chiropractic itself – as in spinal manipulation – contributes to weight loss. ”
    I think I should make a complaint to my chiro as in that case I should look like this:
    http://www.thunderfromdownunder.com/
    Bugger!

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