THE SECOND annual meeting of the longevity enthusiasts with a dreamy title - Eudemonia - was held last weekend in West Palm Beach, Florida.
Three full days. Five thousand people. 165 speakers. An exhibit hall with 67 vendors.
The overarching goal of this community is definitely worthwhile - to live a longer (“longevity”) and healthier (healthspan) life.
I attended with a few goals of my own: (1) to get a crash course in wellness - a 7-trillion-dollar global industry; (2) to hear key voices; and (3) to understand how wellness is the same or different from evidence-based medicine.
In other words, this conference is getting to the same order of magnitude as a medical conference - those are typically 10 - 20 thousand attendees. How is this conference different? Well, for one - I have been to many medical conference, and not once heard the concept of snake oil. Here it’s part of the conference mission. It’s on people’s minds.
At a plenary session in a large auditorium, Tyler Wakstein, Eudemonia’s head of partnerships, said, “Eudemonia at its core is the source of truth. It’s the place to discover what’s real and what isn’t. What is science and what is snake oil.”
Eudemonia’s description echos this sentiment. Also quite different from a medical conference - I have not heard anyone reaffirm that they “believe in science" - that goes without saying usually.
“Our lineup includes leading MDs specializing in gut health, brain chemistry, and cancer detection, alongside renowned nutritionists and groundbreaking entrepreneurs at the forefront of scientific advancements. Our experts represent the front-line practitioners, lauded researchers, trusted clinicians, and compelling storytellers who have spent their lives sharpening the scientific underpinnings of what it takes to be, feel and stay well. These are folks who believe in science, who believe in the freedom of ideas, and who are willing to talk with people who see things differently… Our mission is to cut through the noise of fads and misinformation. We’re here to clear out the snake oil and get to the heart of what empowers you to take charge of your health.”
The other difference is that credibility and status in this community is measured not in terms of basic or clinical research publications. It’s measured in two things: how many millions of social media followers, and how many New York Times best sellers. A faculty position in a well-known institution like Harvard, Columbia, Stanford, Cleveland Clinic is an added bonus.
There were many such several celebrity doctors and influencers - Andrew Huberman, the Stanford neuroscientist whose podcast has about 15 million subscribers; Hally Berry, an actress and women’s health advocate with 10 million followers; Gabby Bernstein, a “world-renowned spiritual leader and best-selling self-help author;” Arthur C. Brooks, Professor at both Harvard Kennedy School and the Harvard Business School who has written many books about happiness, including one with his close friend, Oprah Winfrey.
But it was clear - the star of the show, and the lead organizer, was Mark Hyman. He is the founder of the Cleveland Clinic Functional Medicine Center, a multiple #1 NYT-best-selling author (the number varies from 11 to 15, I have not checked;) and the CEO of Function Health, a company that offers a panel of hundreds of blood tests and full-body scans for its customers for a few hundred dollars per year, calculates your “biological age,” and recommends “personalized” foods and supplements, all without ever seeing a doctor. I joined a few months ago - more on this in a future episode.
What about the rest of the 165 presenters? Some interesting titles I noticed among them were “Master educator,” “Harvard Psychiatrist,” “Gut health expert,” “Breathwork facilitator,” “Aerial somatics and recovery expert,” and “Neurosomatic coach.”
I spent most of my time in the exhibit hall, visiting the vendors and interviewing them. There are two themes I noticed, two violations of the evidence-based medicine principles.
One is the complete lack of safety information, i.e. side effects. I talked to representatives of three companies (see accompanying video) - two of them have a whole line of supplements - one over 100 - and they deny any of them having any side effects whatsoever. To me this just shows they have not looked. And how I know this is the third company that makes a device that does what’s called “tVNS” - transcutaneous vagus nerve stimulation. This technique so far has not had much success, unlike implanted devices. But this company claims they have succeeded in dozens of diseases. They had some devices and I tried one. While I had it on, I was interviewing them and just as I was getting dizzy, they informed me that they have not observed any side effects.
And the other big deviation from evidence-based medicine is over-emphasis on mechanism. Here I will be blunt: mechanism - how something works - is not evidence that it actually works. Yet the mechanism is a favorite topic of discussion between patients and providers. At Eviva Partners we have done surveys - if you ask people, “have you discussed mechanism of a new medication with your doctor?” - 80% of people will say Yes. “Have you discussed whether it actually works (what % of patients are helped, when to expect results, etc, and what the side effects are?) - only 30%.
Why is mechanism not evidence? Think about your phone - do you understand how it works? Or your dishwasher? (Where do all the scraps go?) In those cases, at least the engineers do. But did you know that we still don’t understand how the bicycle works? The formulas became too complicated to physicists so they just let them be.
On the flip side, we have the whole era of perpetual motion machines - perpetuum mobile. To obtain a device patent, you don’t have to prove that it works. So hundreds or perhaps even thousands of patents were filed that explained exactly how a particular machine would work. Except of course they didn’t.
And since the Eudemonia organizers have as a goal to identify snake oil, I will offer one tell-tale sign: a lot of talk about mechanism. In medical conferences, when you present a clinical trial, you have one slide on mechanism, and then you move on to the “does it actually work” part. Imagine if a presenter had a bunch of slides on the mechanism - “it’s an antiinflammatory, antioxidant, oxidant, antibacterial, antifungal, …” Safety was excellent, with no side effects identified. In conclusion, we have a great new treatment. Any questions?
The biggest influencers are particularly guilty of this mechanism talk, I might call it.
One last key aspect that I found strikingly different from evidence-based medicine - there are no things that don’t work. Whole categories - yes. Medications - no good. Supplements - good. HRT - good. Psychedelics - great. But Maya Shankar, an author and podcast host, in a conversation with Andrew Huberman really nailed it. “Are there any supplements that are no good?” She basically asked him. And he could not think of any.
As I left the conference, I was very worried. Clearly, wellness is a growing movement. But it’s so far removed from evidence-based medicine. What is the mass appeal? Are the wellness influencers capitalizing on, or fanning the flames of the popular groundswell? What are the roles of universities and institutions such as Harvard, Stanford and the Cleveland Clinic which have traditionally been bastions of evidence-based medicine? And what is the role of government regulation? Shouldn’t an outlet selling products diagnosing or treating specific conditions be regulated by the FDA?
We will touch on these topics in future episodes of our Wellness Series.
…non evidence medicine is being propagated by traditional practitioners despite it being totally ineffective.
Evidence based medicine is rooted in science. Science does not have to be the sole parameter to substantiate medicine. I agree that it should but no evidence