Cult-like behavior among groups that promote various health interventions or lifestyle practices is the norm. Such groups NOT being cult-like is extremely rare. These groups, no matter what they promote, overhype benefits and underplay risks. They condescend to outsiders; they engage in dogmatic proclamations; and they are highly resistant to new information that might challenge their black-and-white narratives.

In fact, criticism will often be interpreted as immoral, as encouraging people not to undergo the lifestyle practice or health intervention, and critics can risk a kind of quasi-religious “excommunication” from groups that have taken a strong public position on behalf of the intervention.

This occurs for vitamin supplementation, cold exposure, sauna, diets, medicines, exercise regimens, sunscreens, psychedelics, and much more. It occurs for interventions with strong overall scientific consensus for their use, and for interventions with much weaker evidence.

Two papers published in 2015 and 2017 explain part of this bias. In the 2015 paper (PMID 25531451), after looking at 37 research studies involving 27,323 patients it was shown that patients systematically underestimated harms and overestimated benefits. The paper concluded that “clinicians should discuss accurate and balanced information about intervention benefits and harms with patients, providing the opportunity to develop realistic expectations and make informed decisions.”

The problem, however, was with the 2017 paper by the same group (PMID 28097303). This paper showed that the same phenomenon existed among clinicians: the very group that was supposed to provide guidance to patients themselves overestimated benefits and underestimated risks, just like patients.

Cult-like behaviors reflect, to some degree, a systematic bias in the minds of most people when they think about health interventions. We should work hard to make people, both clinicians and patients, aware of this bias so that everyone can make and promote better decisions.

Find the full episode on THE KEVIN BASS SHOW.

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