Dietitians Go After A Blogger

      113 Comments on Dietitians Go After A Blogger

This topic generated what was probably a record number of comments in the Fat Head Facebook group awhile back, so I thought it was old news.  Apparently not, since several readers sent me links to a news article this week:

State Threatens to Shut Down Nutrition Blogger

The North Carolina Board of Dietetics/Nutrition is threatening to send a blogger to jail for recounting publicly his battle against diabetes and encouraging others to follow his lifestyle.

Chapter 90, Article 25 of the North Carolina General Statutes makes it a misdemeanor to “practice dietetics or nutrition” without a license. According to the law, “practicing” nutrition includes “assessing the nutritional needs of individuals and groups” and “providing nutrition counseling.”

Steve Cooksey has learned that the definition, at least in the eyes of the state board, is expansive.

Cooksey, who was hospitalized in 2009 for complications of diabetes, created his Diabetes Warrior blog after a low-carb paleo diet proved so effective, he was able to stop taking insulin and other drugs.  In other words, he did what a lot of us have done:  after discovering a diet that worked, he decided to share the good news online.  That’s the Wisdom of Crowds at work.  Bloggers like Cooksey have probably saved more lives than all the dietitians in the country combined.

That’s exactly the problem, of course.  As I recounted in my Crisis in Nutrition speech, more and more people are turning away from doctors, nutritionists and dietitians and seeking information on the internet because they’re tired of following advice that doesn’t work.  The nutritionists and dietitians don’t like the competition.  So at least in this case, they’re trotting out ridiculous licensing laws in hopes of keeping their monopoly.  As I wrote in a recent post, that’s often the true purpose of licensing laws:  stifling competition.

The article doesn’t say who exactly decided to go after Cooksey, but it does provide us with enough information to make an educated guess:

Jan. 12, Cooksey attended a nutrition seminar at a church in Charlotte. The speaker was the director of diabetes services for a local hospital.

“She was giving all the wrong information, just like everyone always does — carbs are OK to eat, we must eat carbs to live, promoting low-fat, etc.,” Cooksey said. “So I spoke up.”

After the meeting he handed out a couple of business cards pointing people to his website. Three days later, he got a call from the director of the nutrition board.

“Basically, she told me I could not give out nutritional advice without a license,” Cooksey said.

Now why is that, exactly?  Cooksey hasn’t claimed he’s a doctor or claimed he holds degrees he doesn’t.  Far from it, in fact:

Cooksey posts the following disclaimer at the bottom of every page on his website:

“I am not a doctor, dietitian, nor nutritionist … in fact I have no medical training of any kind.”

That means the people who seek his advice know exactly what he is – and what he isn’t.

[Board director Charla] Burill said the disclaimer may not protect a nutrition blogger from the law.

“If I’ve given you reason to not worry that I don’t have a license because I have all these other reasons I’m an expert, you could still harm the public,” she said.

And what harm would that be, Ms. Burill?  How exactly are diabetics going to be harmed by following Cooksey’s advice and restricting carbohydrates?  The only potential harm here will be to the bank accounts of dietitians, who may find there are fewer people willing to pay them to be harmed by their crappy advice.

I’ve seen plenty of books in bookstores that offer nutrition advice, but weren’t written by people with degrees or licenses.  If any of those authors live in North Carolina, will the state’s dietetics and nutrition board be going after them next?  Are those of us who don’t live in North Carolina going to be threatened with fines or jail, since we have readers in North Carolina?

Burill told Carolina Journal she could not discuss the details of Cooksey’s case because his website is still under investigation, but agreed to talk about the law in the hypothetical.

It’s not necessarily against the law to give your sister or your friend nutritional advice, she said.

Not necessarily against the law?  You mean it could be?

And it’s not necessarily against the law to use a blog to tell people what they should eat.

Where it crosses the line, Burill said, is when a blogger “advertises himself as an expert” and “takes information from someone such that he’s performing some sort of assessment and then giving it back with some sort of plan or diet.”

So you can give advice to your friend or sister … well, what about a co-worker?  A co-worker of mine recently asked me for advice about his diet because his triglycerides are way too high and the low-fat diet he was advised to follow isn’t helping.  (Duh.)  He gave me a copy of his lab report and a list of his typical meals.  I’d say that means I performed an assessment. If we were in North Carolina, could I get around the law by declaring that I consider the co-worker a friend?  Would we need to submit pictures of ourselves having drinks together after work to prove we’re friends?

That’s how ridiculous these issues can become.

It’s a fine line between what’s legal and what’s not when it comes to talking about nutrition.

“Anyone can talk about anything they want,” Burill said. “That’s a First Amendment right, so to speak.”

So to speak?

For example, a person could write a blog advocating vegetarianism, she said.

I’ve heard that could happen.

“Now if you advertised that you’d taken classes in nutrition, you’ve worked at [the federal government’s Food and Nutrition Service] for three years, and you say ‘I believe everyone should be a vegetarian, and I’m here to help you if you want to change your diet’ [that could be crossing the line],” Burill said.

No, you flippin’ idiot, the “crossing the line” part would be advertising that you’ve taken nutrition classes or worked for a federal agency if you haven’t.  That’s called fraud.  Prosecuting fraud is a legitimate function of government.  Prosecuting people for stating their opinions about what constitutes a good diet isn’t.

“A vegetarian diet would be a little bit harder [to prosecute] because a vegetarian is not really like a medical diet.”

True, a vegetarian is not really like a medical diet.  A vegetarian is more like a person who doesn’t eat meat.  But plenty of vegetarians write online about the wonders their diet has done for their health, and plenty of them offer advice too.  What the @#$% is the difference?

Declan McCullagh, a CBSNews.com correspondent who writes about online free speech, says the board probably is violating Cooksey’s First Amendment rights.

“In general, I think that as long as someone is very clear that they’re not a licensed dietician, state officials can probably find better uses of their time,” he said.

You’re right about the First Amendment, Mr. McCullagh.  But as for state officials finding better use for their time … naw, I don’t think so.  This is exactly the kind of petty nonsense they live for.  To make better use of their time, they’d have to leave government and get a real job.


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113 thoughts on “Dietitians Go After A Blogger

  1. Bill and andi

    Odd idea but why not have the damn officials arrested for attempted murder its proven that their drugs are able to destroy organs and that without their diet you have no need for their drugs therefore them telling a diabetic to eat in their fashion, is trying to kill them.

  2. Lori

    If the state employee is a dietitian, she can help developing world earthquake victims. No joke:

    http://www.leg.state.co.us/CLICS/CLICS2012A/commsumm.nsf/b4a3962433b52fa787256e5f00670a71/39a2fa1e0b8230788725799c007dfb2e?OpenDocument

    The legislature of the state of Colorado recently defeated a bill that would have required a bachelor’s degree in nutrition, 1200 hours’ apprenticeship, an exam, and a license to practice dietetics. In other words, even an MD couldn’t tell his patients to lay off the potato chips. As it stands, Colorado is one of only a couple of states where dietitians are unlicensed. I guess I can go on blogging about the benefits of a LC, wheat-free diet without fear of fine and imprisonment.

    For now …

  3. Underground

    And a huge part of the problem is that it is relatively easy to pass legislation like this that expressly violates rights enumerated in the constitution. Either through the letter of the law or the sweeping “interpretations” that are made from it.

    But it is difficult and costly to actually challenge that law through established means. If the challenge isn’t simply refused outright.

    Bureaucracy is an infection on the host. Time for some treatment.

    They count on that. As government employees, they prosecute you with taxpayer money. You have to defend yourself with your own money.

  4. Suz @ Paleo Australia

    It’s absolutely unbelievable – seriously, is it going to be illegal to respond to the question “what did you have for lunch?” soon?

    You’ll be able to answer … after a lengthy legal disclaimer.

  5. Glenda

    So this is what it’s come to in “the land of the free and the home of the brave”! Very sad!!! I’m glad my parents chose Canada.

    That’s how they take away your freedom: one little bit at a time.

  6. Jack

    I don’t even know what to say – how can they so blatantly disregard free speech?

    I can’t imagine them getting away with this.

  7. greensleeves

    The Electronic Freedom Foundation also has a program for Bloggers’ Rights – they can help him.

  8. Be

    More rent-seekers. The problem we have is that no one makes money advertising real food, real health, and simple self controlled solutions to our own problems. Yes, an old story about Steve, but it is nice to see him getting some good media attention to his plight. We can only hope he wins the day.

    This is probably the best analysis of the situation and what’s at stake that I’ve yet seen.

    You nailed it: rent-seeking. For those not familiar with the term:

    http://en.wikipedia.org/wiki/Rent-seeking

  9. Valerie

    I read about this on “Free The Animal” and it made me so FREAKING mad! Instead of Steve Cooksey, the board of nutrition and diet in North Carolina should be prosecuted for their advice all these years, which has surely caused some unnecessary deaths. Steve has probably SAVED lives.

    Sigh. Sometimes I can’t help but think “What the hell is wrong with this country?” and then I fantasize about moving to Sweden and wrestling people for butter in the aisles of Swedish supermarkets.

    (Kind of off topic, but oh man! to Shebeeste! I never thought I’d see Regretsy and Fathead cross paths on the internet! Two of my favorite blogs!)

    What’s wrong with this country is that we’ve forgotten the principles on which it was founded.

  10. Bill and andi

    Odd idea but why not have the damn officials arrested for attempted murder its proven that their drugs are able to destroy organs and that without their diet you have no need for their drugs therefore them telling a diabetic to eat in their fashion, is trying to kill them.

  11. Lori

    If the state employee is a dietitian, she can help developing world earthquake victims. No joke:

    http://www.leg.state.co.us/CLICS/CLICS2012A/commsumm.nsf/b4a3962433b52fa787256e5f00670a71/39a2fa1e0b8230788725799c007dfb2e?OpenDocument

    The legislature of the state of Colorado recently defeated a bill that would have required a bachelor’s degree in nutrition, 1200 hours’ apprenticeship, an exam, and a license to practice dietetics. In other words, even an MD couldn’t tell his patients to lay off the potato chips. As it stands, Colorado is one of only a couple of states where dietitians are unlicensed. I guess I can go on blogging about the benefits of a LC, wheat-free diet without fear of fine and imprisonment.

    For now …

  12. Underground

    And a huge part of the problem is that it is relatively easy to pass legislation like this that expressly violates rights enumerated in the constitution. Either through the letter of the law or the sweeping “interpretations” that are made from it.

    But it is difficult and costly to actually challenge that law through established means. If the challenge isn’t simply refused outright.

    Bureaucracy is an infection on the host. Time for some treatment.

    They count on that. As government employees, they prosecute you with taxpayer money. You have to defend yourself with your own money.

  13. Suz @ Paleo Australia

    It’s absolutely unbelievable – seriously, is it going to be illegal to respond to the question “what did you have for lunch?” soon?

    You’ll be able to answer … after a lengthy legal disclaimer.

  14. Joey

    Today you can’t post on the web, tomorrow you have to stop telling your child what to eat since you’re not licensed. Stuff like this makes me glad I don’t live in the US.

    Well, schools have already decided parents aren’t qualified to pack a lunch for their kids when the state inspectors are visiting. They tell us what to pack.

  15. Glenda

    So this is what it’s come to in “the land of the free and the home of the brave”! Very sad!!! I’m glad my parents chose Canada.

    That’s how they take away your freedom: one little bit at a time.

  16. Jack

    I don’t even know what to say – how can they so blatantly disregard free speech?

    I can’t imagine them getting away with this.

  17. greensleeves

    The Electronic Freedom Foundation also has a program for Bloggers’ Rights – they can help him.

  18. Sandra Goff

    I love your comments. You hit it on the nose. These state-trained so called experts are ridiculous and yes, they are scared and should be because people are becoming educated–but not the way they want us to–not through their government funded academic classes which preach the same old food pyramid BS and push whole grains and low fat. People are wise to the truth and nutritionist are losing credibility. Same thing with herbalist and holistic medicine vs. doctors and pharmaceuticals. If Big Pharma can’t get a piece of the proverbial pie, they will shut the naturalist down and say something stupid like, “Well, its not FDA approved.” I say, big deal–all you mean is they haven’t got paid, and I don’t trust the FDA anyway.

  19. Valerie

    I read about this on “Free The Animal” and it made me so FREAKING mad! Instead of Steve Cooksey, the board of nutrition and diet in North Carolina should be prosecuted for their advice all these years, which has surely caused some unnecessary deaths. Steve has probably SAVED lives.

    Sigh. Sometimes I can’t help but think “What the hell is wrong with this country?” and then I fantasize about moving to Sweden and wrestling people for butter in the aisles of Swedish supermarkets.

    (Kind of off topic, but oh man! to Shebeeste! I never thought I’d see Regretsy and Fathead cross paths on the internet! Two of my favorite blogs!)

    What’s wrong with this country is that we’ve forgotten the principles on which it was founded.

  20. mezzo

    Now Tom, you better get those dogs of yours trained up to sniff out members of the nutritition police who may be lurking in your hedges even as I write this!!

    We’re having most of the hedges ripped out this week. That gives me a clear line of fire.

  21. Galina L.

    Probably, it is a good idea to declare LC or Paleo diet to be religious cults. Much safer than to to use a logical explanation.

    That’s a brilliant idea.

  22. HeatherRN

    Kinda off subject but do you know how many carbs a diabetic is allowed to eat per day according to their doctor? After admitting a diabetic pt and giving him his hospital menu, I began to look into the 1800 and 2000ADA diets most doctors prescribe. Being on a 1800ADA diet, most get almost 200gm of carb per day (and if they don’t order that much, dietary will modify their order to make sure that happens by an extra piece of bread or some other starchy food). Some people are put on a 2000ADA diet and their carb allowance is well over 200gm per day! I was floored when I calculated that and realized that’s probably how endocrinologists, dieticians, nutritionists and doctors keep their clients coming back…kinda like sleazy mechanics….yuck 🙁

    I don’t they intentionally tailor advice to keep their patients sick, but that’s the end result.

  23. Joey

    Today you can’t post on the web, tomorrow you have to stop telling your child what to eat since you’re not licensed. Stuff like this makes me glad I don’t live in the US.

    Well, schools have already decided parents aren’t qualified to pack a lunch for their kids when the state inspectors are visiting. They tell us what to pack.

  24. slowe

    So this guy isn’t in court yet, right? If this does go to court, I would be willing to chip in a few bucks to help him “fight the man.” This is ridiculous.

    I’d contribute to that legal defense fund.

  25. Marc Sitkin

    Great post Tom. The Honorable Ancient Guild of Dietitians should be run out of town on the rails. 20 years of bad advice from them and their pimping MD’s nearly killed me. I’ll go with the wisdom of crowds on topics of diet.

  26. Jesrad

    Cooksey is indicted because, according to other sources, he charges 100-150 bucks for personalized online diet counseling. Not that it makes it less unjust to sue him IMO, but that is the difference between him and the myriad other bloggers. Giving your opinion: still fine. Selling the advice ? They crash down on you.

    Going after a guy for charging a fee, even though he doesn’t claim to have any official credentials that he doesn’t? Thomas Jefferson is rolling over in his grave.

    I charge a fee for programming services. I have no official credentials, no certifications, no degrees, nothing. And yet companies happily pay for my self-taught expertise. This is equivalent to the programmers with degrees getting together, forming an association, lobbying the state, and getting a requirement written into law that only people with official credentials can program computers — to protect the public, doncha know.

  27. Carrie @ 20-Something Homemake

    That’s complete bull crap! This kind of thing makes me so puking mad! So what can we do to start changing things??

    Keep being part of the Crowd in the Wisdom of Crowds. Join online groups, write a blog (which I see you’ve done), speak your mind, post links, leave comments.

  28. Joshua Tenner

    Once again, you hit the nail right on the head. I even disagree with some of his advice and think he should be able to speak his mind.

    Absolutely. I disagree with the people pushing vegan diets, but I’d never try to stifle them.

  29. Marilyn

    Just for some perspective, enter an internet search for the words “diabetes” “advice” “vegan”. You’ll find all sorts of people giving out advice. As I read the above story, my hunch is that the dietician didn’t appreciate Steve taking over her show — disagreeing with her and then passing out his own business cards. She was miffed, went back and told her colleagues about it, and the thing escalated from there.

    I think that’s exactly what happened.

  30. mezzo

    Now Tom, you better get those dogs of yours trained up to sniff out members of the nutritition police who may be lurking in your hedges even as I write this!!

    We’re having most of the hedges ripped out this week. That gives me a clear line of fire.

  31. Firebird7478

    “I’ve seen plenty of books in bookstores that offer nutrition advice, but weren’t written by people with degrees or licenses.”

    Shall we start with Suzanne Somers? Also, they say vegetarian diets are not medical diets. If that is the case, then why are doctors and nutritionists recommending their patients/clients follow one?

    Bingo. I’ve seen plenty of vegetarians recommending meatless diets as a cure for health issues.

  32. Galina L.

    Probably, it is a good idea to declare LC or Paleo diet to be religious cults. Much safer than to to use a logical explanation.

    That’s a brilliant idea.

  33. HeatherRN

    Kinda off subject but do you know how many carbs a diabetic is allowed to eat per day according to their doctor? After admitting a diabetic pt and giving him his hospital menu, I began to look into the 1800 and 2000ADA diets most doctors prescribe. Being on a 1800ADA diet, most get almost 200gm of carb per day (and if they don’t order that much, dietary will modify their order to make sure that happens by an extra piece of bread or some other starchy food). Some people are put on a 2000ADA diet and their carb allowance is well over 200gm per day! I was floored when I calculated that and realized that’s probably how endocrinologists, dieticians, nutritionists and doctors keep their clients coming back…kinda like sleazy mechanics….yuck 🙁

    I don’t they intentionally tailor advice to keep their patients sick, but that’s the end result.

  34. slowe

    So this guy isn’t in court yet, right? If this does go to court, I would be willing to chip in a few bucks to help him “fight the man.” This is ridiculous.

    I’d contribute to that legal defense fund.

  35. Galina L.

    According to the article in Forbes http://www.forbes.com/sites/michaelellsberg/2012/04/05/american-dietetic-association, ADA may get you, your site and movie soon despite you living in a different state than South Carolina (or you will have a choice to pay $10000 a day). Official Dietitians are getting really serious about fighting a competition. All of care for the safety of public, of course.

    If they send me cease and desist orders, I’ll ignore them. If they send a notice of fines, I’ll tear them up. If they show up at my door, they better be packing.

  36. Dave, RN

    “But plenty of vegetarians write online about the wonders their diet has done for their health, and plenty of them offer advice too. What the @#$% is the difference?”

    I’ll tell you the difference. Being a vegetarian is politically correct. Eating paleo isn’t. It all goes back to our government telling us to eat a “plant based diet”. We all know if that guy was promoting the food pyramid, there would be no issues. It’s not a matter of being unlicensed. It’s a matter of preaching against what the government recommends.

    My thoughts exactly.

  37. Marc Sitkin

    Great post Tom. The Honorable Ancient Guild of Dietitians should be run out of town on the rails. 20 years of bad advice from them and their pimping MD’s nearly killed me. I’ll go with the wisdom of crowds on topics of diet.

  38. Jesrad

    Cooksey is indicted because, according to other sources, he charges 100-150 bucks for personalized online diet counseling. Not that it makes it less unjust to sue him IMO, but that is the difference between him and the myriad other bloggers. Giving your opinion: still fine. Selling the advice ? They crash down on you.

    Going after a guy for charging a fee, even though he doesn’t claim to have any official credentials that he doesn’t? Thomas Jefferson is rolling over in his grave.

    I charge a fee for programming services. I have no official credentials, no certifications, no degrees, nothing. And yet companies happily pay for my self-taught expertise. This is equivalent to the programmers with degrees getting together, forming an association, lobbying the state, and getting a requirement written into law that only people with official credentials can program computers — to protect the public, doncha know.

  39. Linda

    “If that is the case, then why are doctors and nutritionists recommending their patients/clients follow one?” [Vegetarian Diet]

    Exactly!
    After my angiogram and stent placement last year, I was told I had to listen to a nutritionist prior to being released. When he walked into my room and started in with the vegetarian diet recommendations, I was aghast, told him there was no way I was going to follow his advice, that I was going to continue eating LC regardless. He, of course, told me I was making a foolish decision, yada, yada, and I pretty much turned him off until he walked back out.

    But of course, he had a license.

  40. Carrie @ 20-Something Homemaker

    That’s complete bull crap! This kind of thing makes me so puking mad! So what can we do to start changing things??

    Keep being part of the Crowd in the Wisdom of Crowds. Join online groups, write a blog (which I see you’ve done), speak your mind, post links, leave comments.

  41. Joshua Tenner

    Once again, you hit the nail right on the head. I even disagree with some of his advice and think he should be able to speak his mind.

    Absolutely. I disagree with the people pushing vegan diets, but I’d never try to stifle them.

  42. Peggy Cihocki

    “I don’t much care for how it was resolved. If people want to pay him for advice even though he makes it clear he doesn’t have a (worthless) degree, it’s none of the state’s business.” I agree. Unlicensed people peddle their advice all over the place. If it’s bad advice, people will find out and stop going to them. As long as people know the credentials of the person peddling, it shouldn’t make any difference whether or not they have them. Steve wasn’t forcing people to buy his services.

    Bingo.

  43. Marilyn

    Just for some perspective, enter an internet search for the words “diabetes” “advice” “vegan”. You’ll find all sorts of people giving out advice. As I read the above story, my hunch is that the dietician didn’t appreciate Steve taking over her show — disagreeing with her and then passing out his own business cards. She was miffed, went back and told her colleagues about it, and the thing escalated from there.

    I think that’s exactly what happened.

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