Naturopathy, its interest and its risks in 6 questions

Healing in a natural way: the promise has everything to seduce. And in fact, the French have a good image of naturopathy. But for several months those who practice it have been under heavy fire from criticism. The abuses of these “care” with vague outlines are in question. In mid-January, a naturopath, Eric Gandon, was placed in pre-trial detention after the death of a man practicing the fast he had prescribed.

A few months earlier, in a video, Irène Grosjean, a figure of naturopathy, praised the practice of “derivative baths” for feverish children, which consists of “rubbing” their genitals. Faced with the outcry, the Doctolib platform announced the delisting, by April 2023, of naturopaths (among other practitioners whose training is not recognized by law).

• What is naturopathy ?

“There is not a naturopathy, but naturopathies”warns Bruno Falissard, director of the Center for Research in Epidemiology and Population Health (CESP), in Villejuif (Val-de-Marne). It is a set of unconventional care practices, that is to say not recognized by modern medicine, which promises to “restoring the balance of the human body”according to its practitioners. “Anything that is assessment, improvement of lifestyle, food rebalancing advice, it’s typical of what we do”explains Alexandra Attalauziti, president of the Professional Union of Naturopaths.

In detail, those who practice naturopathy provide daily life advice (physical activity, breathing, etc.), natural remedies (plants, aromas, vitamins) and non-drug interventions (manipulations, massages, fasting, etc.) . It therefore covers many disciplines, including aromatherapy, micronutrition and phytotherapy.

Naturopathy is part of a very wide range of alternative medicines. The Interministerial Mission for Vigilance and the Fight against Sectarian Aberrations (Miviludes) has counted around four hundred unconventional practices for therapeutic purposes. If some are recognized by law and are the subject of approved diplomas (acupuncture, chiropractic, osteopathy, sophrology), a large number come from wild exotic proposals with questionable rationality, such as “cranio-sacral therapy” or “biology total of beings. Between these two extremes there is a whole continuum, with many practitioners multiplying labels. “We are dealing with a real nebula, it is so vast that it is difficult to classify”, is in despair Pascale Duval, spokesperson for the National Union of Associations for the Defense of Families and Individual Victims of Sects (Unadfi).

• Is naturopathy really a medicine of yesteryear?

This is often what one can read of it; beware, however, of some misleading accounts. For example, an approach presented as medieval, the “Hildegardian medicine” – a popular German school of herbal medicine and naturopathy claiming to be a mystical abbess of the twelfth century^e century, Hildegard of Bingen – was in fact built in the XX^e centuryand comes under a “therapeutic construction of marketing strategists”, judge medical historian Irmgard Müller.

More generally, phytotherapy was brought back into fashion in Germany during the First World War, in a context of drug shortages, before being actively promoted by the III^e Reich for ideological reasons – the idealization of natural purity – and practical ones. The Nazi regime has favored the rise of untrained therapists to deal with the shortage of caregivers during the Second World War, linked as much to the human losses as to the exclusion of the Jews.

The opposition between nature and chemistry is also superficial: many medicines were first active ingredients found in plants, before being synthesized – like aspirin, which was found in willow bark. Finally, the age of a medicine is not a guarantee of its effectiveness or its relevance. “In China, if you have a cardiac arrest, we will not give you traditional Chinese medicine, we will put you in a stent”a modern medical device, recalls Bruno Falissard.

• What do we know about the effectiveness of naturopathy?

It really depends on the case. The effectiveness of several unconventional practices has been proven, such as that of ear manipulation (or auriculotherapy) against anxiety before surgery, hypnosis for smoking cessation or even music therapy against mental disorders. behavior linked to Alzheimer’s disease, lists Grégory Ninot in 100 alternative medicines validated by science (Belin, 2022). Ditto for natural remedies popular in naturopathy, such as ginger against nausea during pregnancy, green tea against acne, or hedgehog’s mane (mushroom) against memory problems.

Others have, on the contrary, failed to prove their effectiveness, such as shiatsu against stress, ginseng against erectile dysfunction or even fasting against cardiovascular disease. “At best, these so-called alternative medicines will entertain you, without having any effect on your health, but lightening your wallet”writes Grégory Ninot, deputy director of the Desbrest Institute of Epidemiology and Public Health at Inserm, in Montpellier.

Finally, in the majority of cases, science has not decided, quality studies being rare, costly and not always easy to set up. But public health code “prohibited from presenting as beneficial and without danger unproven treatments or therapies”.

• Are these “natural” practices safe?

Again, it depends. Whether a treatment is old or natural does not necessarily make it harmless: several patients treated according to the precepts of Ayurvedic medicine have been victims of heavy metal poisoning; acupuncture procedures have also resulted in pneumothorax (perforation of the lungs); treatments with bee venom (apitherapy) for fatal anaphylactic shocks; or even osteopathic sessions for serious vertebro-basilar accidents.

Other practices are not only useless, but rather suicidal. This is the case of fasting against cancer, “scientifically beyond absurd”, warns Mr. Ninot. The risks inherent in magical therapeutic promises are not new: a study showed that, in the sixteenth^e century, the courtesan Diane de Poitiers died of poisoning after drinking an alleged elixir of youth based on gold.

The other risk is that of sectarian drift. Three thousand doctors, two hundred “bio-decoders”eight hundred kinesiologists would be linked to the sectarian movement, according to Miviludes. Among these, the total biology of living beings, biomagnetism and biorespiration, shamanism, flower elixirs, instinctotherapy, fasting, sophrology or even yoga, all disciplines related to naturopathy. And the phenomenon is getting worse: in 2021, 47% of the reports recorded by Unadfi concerned the field of health, personal development and well-being.

• What are the risks of deviations?

Recently, several naturopathic pundits have hit the headlines for their practices, in particular the raw foodist Thierry Casasnovas, concerned by a judicial investigation for “illegal practice of medicine”, the influential nonagenarian trainer Irène Grosjean, who promotes sexual touching of minors, or more recently Eric Gandon, a former commercial converted into alternative therapies, indicted for “involuntary homicide”, “endangering the lives of others “, “abuse of weakness” and “illegal exercise of the professions of doctor and pharmacist” after the death of three participants in his intensive fasting courses. extreme cases that “do not represent modern naturopathy”, rejects Alexandra Attalauziti.

Naturopathy is also criticized for claiming to compete with so-called conventional medicine without having the skills to do so. For the Syndicate of Naturopathic Professionals, however, this is “a practice of well-being and prevention” which can be complementary, but should never replace modern medicine. But, in fact, opposition to conventional medicine is often latent, and some naturopaths spread the idea that everything natural is good, and everything chemical is bad. “It is false and dangerous, gets angry Bruno Falissard. Cancer is natural, tobacco leaves too. If we tell people that we are going to heal them with kind nature against bad chemistry, people will die. This is not rational speech. »

Conversely, in Rousseau’s universe of naturopathy, everything relating to the pharmaceutical industry is often struck with the seal of suspicion, and modern technologies (in particular radiology, chemotherapy, vaccines, etc.) considered intrusive, dangerous and contrary to the natural order of things… with the risk of treatment abandonment and loss of chance. “Some fairly honest practitioners won’t play that game, but unfortunately this type of anti-science discourse is often present, or at least underlying it”, regrets Pascale Duval. For Bruno Falissard, holding this type of speech to his client is often the red line that characterizes an irresponsible naturopath. On the side of the union, we recognize reluctance, but which is in the private sphere and should not invite itself into the cabinet.

• Are these professions sufficiently supervised?

All the experts questioned are unanimous in saying that this is not the case. While the well-being market appears to be a popular route to professional retraining, the rapid growth of these professions escapes any follow-up. “It is impossible to say how many naturopaths there are in France, whether they were trained in a school for six months or five years, etc. »laments Mr. Ninot.

A situation that Mr.^me Attalauziti, whose union has been campaigning for years for state recognition of the profession of naturopath, with recognized training, which would make it possible to move towards more regulation. “This is the whole problem of the well-being professions, we authorize the installation of self-taught people”, she notes, all without a supervisory body to drive out deviant professionals. In August 2022, the president of the Confederation of French medical unions, Franck Devulder, denounced practices “which sometimes amounts to charlatanism” and called for their strict regulation.