A paper describing the death of a young woman trying to lose weight by consuming Herbalife® products has been withdrawn after the company threatened to sue the journal.
Herbalife and criticism
Herbalife Nutrition develops and sells plant-based dietary supplements for weight loss. According to Wikipedia, 58 percent of their shakes, protein bars, teas, and other products are made in company-owned manufacturing facilities in the US and China, with the remainder manufactured by third-party contractors.
In addition the company has been criticized for the accuracy of their claims about health benefits, and also for the presence of lead and other toxic ingredients in several of their products. The Herbalife Wikipedia page lists hospitals all over the world that have reported liver damage in patients using Herbalife products.
Philips CA et al. REMOVED: Slimming to the Death: Herbalife®-Associated Fatal Acute Liver Failure-Heavy Metals, Toxic Compounds, Bacterial Contaminants and Psychotropic Agents in Products Sold in India – J Clin Exp Hepatol. Mar-Apr 2019;9(2):268-272. doi: 10.1016/j.jceh.2018.08.002.
The paper — now removed by the journal — describes a case report of a young woman in India with a BMI of 32.1 (obese) who consumed Herbalife slimming products. According to the now-removed paper, India is the fastest growing market for Herbalife products.
The woman bought the products at a nutritional club that was later shut down by the Government of Kerala. After 2 months of using the products, she developed jaundice, and was admitted to the hospital where she was diagnosed with liver necrosis.
Unfortunately the young woman died while on the waiting list for a liver transplant.
Herbalife analysis in the now-removed paper
Since the authors were unable to obtain the remainder of the slimming products from the family for a toxicology analysis, they bought similar Herbalife products from the same seller in Kerala, India, and from online stores. In total, eight products were subjected to gas chromatography, mass spectroscopy, and other methods for chemical and microbial analysis.
The chemical analysis detected heavy metals, including cadmium, mercury, and lead, as well as other toxic chemicals in all eight products. In addition, 16S rRNA gene sequencing revealed a range of bacterial contaminants in most of the products.
The authors describe similar case reports of other Herbalife-using subjects with hepatotoxicity, and raise the possibility that the heavy metals and bacterial contamination of these unregulated Herbalife products — maybe in combination with unknown toxic phytochemical constituents — could have contributed to these morbidities.
Criticism and legal threats by the company
As per a Twitter thread [archived] by first author Cyriac Abby Philips (@drabbyphilips), several professors working with/at Herbalife or associated companies then requested that the journal should retract the paper because of a lack of evidence.
The authors were asked by the editors to write a scientific rebuttal to the concerns. Both the Herbalife concerns and the rebuttal were published in the journal — but subsequently removed [PDF copy].
Next, a law firm threatened legal action, upon which the journal decided to retract the paper with no clear scientific reason.
Complete removal of the paper
In a breach of COPE guidelines, and despite the fact that the article had been assigned an issue number ( Clin Exp Hepatol. Mar-Apr 2019;9(2):268-272), the original paper was completely removed by the journal.
COPE guidelines state that the original paper should remain available, but be clearly marked as retracted. Instead, publisher Elsevier removed the paper, and replaced it with a short retraction notice:
“This article, which was published in the March-April 2019 issue of the Journal of Clinical and Experimental Hepatology (“JCEH”), has been removed at the request of the JCEH’s Editor-in-Chief and the Indian National Association for the Study of the Liver (INASL). INASL and JCEH no longer support the content of and conclusions drawn in the article because the scientific methodology, analysis and interpretation of data underlying the article were insufficient for the conclusions drawn, and, with its removal, the article can no longer be relied upon.“
Money wins, science loses
This case is particularly ironic because I have raised scientific concerns about dozens of other Elsevier papers with severe image problems or flawed non-randomized hydroxychloroquine results. None of these concerns have been addressed, and the papers have not been touched.
But as soon as powerful companies threaten to sue a publisher because they are unhappy about a paper, suddenly things get retracted — with no scientific reason.
This is just wrong. Science should be about finding the truth.
I hope the authors can find a publishing house with more courage that will republish their paper.
Update December 22, 2020: Herbalife responds
From an email that Herbalife’s Julian Cacchioli, Vice President, Corporate Affairs, EMEA & India sent me today:
“We were made aware of the above post yesterday – incorrectly suggesting that the decision by Elsevier to remove the original JCEH article was made for non-scientific reasons – which we believe is neither justified nor accurate. It is disappointing that you did not contact Herbalife Nutrition for any comment on this.
The claims made in Dr. Philips’ et al original article were false and unsubstantiated. According to Elsevier’s Policy on Article Withdrawal, ‘in an extremely limited number of cases, … an article [may be removed] from the online database where the article is clearly defamatory, or infringes others’ legal rights, or where the article is, or we have good reason to expect it will be, the subject of a court order, or where the article, if acted upon, might pose a serious health risk.’ The original article contained numerous deficiencies, inappropriate analytical methodologies and incomplete investigative protocols. We presented to the publisher a comprehensive analysis of product testing by three independent international laboratories that undermined the findings of the article. Based on those deficiencies the publisher, Elsevier, took the extraordinary step of removing the article at the request of the Journal of Clinical and Experimental Hepatology (“JCEH”) and the Indian National Association for the Study of the Liver (INASL), stating they ‘no longer support the content of and conclusions drawn in the article because the scientific methodology, analysis and interpretation of data underlying the article were insufficient for the conclusions drawn.’
I am sure you will appreciate the importance of presenting a full and accurate picture, so would ask that you immediately update your site to reflect the above facts. If you have any questions, feel free to contact me.“
Note Elisabeth Bik: The wording provided by Herbalife actually DOES suggest the paper got retracted for non-scientific reasons, so I am not sure how my writing was incorrect.