Watching Netflix’s Apple Cider Vinegar can feel like you’ve ventured into the pit of a misinformation cesspool and are oscillating between horror, disgust, and bewilderment the entire time.
The series tells the story of real-life health influencer Belle Gibson (played by Kaitlyn Dever), the Australian sensation who in 2015 confirmed that she had faked having brain cancer and that she had cured it through alternative medicine in order to achieve celebrity status. The true story is nightmarish, in part because Gibson’s practice of building a massive following based on lies that endangered everyone but herself is far from an anomaly, especially in the influencer space.
Apple Cider Vinegar frustratingly elides some of the nuances that made Gibson’s ascension possible, including her whiteness, race- and gender-based inequities in medicine that can lead patients to mistrust doctors, and a frightening disinterest in the truth amid our social media age. There’s been a widespread rise in misinformation from health and wellness influencers. And Apple Cider Vinegar is far from the first instance of people turning to other remedies to try and cure cancer. Liana Werner-Gray, who advocates for “natural health” remedies, wrote a bestselling 2014 book titled The Earth Diet, about how she overcame cancer by going on “a massive detox plan.”
Fake truths like those are a particular source of concern for many medical professionals. Gail Cresci, a dietitian and researcher at Cleveland Clinic, says that people often come to her reciting whatever a health influencer has said with little regard for facts. Take, for instance, an apple cider vinegar antidote that’s portrayed in the Netflix series. While Cresci, who offers advice on product development as a member of Bragg’s Scientific Advisory Board, considers the benefits of apple cider vinegar “wonderfully diverse,” she quickly adds, “But can it cure cancer? No.”
“I teach medical students, and I hear how they’re even talking about things that are just on social media,” she says. “They listen to an influencer. I’m like, ‘There’s no evidence for that.’”
Why people are drawn to wellness influencers
Apple Cider Vinegar reflects the clout health influencers have and the stark medical reality facing many patients. In one episode, a sarcoma patient named Milla (played by Alycia Debnam-Carey and partly inspired by the real-life Jessica Ainscough) dismisses her doctors’ recommendations to amputate her arm in favor of so-called cures like apple cider vinegar that she learned about from Gibson’s popular social media account.
It isn’t until Milla’s illness progresses that she desperately returns to her doctor seeking his help. But by then, it’s too late. She dies at age 30.
“I think a lot of patients, when you get that early diagnosis, don’t feel pain,” says Cresci. “I deal with this all the time. People who have early pre-diabetes or hypertension, they don’t really feel it until it gets more progressed. And then they start to feel what’s going on.”
But Cresci says she understands why a patient might seek out advice from wellness influencers, particularly in the cancer space. They may be unvetted but they often offer solutions that are more recognizable to patients—at-home remedies like apple cider vinegar instead of an expensive medication, for example—and the temptation to believe it can work is hard for many to resist. “When you’re dealing with medicine, it’s prescribed to you and you may not fully understand it,” she says. Cresci adds that the severe side effects and uncertain success rates of cancer treatments can make people feel like “there’s nothing really left for them.”
“So, they’re grabbing for anything. The person has control over what’s going on.”
That lack of information and familiarity feeds into a fundamental issue patients feel toward their doctors: a lack of trust. Even Cresci has experienced how difficult that can be. She recalls visiting a doctor after suffering an injury as an endurance athlete and not feeling heard. “They don’t understand someone who likes to run all the time and they say, ‘You can never run again,’” she said. “It’s like, ‘Well, that doesn’t fit my lifestyle.’ So, you’re going to go look for another opinion, someone who is going to tell you what you want to hear.”
That second opinion is no longer always coming from another doctor or trusted professional, Cresci says.
For one thing, some patients feel far too rushed at the doctor’s office. “Now, doctors don’t have as much time to spend with their patients,” she says. A backlog of patients sitting in a doctor’s waiting room has contributed to that issue. Understaffed medical offices are another. “A lot of times patients are rushed through the system or the doctor doesn’t really know how to communicate to the level that the patient understands what they’re actually trying to convey to them.”
That’s a problem that’s only compounded by the racial and gender disparities that have long plagued women across the board, but particularly Black and brown people. A study just last year suggested that female patients are more likely to die when they have a male and not female doctor. Meanwhile, NPR reported that Black Americans typically receive inferior treatment than their counterparts.
Apple Cider Vinegar doesn’t acknowledge any of this. The series centers a pervasively white online wellness community that includes both influencers and their followers, but that world is so much bigger and more complex. And considering the experiences of many women and other nonwhite people at the doctor’s office, it’s not hard to imagine that some might actually be choosing to heed the advice of influencers who look more like them and that they might be able to relate to. “I think that happens quite often,” says Cresci. She works to accommodate this reality by conducting outreach and talking about it with her students. “It’s part of the curriculum for medical students to learn about these different social determinants of health and how to communicate with patients and how to do good interviews with patients.”
But that has also come with challenges. For example, Cresci is the principal investigator for a study looking into why Black Americans have a higher rate of colon cancer. While it’s often wrongfully presumed that that’s due to not seeking access to preventative care, her study is looking into diet and microbiome as driving factors. But it doesn’t have enough Black enrollees.
“We had a couple women who enrolled come in that said, ‘Oh, you’re not going to get any men to enroll,’” said Cresci. “They said, ‘Unless it’s directly going to benefit them, they’re not going to participate.’ A lot of it is that trust issue and understanding.”
How influencers exploit a lack of trust—and how doctors can recoup it
Apple Cider Vinegar mirrors the reality that the wellness influencer space has several issues too when it comes to trust and understanding. The fact that Gibson was able to build such a large and dedicated following based on so many lies shows just how desperate people who believed her were for some kind of answer—and in some cases, how naive they were.
“She just appealed to people,” Cresci said. “She was a good actress. Throughout the story, her mom was saying that she did it for attention. She was really good about being able to turn her tears on.”
Anyone who’s been paying even a little attention to how white female fragility has been weaponized throughout history knows that fake tears are crucial to garnering sympathy and, subsequently, belief. In a pivotal moment in Apple Cider Vinegar, Belle throws herself onto the floor at a party in her own home and pretends to have a seizure right before her cover is about to be blown. Manipulating people’s real concern and pity was critical to Belle’s game. For medical professionals, dealing with their patients being dangerously manipulated or knowing they are seeking the guidance of influencers is a tightrope situation. Cresci tries to assess each individual patient’s learning and communication style, understanding that they’ve come to her to see if improving their diet could help them manage a health issue.
“I see people with a lot of gastrointestinal issues. And diet is known to be one way to help manage that. So, they’ll tell me they’re doing something and then I’ll point out to them why this is probably not the best thing to do.”
Cresci describes that as an evidence-based approach.
“Once they understand what’s going on with them,” she says, “then they can hopefully understand why what they’re doing is counterproductive.”
When patients bring up wellness influencers with her, Cresci advises they research the person offering health advice. “Look at their credentials,” Cresci suggests. “Anyone can call themselves a nutritionist. That’s not an official certified license.” Registered dietitians, on the other hand, require four years of undergraduate work, two years for a master’s degree program, one-plus year of an internship, months of preparing for and taking the CDR exam, and extra time on a coordinated degree program and obtaining a license in their state, if applicable.
Cresci’s advice might sound basic, but, as she says, anybody could write a book and claim to be a nutritionist. “Even if someone says they’re a medical doctor, they may be trying to sell their agenda,” Cresci said. “It may not be evidence-based, or they take a bit of truth and expand upon it.”
The patient or individual is then trying to do the research of a medical professional, and largely on social media where there are no checks and balances—and all kinds of supplements are advertised and sold without actual proof that they work. The Food and Drug Administration regulates the safety of supplements as food, not as drugs. “A lot out there is not being monitored,” says Cresci. “People can just buy them off the shelf. There’s no gatekeeper there.”
She adds: “It’s scary because, what can you trust?”
That question could be asked of both influencers and doctors.
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