Health Blogger Could Be Jailed for Giving Health Advice While Unlicensed

On the web, the line between "expert" and "licensed expert" is a thin one.

In February of 2009, Steve Cooksey checked himself into a North Carolina hospital, suffering from what seemed to be complications from Type 1 diabetes. Over four days of treatment, Cooksey kept remembering the experience of his diabetic grandmother, whose life had come to involve daily insulin shots. Something, he decided, had to change. Cooksey, who had never thought much about dieting, began reading up on eating plans that would keep his insulin levels low, and eventually adopted the Paleo diet -- a low-carb, high-protein eating plan that mimics the imagined consumption habits of humans' hunter-gatherer ancestors. Cooksey eventually lost 45 pounds on the diet, and managed, even more significantly, to prevent the need for insulin treatments and other drugs. He also blogged about his experiences, sharing his meal plans and exercise regimen and, eventually, providing a support service to readers that offered one-on-one advice for a small fee.

Now, the North Carolina Board of Dietetics/Nutrition is threatening to send Cooksey to jail. Yes. Cooksey, the Board argues, is violating Chapter 90, Article 25 of the North Carolina General Statutes, which makes it a misdemeanor to "practice dietetics or nutrition" without a license. (Per the statutes, "practicing" nutrition includes "assessing the nutritional needs of individuals and groups" and "providing nutrition counseling.")

This is, on the one hand, ridiculous. Cooksey is a blogger in the classic sense: He's experiencing something, and sharing that experience with others. He's not pretending to be a doctor -- or even a dietitian. (He posts, in addition to a detailed disclaimer tab at the top of each page, a disclaimer at the bottom of each page on Diabetes-Warrior.net: "I am not a doctor, dietitian, nor nutritionist ... in fact I have no medical training of any kind.")

And yet. The case is also fascinating, because Cooksey is, in the end, giving advice. And not just advice about books to read or restaurants to eat at, but about matters that have a direct bearing on people's health. He may not be posing as a doctor, but he is posing as an expert -- licensed not by a bureaucratic board, but by experience itself. 

In that sense, the Board's case against him -- and you can see, in hand-scrawled detail, that case in this fascinating mark-up -- is not without merit. The Paleo diet may be a route to good health or a passing fad; all Cooksey knows is that, so far, it has worked for him. And that's a telling tension -- one that hints at the way the web is changing the dynamics of authority. The bureaucratic bodies that used to be charged with regulating expertise -- through education standards, through licensing, and the like -- are now competing with regular people, made expert by their regular experiences.