آیا بازاریابی چندسطحی از مکمل های غذایی یک عمل قانونی و اخلاقی است؟ Is multi-level marketing of nutrition supplements a legal and an ethical practice?

1. Introduction Multi-level marketing (MLM) also known as network marketing is a form of direct sales in which independent distributors sell products, usually in their customers’ home, by telephone or through the internet [1]. In this practice, the distributors (or sellers) are rewarded not just for the sales they generate personally, but also for the sales generated by the people they recruit. In other words, sellers are rewarded economically down through multiple levels of recruits. The MLM distributors become a non-salaried workforce, which do not only sell the company’s products, but also encourage others to join the company as a distributor. In 2015, more than 103.3 million people around the world worked for MLMs, creating a retail turnover of approximately 183.7 billion US dollars [2]. ‘Wellness’ is the second most popular niche in the MLM industry, after cosmetics and personal care products only. This category represents 35% of sales among all products in 2016 and includes dietary supplements, weight management products and sports products (Table 1) [3]. Among the top 20 MLM companies by global revenue in 2017, eleven companies are devoted to selling ‘wellness’ products (Table 2) [4]. Some companies such as Herbalife and Usana are specialized in dietary supplements and weight control, other enterprises sell dietary supplements as well as a wide range of products such as disinfectant cleaners, skincare, make-up, air purifiers and cookware. On their official websites, these companies claim a wide range of benefits to nutritional status and health. In fact, companies are responding to people’s deluded demands for health and fitness maximization, anti-aging solutions, immunity improvement, boost of metabolism, weight loss, vitality or organs ‘detoxification’. Moreover, some distributors make illegal claims, for example, that nutritional supplements can cure all sorts of diseases or illnesses. In 2016, the watchdog organization Truth in Advertising investigated the 62 companies selling nutrition supplements that were members of the Direct Selling Organization. They found that 60 of them (97%) had illegally claimed or were claiming e either directly or through their distributors e that their products could treat, cure, prevent, alleviate the symptoms of, or reduce the risk of developing diseases or disorders [5]. They found more than 2000 problematic product claims made by those companies. The list can be consulted at: https://www. truthinadvertising.org/mlm-health-claims-database/. Consequently, the lack of truthfulness within the MLM strategies has become particularly problematic. We must also ask whether this marketing strategy for nutrition supplements is legal and ethical in and of itself? Can physicians and dieticians legitimately become distributors?