Post Exertional Malaise (PEM), is the hallmark symptom of ME which means patients deteriorate following even minor activity. Exercise makes patients worse by definition. Pulitzer prize winner Ed Yong gives a good description of PEM.
https://archive.li/2023.07.27-111449/https://www.theatlantic.com/health/archive/2023/07/chronic-fatigue-long-covid-symptoms/674834/… The article opposing NICE was largely written by Peter White lead author of the PACE trial. NICE graded all research (inc PACE) as low or very low quality. Opposition is from a minority with close links to the research or researchers. All charities support the guideline.
There are major issues with the article (note: its an article defending research that NICE graded as poor quality).
Professor Brian Hughes
@Brian Hughes has written extensively on the subject. His summary about the NICE guideline is a good introduction.
http://thesciencebit.net/2021/08/15/the-new-nice-guideline-for-me-cfs-ten-questions-answered/…This rapid response highlights some of the main issues with the article. For example referencing obsolete CDC diagnostic criteria from 1994, which doesn't include PEM (the hallmark of ME).
https://jnnp.bmj.com/content/early/2023/07/09/jnnp-2022-330463… George Monbiot has also written about issues with Graded Exercise and CBT research for ME. His Twitter thread has more detail about how the "media establishment closed ranks around bad science"
https://twitter.com/GeorgeMonbiot/status/1382258404215914498?t=r2gLIDw-vNc-Ie-XYPd7QA&s=19…
His article is also worth a read.
https://www.theguardian.com/commentisfree/2021/apr/14/super-spreading-long-covid-professor-press-coverage?CMP=Share_AndroidApp_Other…The NIH, The Agency for Healthcare Research and Quality, Cochrane and NICE have all raised serious concerns with the diagnostic criteria used in research.
Patients that showed benefit in research might not have had ME.
Patients and advocates are opposed to the treatments because they don't work, the research is flawed and there are high reports of harm. ME does not have a psychological component so a psychological label is not appropriate.
In 2015 The IOM report concluded that ME "is a medical-not a psychiatric or psychological — illness" . 15 experts reviewed over 10, 000 peer reviewed studies to produce the report which cost $1M.
https://me-pedia.org/wiki/Institute_of_Medicine_report#:~:text=Among%20its%20key%20findings%20were,million%20Americans%20suffer%20from%20myalgic…Viewing
#MECFS as a condition curable through attitude and effort, has caused a lot of harm. Its stigmatizing, It wrongly suggests patients can cure themselves by their own effort and patients often get blamed for not helping themselves.
Full Segment from the This Week Unwrapped podcast that covers
#MECFS and the Governments new delivery plan.
https://youtu.be/efNFekjw57g