What Our Devotion to "Wellness Cures" Costs Us

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Today I’m feeling a little giddy to tell you about Rina Raphael’s new book, The Gospel of Wellness: Gyms Gurus, Goop and the False Promise of Self-Care. It’s part investigative journalism, part cultural critique. I’m excited because it’s one of those books that once you read it, you can’t “unsee” what you’ve learned, and you start to witness evidence of what the book is talking about all around you.

The Gospel of Wellness explains how “wellness” is not merely a vague and noble goal but is a growing $4.4 trillion industry seeking, first and foremost, to influence our spending habits and capture as much of our money as possible. And the industry’s biggest target? Women.

As I walked around last week in NYC, I passed a "clean beauty" storefront touting lymphatic drainage, IV treatments and red algae skincare. I saw subway ads for "whole food vitamins" promoting energy and “beauty support.” A close friend told me her son’s private school has rebranded PE to “wellness class.” The conference I attended on the future of work had a panelist who thought “wellness” would be the big HR focus for 2023.

Rina Raphael was once a wellness enthusiast herself, a devotee of expensive workout classes, juice bars and lecturing people about their deodorant. Then she started covering wellness as a journalist, more from a "trends" perspective than a science perspective. At first she bought what the latest influencers or companies were selling, but as she started to look into so many of the claims that were being touted, and how many were actually refuted by experts, like food scientists, toxicologists, physiologists and medical doctors, she started taking a much more nuanced look at what was for sale.

I’m gonna be honest that I feel self-conscious that this newsletter may not be received well by some, or seen as a personal attack, which isn’t my intention. Perhaps you work in the wellness space and have personally witnessed alternative treatments help people. Perhaps bee pollen cream was the only thing that actually cleared up your eczema. Whatever your personal relationship is with wellness, this newsletter and Rina’s book isn’t meant to call out individual consumers or personal choices, it’s more to look at problems with systems that we all interact with.

One of my big takeaways from this excellent book (that I am honored to have blurbed!) is that the rise of wellness culture has grown in response to very real problems, many acutely felt by moms. I have so much to say about this, especially related to capitalist angles, that I’m actually going to write more about this in next week’s newsletter. For today I’m going to focus on wellness’ intersection with traditional western medicine.

“Marketing has a far stronger power than scientific proof”

“Marketing has a far stronger power than scientific proof,” Rina writes, and “wellness propaganda” she posits, unfortunately isn’t a benign helpmate but instead preys on legitimate, deep flaws within the medical establishment to profit off of women at vulnerable moments in their lives.

I know that’s quite a provocative angle, and one I can’t stop thinking about and tying to some of my own personal experiences.

While I had different flirtations with “wellness” culture in my 20s, like buying organic foods when possible, or trying a gluten-free diet to address digestive issues, I didn’t really let the full power of the wellness mindset influence me until an important health turning point in my life – I started trying to get pregnant. As a healthy 29-year-old I wasn’t too uptight about it at first, but when the one-year mark rolled around without a positive pregnancy test, I started to get a bit panicked that something was seriously wrong. I had to change doctors, and I visited a grumpy gynecologist, who looked at my chart, saw my age and (at least in my memory,) rolled her eyes and said, “You’re only 30. I’m sure it will happen soon,” as if age could be the only factor affecting fertility. She reluctantly agreed to some additional tests that I advocated for based on my own google doctoring. But I left that appointment feeling like I didn’t want to leave something so important up to doctors who ran two hours late and then gave you an indifferent 15 minutes. I started seeking out “alternative” and complementary practitioners. I found a “holistic” MD who did tons of bloodwork and would talk to me for an hour in his purple steampunk-themed office about all of my health history and recommended some “natural” over-the-counter thyroid supplement he sold in his office and a special kind of b-12 I needed to get from a compounding pharmacy shipped from New Jersey. I spent over $1000 on a package from a nutritionist who used kinesiology practices to determine the appropriate diet I should be eating for fertility. I recall it involved a lot of warming vegetable soups and turkey, and also some over-the-counter progesterone cream. All of this was expensive, for sure, but isn’t something so important worth spending money on? As a well-paid NYC professional, it felt like a necessary investment.

After about two months of going all in on “wellness” for fertility, I got pregnant. I absolutely cannot say if any of these wellness changes contributed to making it happen, but I quickly pulled back from these new health advisors. I suffered from serious morning sickness, and I found the nutritionist's “coaching” check-ins sternly suggesting what I should be eating when I could only keep rice cakes and ginger ale down to be so upsetting, I canceled our remaining sessions. We made a last visit to the steampunk doctor’s office and Travis and I told him I was pregnant. “Congratulations! It’s a girl,” he declared, like he was some kind of oracle. We later found out it was a boy. I managed to find a new OB-GYN who I really liked, who was more expensive and out-of-network but let me text her questions (!!!) and I decided I trusted her enough to follow her advice and didn’t want lots of conflicting information from other practitioners and Doctor Google.

That mostly ended my intensive time and money investment in the complementary medicine space. I didn’t have any trouble getting pregnant with my subsequent pregnancies without any special supplements, interventions or diet changes. But Rina’s book has me thinking about this experience in a totally different light. “Women’s health conditions are under-researched and underfunded, so of course sometimes your doctor doesn’t know what’s going on,” she explains. This can include fertility, other reproductive conditions like fibroids or endometriosis, pain conditions or hard-to-diagnose autoimmune diseases. Add all of this to people’s very legitimate experiences with medical racism or having their concerns completely dismissed while being rushed out the door under a for-profit medical system, it’s no wonder women are such a target for those touting “wellness” alternatives. But what bothers me is that too often “wellness” solutions are expensive and target us where and when we are most vulnerable, like when you are desperate to have a baby, or desperate to be out of pain, or desperate for someone to legitimize your very real symptoms. Sometimes there is absolutely no actual evidence beyond some anecdotal stories to back up the claims of practitioners or the companies selling products.

But, again, here’s the chicken and egg part... sometimes some of these things do work for some people, or appear to. Maybe it's the placebo effect, or maybe you can’t say one way or the other, like in my case. And there isn’t always lots of peer-reviewed studies on new solutions for old problems, meaning there could be things out there that help people, we just don’t have the data on it. It’s thorny, but it isn’t harmless. I was shocked to learn from the book that a 2018 study in JAMA Oncology “found that cancer patients who depended on complementary medicine like herbs, vitamins and homeopathy, where more likely to refuse other kinds of conventional treatments, such as chemotherapy and surgery, and therefore had a twofold higher risk of dying compared to those who never sought complementary care.” (A great episode on this exact topic just came out on Death, Sex and Money. I recommend listening.)

There are concrete ways to address this. Investing more in women’s health research, changing some of our medical system models that rush healthcare and make it hard to access and training clinicians to really listen to women’s complaints and to take them seriously, especially around pain, could all be systemic solutions that make the appeal of “wellness cures” less powerful. But obviously, none of these things are as easy as trying a well-marketed herbal supplement.

Rina has a story in the book of a marketing executive named Naomi suffering from rheumatoid arthritis and ulcerative colitis, both with miserable and debilitating symptoms. A holistic doctor urged her to cut out gluten, dairy and sugar, and it was the first breakthrough for her with something that actually improved her symptoms. Her traditional doctor dismissed her improvements, claiming the diet changes couldn’t really be working, even though Naomi was feeling better. Over the next few years, because of her experience with dismissive doctors, she became more enmeshed in the “wellness world,” avoiding western medicine except when she has surgical needs. She focuses on “whole, gluten-free foods and juicing” to stay healthy, and when she gets sick, she heads straight to an energy healer.

“If we don’t overhaul certain practices and certain conditioning within the medical industry, we are going to continue to bleed women to pseudoscience," Rina told me in an interview. And let’s be honest, there are not very many steps from wellness as a response to medical skepticism to becoming a full-blown anti-vaxxer.

“If we don’t overhaul certain practices and certain conditioning within the medical industry, we are going to continue to bleed women to pseudoscience."

My own experience lines up with this. Ultimately what keeps me away from most medical “wellness” these days is relatively good health and getting great traditional medical care, which sadly in this country is a rare privilege. Since moving to Durham, I’ve been extremely happy with my doctors who are all in-network and all take my insurance. I didn’t need to seek out an alternative therapy for pregnancy back pain when I had the twins because my doctor took my complaint seriously and suggested a specific kind of belly band I’d never heard of that actually helped a lot. I didn’t desperately take a flier on a $66 vaginal jade egg from Goop for my pelvic floor problems after I had my twins because I actually got in to see a great pelvic floor PT who solved my issues. How many women even know about pelvic floor physical therapy for post-birth issues, much less have insurance that actually covers enough sessions? For my postpartum mental health issues, I’ve found practitioners who diagnosed me quickly and correctly and prescribed low-cost SSRIs that work pretty darn great. I got the support I needed and therefore didn't need to seek out micro-dosing/reiki/placenta smoothies/fill in the blank vitamin etc etc etc.

There are no quick fixes to these problems, but being aware of them is a first step. Next week I’m going to talk about how all of the pressures of capitalism conspire to make “wellness” so appealing, and how we can be more savvy consumers and citizens about all of this. I’ll also get into some of the socio-economic issues around wellness, as its pursuit is out of reach for so many.

Buy The Gospel of Wellness at Bookshop.org.

This week's member thread: I'll let you all share your thoughts on some wellness themes after next week's newsletter, but in the meantime, I'm curious to hear, how you all are handling "back to normal" levels of social engagement? Are you feeling overwhelmed by commitments? Do you feel like you signed your kids up for too many things after some years of low/no activities? Are you feeling left out because you have different precaution standards than others in your community? Are you delighting in a full calendar? I want to hear from you. Members, check your inboxes tomorrow at noon for the prompt.  And if you want in on this fun, become a member.

What I’m Listening to: I loved this through-provoking story from Invisibilia about reframing abortion pills as “period pills” to get around social stigma and legal hurdles in getting women the reproductive care they need.

Thought you’d enjoy: I was a guest on the wonderful podcast, No One is Coming to Save Us. Double Shift podcast listeners are in for a treat as Gloria Rivera and I hit it off swimmingly.

Time-sensitive! Free HEPA air purifiers for schools in the U.S. Double Shift member Kayla Lengyel is part of an effort to provide free HEPA air purifiers to all schools in Utah, but this program can happen in your state, too. Most states are not taking full advantage of this grant to improve indoor air for our children. The grant expires in July 2023. Please reach out to your state's health department (except Iowa and Florida who opted out of the grant), and ask them to get in touch with Kayla and Jessica Kjar (jkjar@utah.gov; klengyel@utah.gov) for information on how to implement this program. Don't delay!

Double Shifters Unite: I got to hang out IRL last week at Charter’s Future of Work summit and get to see Double Shift folk hero Erin Grau, along with Double Shift listener/member/advisor/friend Emily Goligoski. They just hired a third Double Shift member for their amazing startup they connected with on one of our members-only hangouts. HOW COOL IS THAT!?!

Join us for our next members-only hangout! This month's topic will be a casual "Ask Me Anything" with moi, Katherine. Is anyone else's fall schedule feeling kinda overloaded? Let's decompress before the sugar high of Halloween weekend and have the relaxed feminist mom hangout we all need and deserve. We can talk all things Double Shift newsletter, you can share a current quandary, you can ASK EACH OTHER things, you can give me feedback on the membership program or things you'd like me to cover....you can ask me what kind of car I drive (this was a real question from a previous AMA) or we can just shoot the shit. Come on, let's hang out. OCT 28th at 2pm EST. Members will also get an email reminder and a google calendar invite. If you want in on this kind of fun, don't forget to join!