Why Is Wellness So Confusing?
A peek down the rabbit hole
I left no hot stone unturned in my wellness journey. This journey included acupuncture needles in my face, the furrowed brows of countless doctors, dizzy spells from keto, and nontrivial losses of hard-earned cash. It also included the discovery of The Documentaries.
The Documentaries is the term I use to refer to the Netflix documentaries that have had a seemingly unusually high success rate of converting people to veganism. (Before you ask, no, I don’t believe you must adopt a 100% vegan diet to achieve great health, although I am plant-based myself.) I was just looking for more information on plant-based eating. I ended up learning a lot more than I bargained for.
What the Health, Fat, Sick, and Nearly Dead, The Invisible Vegan, and Forks Over Knives were a few of these documentaries. They covered a lot on food and health in the US: why we eat the foods we eat, food systems and animal welfare, and healthcare. They all started to paint a picture of why so many Americans, like myself, couldn’t become healthy or reach an optimal weight no matter how hard we tried. All this time, I’d internalized my health conditions as personal failures or bad genetic luck. Questions I hadn’t asked were, why is it so difficult to understand how to be healthy on a day-to-day basis? Why are people touting so many different dietary theories and wellness practices?
The deeper I got into wellness and, crucially, the more success I had in reversing my own chronic health conditions, the better I was able to answer why information on health and wellness is so confusing.
This is a dense topic, but we can first look at the industries that largely shape our health and the information around wellness, what their incentives are, and then how consumers perceive health and wellness information. Altogether, these explain why there’s so much confusion.
One of the largest determinants of health is the food we eat. Let’s take a look at the entities that produce most of the food Americans consume: Big Food and Big Agriculture (Big Ag). Big Food corporations maximize profits by selling food that’s both cheap and addictive. Unfortunately, cheap and addictive food is made with substances that are bad for human health. Have you ever wondered what makes Doritos so delicious?
Chemicals like stabilizers, preservatives, food dyes, and refined fats, sugars, and salts are linked to chronic conditions like obesity, high blood pressure and cholesterol, and cancer. So, in acting in their best interests, food corporations create a negative externality of chronic disease in the public.
In Big Ag, we see a similar problem: farmers are incentivized to produce crops and livestock that are bad for human health. Namely, commercial meat and dairy, wheat, soy, and corn are all subsidized by the Department of Agriculture, meaning farmers make higher profits cultivating these foods. In fact, farmers will actually be disqualified from direct subsidies by growing fruits and vegetables. This partially explains why salad costs more than a Big Mac.
Wheat, soy, and corn are not only low-nutrient foods, but they’re mostly either processed in a way that’s harmful to human health, or used to feed livestock. For example, high-fructose corn syrup, which is derived from corn, is pumped into processed snacks, desserts, and beverages and probably plays a big role in the obesity epidemic. Corn also accounts for 95% of feed grain in the US. Commercial meat and dairy products have been shown to increase the risk of cancer and other chronic diseases and, importantly, these detrimental health impacts are outsized in BIPOC communities. Yet, every year, over $20 billion in taxpayer money goes to subsidies that create the widespread production of these foods.
So, two things at play here: 1. Big Food and Big Ag producing the majority of food that’s available in the US, and 2. Both industries being incentivized to produce food that’s mostly harmful to human health. When the majority of food options available are highly-processed, chemical-laden, or filled with high-fructose corn syrup, it’s difficult to understand what’s a healthy choice. It’s a far cry from previous generations that didn’t have to worry about checking ingredient lists, or our ancestors who ate abundant produce grown locally in healthy soil and hunted steroid-free, antibiotic-free game.
Although food has one of greatest biggest impacts on our health, the food industry is not necessarily in the business of health. What about industries and sectors that are?
Naturally, we look to the healthcare system as the authoritative field on health. While it’s exceptional in handling acute illness, our healthcare system has failed to solve for chronic illness. Why is this the case? For one, doctors aren’t properly trained to advise patients on diet and lifestyle habits, typically the root cause of chronic illness. Instead, they have to deal with time constraints while seeing their patients (on average, eighteen minutes per visit) and Big Pharma’s influence on the treatments they prescribe. These factors usually result in band-aid solutions: doctors will often manage symptoms with pills, instead of treating or investigating the root causes of chronic conditions. As physician Brandon Colby explains, the current healthcare system incentivizes doctors to treat disease once it manifests, instead of focusing on preventative treatment or promoting wellness. This all points to another reason why wellness is so confusing: the designated health experts we traditionally rely on aren’t well-trained in or even incentivized to teach proper wellness information like optimal diet and good lifestyle habits.
Beyond patient care, there are also incongruent incentives in the public health space that result in health misinformation. The most prominent reference for public nutritional information, the food pyramid, was created on the grounds of shaky science and industry lobbying efforts. Some of these efforts resulted in quadrupling the recommended servings of grains from the original recommendation of 2-3 servings and deeming grains nutritionally equivalent to fruits and vegetables. The meat and dairy industries’ stranglehold on nutritional guidelines has effectively censored words like “eat less” when referring to their products.
The food pyramid was released in the 1990s, but conflicts of interest still exist in public dietary advisory. Nineteen out of the twenty advisors on the committee for the 2020-2025 U.S. Dietary Guidelines for Americans had conflicts of interest by having connections with pharmaceutical companies and Big Food corporations.
We’ve laid out the landscape: we see how the food and healthcare systems are incentivized to create systems that maximize profits at the expense of our health. How do consumers act in this landscape?
Generally, people care about their health and want to be healthy, especially post-pandemic. It’s difficult though, since the perception of what’s health-promoting and what’s not has been skewed by powerful marketing efforts and a general culture of calm-mongering (read on).
Big Food and Big Ag largely produce unhealthy foods but need to convince consumers otherwise. Some tactics used by these industries include manipulating scientific studies, lobbying public health policies to protect their interests, and even engaging in anticompetitive behavior. Would you ever think that the “Got Milk?” ads from the 90’s and early 2000’s or Dominos’s extra-cheesy pizzas were government-led campaigns to help increase dairy sales? Dairy has been linked to an increased risk of cancer and is the primary source of saturated fat in the American diet. Yet, prevailing culture will tell you that dairy is healthy for adult humans and that we need it for strong bones — an unfounded claim.
In his book Hooked, investigative journalist and food industry expert Michael Moss makes the argument that food corporations have engineered foods to hijack the reward circuitry in our brains, which has helped fuel the chronic disease and obesity epidemics. In a NYT article, he says, “I’ve been crawling through the underbelly of the processed food industry for 10 years and I continue to be stunned by the depths of the deviousness of their strategy to not just tap into our basic instincts, but to exploit our attempts to gain control of our habits.”
Healthwashing is a prevalent form of marketing used by Big Food. Taglines like “fat-free,” “low-sugar,” and “heart healthy” are all used to make consumers think they’re making healthy choices, when they might actually be buying inflammatory, sugary, and chemical-laden foods. I remember thinking I was making a healthy choice years ago by drinking Special K protein shakes, which contain gums, artificial sweeteners, and canola oil. Like many, I was duped by the marketing and branding (Special K? The same brand that makes grandma’s cereal and campaigns for breast cancer awareness? They can’t possibly be making unhealthy products!). Here are some examples of healthwashing:
More insidious than marketing tactics is a general culture of calm-mongering when it comes to diet and health. I came across the term “calm-mongering” in Jessica DeFino’s newsletter, and I think there are few better situations it applies to than in health and wellness. DeFino writes, “As Evolved By Nature put it, ‘Calm-mongering can be just as unproductive as fear-mongering. Everybody likes to be told not to worry. But “everything is fine” is just as much a marketing tactic as “fear for your life”.’ The way I see it, the truth lies in the space between fear-mongering and calm-mongering. Sometimes the truth is upsetting and scary. Sometimes the truth is light and joyful. We can’t discount facts just because they cause fear, and we can’t celebrate lies just because they make us feel better.” If it’s not clear by now, we’re up against a lot, and the data reflects that: a shocking eighty-eight percent of Americans are metabolically unhealthy.
Calm-mongering can look like the normalization of menstrual pain and stomach issues, or dietitians saying we shouldn’t worry about chemicals in our food or that seed oils are healthy. A painful period during a stressful month, or some fried food here and there aren’t the end of the world. But, month after month, and year after year, buying into seemingly innocent habits propagated by Big Food and ignored by your doctor can lead to compromised health. After all, it takes years of improper diet and lifestyle choices for disease to manifest. This is why, in the realm of health and wellness, calm-mongering is especially dangerous — because it can result in the destruction of the most valuable asset you’ll ever own: your body.
Once we depart from industry incentives, marketing schemes, and consumer perception of health and wellness information, we’re basically left with a slew of dietitians, nutritionists, doctors, entrepreneurs, and wellness practitioners who tout different dietary theories, wellness practices, and products. Collectively, they make up the “health and wellness” industry. In a way, this space exists in direct response to the negative externalities created by Big Food/Big Ag and inadequacies in our current healthcare system. It also contributes to the onslaught of wellness confusion.
This is where I found myself after fruitless doctor visits and nearly two decades of rarely ever thinking about the foods I eat or the general health of my body. In other words, I entered this space because I had to — I wasn’t looking to emulate the “that girl” aesthetic or find the most powerful and elusive “superfood.” I just wanted to feel normal: I wanted to live without digestive issues, not have to worry about getting heart palpitations when I’m out in public, and not routinely miss work because of debilitating menstrual pain.
In reversing my chronic conditions, it became clear to me that once you understand the framework of health and what works for your body, navigating through different diets, services, and products isn’t all that complicated. You learn how to cut out the noise. Wellness is found in minimally processed foods, in therapies and products that enhance the body’s natural functions (as opposed to manipulate them), and in calm simplicity. Like Michael Pollan distilled, “Eat food, mostly plants, not too much.”