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The “Wellness” industry has an Orwellian name – the name itself is propaganda and flies in the face of reality. In fact, there is no reason to believe that the wellness industry improves anyone’s health. It is really a snake-oil industry selling lies and misinformation, and largely targeting a vulnerable population – women. Women are vulnerable in this context only because they have been the target of decades of cultural conditioning.

A recent commentary by Jessica Knoll in The New York Times makes a compelling case for this conditioning. She makes the argument, largely from personal experience, that “wellness” is mostly a euphemism for being thin. Women are disproportionately shamed for their bodies, and made to obsess over their weight and eating habits. For sure this is culture-wide and extends to men also, with specific vulnerable subpopulations including athletes, performers, and celebrities. But women are disproportionately targeted by our obsession with thinness. This may explain why they are disproportionately targeted by the wellness industry.

Knoll argues that eating “clean”, detoxing, avoid “bad” foods, and all the magic snake oil is really about losing weight. Of course, much of the promotion of snake oil is explicitly about weight control, but she argues much of the rest is implicitly about being thin as a marker of being healthy. Goop is now the ultimate expression of exploiting women by selling them all kinds of pseudoscientific nonsense claiming to promote “wellness”. But this phenomenon started long before Goop and extends well beyond it.

It’s interesting to consider the cultural threads that lead to and connect to the current wellness industry. I think the base of this pyramid, the underlying phenomenon that ties everything together, is simply quackery – marketing health claims, treatments, and products based on magic and pseudoscience. This is as old as history, and of course all medicine was essentially quackery until a few hundred years ago, and Western medicine was not fundamentally science-based until about a century ago. For most of human history quackery thrived for a few core reasons. One is that it is easy to sell people what they want to hear. Second, placebo effects can easily fool most people into believing that almost any treatment works. This generates anecdotes which can be marshaled to promote anything.

Over the centuries quacks have fine-tuned their craft. They know who to target and how. They weave sciencey-sounding statements into their claims, exploiting the public’s fascination with but mostly misunderstanding of cutting edge science. They exploit celebrity, pseudo-expertise, appeals to ancient wisdom, and health halos like being “natural”. Theirs is as much a craft of illusion as the stage magician.

It’s important to realize that the quacks were there first – before science, regulation, standards, ethics, and accountability infiltrated medicine. They were knocked back by the advent of modern medicine, arguably beginning in this country with the Flexner report of 1910, but they never went away. They simply adapted.

In addition there is also spa culture, the “wellness industry” of the 19th century. Spas go back to ancient time, originating as bath houses, but also hot springs and natural mineral lakes. These locations became popular for their alleged healing properties. Of course if you have people going to a location to get healed by special water, that is an opportunity for quackery waiting to happen. Formal spas evolved out of these natural spring locations, slowly adding other treatments to the hot baths. Carbonated drinks, in fact, were originally marketed for their healing properties and became part of spa culture, weaving in with herbalism. These cultural origins survive to this day, with products like root beer and ginger ale. These were tonics, only later repurposed as beverages.

This process continues to this day, with spas adding all sorts of pseudoscientific treatments, from reflexology to toxin cleanses. They are now inextricably interwoven with the wellness industry.

In modern times we now also have the alternative medicine industry. This is all just a rebranding of the quackery and spa culture of old. This was their response to science and regulation trying to take over medicine. They fought back by rebranding as “alternative” and trying to wrap themselves in the very science that was used to exclude them in the first place. This, unfortunately, worked spectacularly. But let’s make no mistake – alternative medicine is nothing but old-fashioned quackery dressed up in modern scientific trappings in order to game the system, to work their way into the modern system of regulation designed to protect patients from quackery.

Alternative medicine and “wellness” are a natural combination.

Another pillar is straight-up antiscience, like the anti-vaccine movement, anti-fluoridation, mercury fear mongering, Lyme quackery, and the like. These are all sub-movements within the greater alternative medicine movement. They all also share a feature in that they overlap considerably with conspiracy culture. There is also even overlap with movements not directly related to health, like environmentalism. The quacks have infiltrated this movement as well, promoting anti-science and conspiracy theories.

So now we have a massive cultural movement that includes spa-culture, wellness culture, the weight-loss industry (which is mostly redundant), conspiracy theorists, science deniers, snake-oil peddlers, and old-fashioned quacks – all working together under the giant umbrella of “alternative” medicine. Their collective goal is to chip away at the regulatory infrastructure designed to promote a standard of care and protect consumers. They are blurring the lines between science and pseudoscience, true and fake expertise, reality and conspiracy theories, academia and fake professionals.

Academics and scientists have generally failed to recognize this threat, and therefore have not adequately done their job of protecting the public. Politicians generally don’t have a clue. The public is left understandably confused. Social media was rocket fuel for this blurring of reality and promoting nonsense. And ironically, the evidence-based medicine movement gave inadvertent cover to pseudoscience by formally eliminating scientific plausibility from consideration when evaluating clinical claims.

These problems are all fixable, but I don’t think they will be anytime soon. And even if we did, quackery is not going away. It can only be minimized.

So yes, the “wellness” industry is a snake-oil industry, specifically targeting women and exploiting cultural pressure to be thin. But this is just the tip of a very large and very old iceberg of quackery.

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Posted by Steven Novella

Founder and currently Executive Editor of Sivasucakbileti Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also has produced two courses with The Great Courses, and published a book on critical thinking - also called The Skeptics Guide to the Universe.