The wellness media ecosystem is a scam (2023)

The opening line of Tolstoy’s novel Anna Karenina is “all happy families are alike; each unhappy family is unhappy in its own way.”

That line applies to health just like it applies to families.

Every healthy person is alike; each unhealthy person is unhealthy in their own way.

What I mean by that is straightforward. Healthy people have the same things in common:

  • They don’t smoke

  • They don’t drink too much alcohol

  • They exercise regularly with a mix of aerobic and resistance training

  • They eat a healthy diet with an amount of calories that prevents weight gain and enough protein to maintain muscle mass

  • They make sure to sleep

  • Their blood pressure, blood sugar, and lipid numbers are well controlled

But unfortunately, if you read the New York Times Well section, listen to health podcasts, or follow influencers in this space on social media, you’re probably confused about what you should do.

The simple quickly becomes obfuscated through a miasma of superfoods, sleep supplements, and exercise hacks.

Which diet is best? Let’s ask US News and World Report for their ranking of the top weight loss diets each year - there are 24 items on the list, each with ratings on weight loss, overall score, and healthiness. Is it better to choose the diet that’s best for health or best for weight loss? Or should I pick the best overall diet?

Take a look at Andrew Huberman’s toolkit for sleep - how many of those supplements are you supposed to buy to optimize your sleep? And how should you be tracking it?

Follow a fitness influencer on Instagram or Tiktok and see how they always post a new workout - how are you supposed to keep coming up with new fitness ideas and change up your workouts? How much muscle confusion do you need? How do you keep inventing new exercises?

Ultimately, you should think of this industry as a content farm that takes the simple and makes it complicated.

The focus of my clinical practice is on secondary prevention of cardiovascular disease.

That means I take care of people who have had heart attacks or had strokes. Our goal is to prevent another one.

As you might imagine, I get a lot of questions about eating a “heart healthy diet.”

I’m always amazed by how into the weeds some of the questions I get from patients can be. I’m also amazed by how often some of these questions totally miss the point.

Trying to perfect your diet is majoring in the minor - stay as far away from the Standard American Diet as you can, and the rest will take care of itself.

You don’t need to figure out whether the Engine 2 Diet is better than the Ornish diet or whether US News is right that Weight Watchers is better than the DASH diet for weight loss but worse than DASH for overall healthiness.

I mean, look at this graphic. It’s a masterclass in confusing people while simultaneously providing essentially no useful information:

The wellness media ecosystem is a scam (1)

Junk food is bad for you, and almost everyone knows this.

You shouldn’t have most of your calories come from ice cream, no matter what The Atlantic tells you:

The wellness media ecosystem is a scam (2)

I firmly believe that most people have a general sense of what constitutes a healthy diet - meat, eggs, legumes, vegetables, fruits, unprocessed starches - and that the vast majority of questions about healthy eating are trying to find loopholes in this concept.

Most people advocating for a specific diet are trying to sell you something

Part of the reason I care so much about this stuff is that I feel like many of my patients get scammed here.

Influencers steal your time and attention so that companies can sell you crappy products in exchange for your money and your health.

Big food is going to innovate to create products that game the system if you concretely apply hard and fast rules around a micro-specific dietary plan.

Is some of this stuff better than candy?

Sure, of course it is.

But is it actually health promoting?

I doubt it. It’s applying a harm reduction framework to diet.

You should be skeptical of anyone who is trying to sell you both a diet and a product, because they might not update their recommendations in the face of new evidence that contradicts the party line since that might impact their sales.

You can’t trust these people.

If you talk to the experienced non-experts who sort-of know the nutrition literature, they’ll tell you that no diet works for anyone over the long term.

But that’s not exactly true.

The real experts in this field will describe to you that the reason diets fail is that people think of them as diets.

Long term adherence is poor, and people revert back to their old habits.

Any dietary strategy can work provided that it is maintained rather than thought of as a temporary fix.

If you go on a diet hoping to lose weight, and then you go back to your old diet, what do you think will happen?

If you’re cold because you live in a cold place, and then you go on vacation to a warmer place, it doesn’t magically make you warm forever. When you go back home, you’re going to be cold again.

I think Layne Norton says it best:

The wellness media ecosystem is a scam (3)

The same thing that can be said about dieting applies to exercise.

You don’t need a hack, you need consistency and adherence. The magic is in the work you’re trying to avoid.

The advice I give my patients is that if you can’t imagine yourself doing something forever, you’re probably wasting your energy doing it for a short period of time.

Remember that most of this content isn’t advice from someone who cares about you, it’s entertainment

For every legitimate advance in science that actually changes something real, there are are a million experiments, press releases, and news articles that change nothing.

I have a few friends that send me articles about new studies all the time asking, “how good is the science here?”

My answer is almost always somewhere between “this is too preliminary to mean anything” to “this is total nonsense and I’m disappointed that I had to waste a few minutes of my time thinking about it.”

As I’ve written before, there is a symbiotic relationship between an infotainment ecosystem that requires lots of content and a seemingly endless group of researchers willing to overhype the significance of their findings to get more research dollars or more attention.

This stuff makes us stupid.

Most scientific ideas ultimately don’t pan out.

Most new treatments don’t end up helping anybody.

Your bias should always be towards the null - this changes nothing and the preliminary data won’t ultimately mean anything.

You have to be your own advocate and keep focused on the important stuff.

Just because something is new doesn’t make it important, and most things that are important simply aren’t new.

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