The global wellness industry is booming. Worth trillions of dollars, it’s now four times larger than the global pharmaceutical industry. But given the flurry of misleading health-related claims made by major players within the sector, is it time for independent watchdogs to intervene?
We live in an age of growing distrust in science. Across the world, influential figureheads are propagating ideas that fly in the face of decades of scientific research.
From Donald Trump having made high-stakes strategic decisions based on climate change denial to certain celebrities amplifying anti-vaccine sentiment to an audience of millions, an alarming trend of pseudoscientific grandstanding is emerging. And with COVID-19 conspiracy theories still widespread, the anti-science agenda carries real-world consequences.
An alarming consequence of this anti-science rhetoric is the growing number consumers and patients that are turning their backs on traditional medicine in favour of so-called “alternative medicine." This can encompass everything from mind-body fitness to homeopathy to spa tourism.
Many of the natural health products available on the wellness market have minimal grounding in scientific or medical research. Far from being benign placebos, however, some of the products and ideas peddled by wellness giants such as Goop can actually prove harmful to people’s health.
Raw water and vaginal steaming are just two such examples of dangerous health crazes that are actively promoted by wellness brands. Others, like the “do-it-yourself coffee enema”, have been slammed as “absolutely absurd” by health experts. From the dangerous to the ridiculous, it’s no wonder that scientists are alarmed.
Is “alternative medicine” just a byword for pseudoscience, then? And given the flagrant level of disregard for empirical testing and peer-reviewed science, do wellness gurus pose as much as a threat to public health as anti-vaccination proponents or anti-masker conspiracy theorists? This article will examine these issues in depth.
But isn’t ‘wellness’ something that should be encouraged?
Wellness — roughly defined as the state of being in good health — is something we can all get behind. As humans, it’s in our very nature to not only survive but to thrive. And with mental health problems, chronic illness and unhappiness increasing in industrialised societies, it’s clear that public health policy needs a major rethink.
It seemed inevitable, then, that a global wellness industry would emerge. But the scale at which it has developed has surprised almost everyone.
Prior to the coronavirus outbreak, the sector was valued at an estimated US$4.5 trillion. That’s more than half of the total pre-COVID global health expenditure (US$7.8 trillion) and almost four times the global pharma industry (US$1.3 trillion). Altogether, wellness represents 5.3% of global economic output. Business has never been better.
Meanwhile, the industry employs millions of people and genuinely improves the lives of millions of customers, so it certainly brings benefits to those involved.
The problem? Some companies frame their natural therapies as substitutes for traditional medicine, despite these therapies having no basis in real science or medicine.
Dr Jen Gunter, a prominent obstetrician-gynaecologist who frequently challenges dubious health claims, encapsulates this increasingly cynical view of the wellness industry in her New York Times piece on the "wellness-industrial complex":
“Wellness used to mean a blend of health and happiness. Something that made you feel good or brought joy and was not medically harmful — perhaps a massage or a walk along the beach. But it has become a false antidote to the fear of modern life and death.”
Of course, not all wellness companies are culpable. Major brands like Peloton (boutique fitness), Calm (meditation), and hers (women’s health) all promote products that are strictly therapeutic and intended to act as nothing more than an add-on to proper medical advice. However, this does not negate the need for rigorous empirical investigation and regulation within the industry.
The high priests of wellness
Since its anti-consumerist, counter-cultural beginnings on the fringes of society, the wellness industry has morphed into a multi-trillion-dollar juggernaut that is driven by the cult of the wellness “guru”.
From Kate Hudson’s Fabletics to Jessica Alba’s The Honest Company, a host of celebrities, influencers and figureheads have jumped on the wellness bandwagon. One celebrity endorsement on Instagram can quite literally change the fortunes of a business, so the idea of wellness brands promoting their own “guru” is an integral part of their marketing strategy.
“Guru” is Sanskrit word that originally referred to a Hindu spiritual teacher. In common parlance, it has been appropriated across wider society (particularly in management and sports) to signify an influential teacher or popular expert. When it comes to wellness, the word seems to have found its most overt usage — and its cultish connotations are not always positive.
Goop, a natural health company founded by another Hollywood A-lister, Gwyneth Paltrow, is no stranger to controversy within the wellness industry.
Originating as a newsletter before being incorporated as a company a few years later, the brand promotes what it considers to be advice for healthy living. It sells a range of products through its online store — including cosmetics, vitamins and supplements, oils, crystals, homeware, and even clothing.
The company — and Paltrow herself — have been widely criticised by scientists and independent regulators for promoting practices and cures with no scientific basis. According to the American advertising watchdog, Truth in Advertising, Inc., Goop “...uses unsubstantiated, and therefore deceptive, health and disease-treatment claims to market many of its products.”
The slew of misinformation is not just limited to its products. Through slick content marketing, Goop helps to perpetuate pseudoscientific beliefs about self-diagnosis and self-cure. For example, it claims that "earthing” — the act of walking on grass with bare feet — can cure insomnia and depression. For Goop subscribers without a grassy verge to practice on, an “earthing kit” can be purchased for the princely sum of $200 (£156).
In a 2015 article, Goop published an article which quoted debunked research and claimed that bras can restrict the lymph nodes around the breasts — even suggesting that wearing them can lead to breast cancer. The article was released during Breast Cancer Awareness Month and was rightly blasted by critics as a “scaremongering” tactic.
Which brings us to “vaginal steaming”. Despite no scientific evidence that it works, Paltrow has promoted this dangerous act as a way to balance female hormone levels and “cleanse the uterus”.
Dr Gunter strongly warns against such an act: “steam isn’t going to get into your uterus from your vagina unless you are using an attachment with some kind of pressure. Most definitely never, ever do that.”
Without the evidence to support such dubious claims, many in the industry are walking an ethical and legal tightrope. According to Goop’s Chief Content Office, Elise Loehnen, the brand’s content is vetted by lawyers and a team of scientists and doctors. As we will see, however, few of the products on the brand’s online store stand up to rigorous fact-checking.
Subverting the idea of scientific truth
The sheer scale of the wellness industry makes it notoriously difficult to regulate.
Regulation around the types of claims companies are allowed to make differs from country to country. Goop, for example, has had problems in the UK and Canada because of the unsubstantiated health claims that it makes.
In the US, the Food and Drug Administration (FDA) does not have to approve of dietary supplements before they are marketed. Instead, it’s up to the manufacturers and distributors of such supplements to make sure there are safe before they go to market.
The lack of stringent FDA regulation in these areas has caused a marketing opportunity for brands such as Goop, which heavily promotes dietary supplements on its website. The company’s disclaimers state that none of its products have been approved by the FDA and nor should they be seen as “a substitute to professional medical advice, diagnosis, or treatment.”
Despite this, Goop continues to promote products from other companies (while stating it is not explicit “promotion”) and continually uses terms like “trusted experts” to describe influencers who are peddling irresponsible pseudoscience.
One such “trusted expert” championed by Goop is the self-marketed “Medical Medium”, Anthony William.
In his best-selling books, William claims to receive his medical advice — including only eating one kind of fruit — not from scientific research but from a supernatural source. With 5-star reviews on Amazon, it’s clear that customers are being duped into interpreting such ideas as legitimate health advice.
There are two tiers to such quackery. On a benign level, the products that have little to no effect are being sold at extortionate prices, ie. customers are being ripped off. On a more ominous level, some products can actually be medically harmful.
Even using terms such as “alternative medicine” is profoundly problematic. Medicine either works, or it doesn’t — and to propose an alternative is disingenuous at best and highly irresponsible at worst. Without evidence and rigorous empirical testing, the true effects of alternative treatments are difficult to predict — and potentially dangerous.
Why do people openly embrace pseudoscience?
In their brand messaging and marketing campaigns, wellness gurus have been accused of preying upon those who feel they have been failed by traditional medicine.
With a vast array of natural products, the wellness industry frequently targets people who are sick, desperate, or have strong ideological opinions about big pharma. People who are looking for a more holistic approach to health and lifestyle. People with a bank balance big enough to afford their products.
Prominent wellness influencers on social media are primed to step in and offer an attractive, alternative solution to people’s pain points — even though science has proven that many of these products are ineffective.
For people living with chronic pain, the opportunity to take their health into their own hands is incredibly enticing — especially when it comes with slick packaging and celebrity endorsement.
Wellness gurus continue to exploit this disillusionment and, in many cases, desperation, by framing their brand as an empowering, life-affirming solution to such ailments. But, of course, false information empowers nobody, and the much-vaunted elixir they require turns out to be nothing more than snake oil.
Calling “BS” on false claims
To take yet another case of potential quackery, Goop charged up to $120 for a pack of 24 “Body Vibes” stickers: “wearable stickers that promote healing” and supposedly “rebalance the energy frequency in our bodies.”
In the product description, the company claimed that these patches were “made with the same conductive carbon material NASA uses to line space suits so they can monitor an astronaut’s vitals during wear.”
To put this claim into context, NASA spacesuits are not made with any conductive carbon lining. The description was an outright lie. Perhaps it’s little wonder that Goop’s claims were called "a load of BS” by the former chief scientist at NASA’s human research division, Mark Shelhamer.
This is only one of many misleading statements that the wellness brand has made. Faced with the charge of pseudoscience, Paltrow told the BBC,
“We disagree with that wholeheartedly. We really believe that there are healing modalities that have existed for thousands of years. They challenge a very conventional Western [sic] doctor that might not believe in the healing powers of essential oils or any variety of acupuncture... we find that we are very helpful to people.”
The State of California disagreed with Paltrow — ordering the company to pay a settlement of $145,000 (£112,514) after making unscientific claims about the health benefits of vaginal jade eggs.
Aside from being laughable, such reckless advice can actually cause irreversible physical damage that may even require significant medical treatment. Any potential placebo effect that customers claim to get from these products must surely be counteracted by the tangible physical dangers.
Making radical changes to the body’s system without expecting any repercussions is dangerous territory.
In some instances, the burgeoning wellness industry can descend into outright fraud. Take the example of Belle Gibson, a 23-year-old Australian wellness blogger who claimed to have cured her terminal brain cancer through diet and lifestyle alone.
With a sizeable, largely female online following and a lucrative book deal, Gibson’s “inspirational” story was held up as evidence that foregoing professional medical advice and following her lead can have substantial health benefits for adherents. Except it wasn’t evidence at all: Gibson fabricated her story — she never had cancer in the first place.
Nobody likes deceit, especially from people with influence. But when that deceit is accompanied by potentially dangerous health advice, public health is put at risk, too.
Why is so much pseudoscience targeted at women?
According to research, women wait in emergency rooms longer than men. Meanwhile, chronic conditions such as fibromyalgia, ME, and lupus have a higher prevalence among females, and women are more likely to report higher instances of pain but receive less treatment for it. For many women, medical research has failed them.
There’s also an historical culture of bodily imperfection that has long been a staple of marketing to women. From early to mid-20th century adverts that encouraged housewives to wash their genitals with disinfectant to modern marketing campaigns that shame women into being "beach body ready”, businesses have highlighted female physical flaws to sell their products.
These traditional, long-held beliefs about a woman’s body being toxic (and the anxiety caused by this notion) have arguably been the catalyst for the wellness industry boom. Indeed, the wellness industry is led by female entrepreneurs, and most of its products are marketed and packaged towards women.
As the CBC report, however, wellness brands like Goop have consciously exploited the medical establishment's failure women's health. Rather than pushing to increase female representation in science and medicine, the industry instead intends to provide an alternative care pathway that languishes ominously outside the mainstream. By continuing to expand in such a gendered way, the industry will disproportionately expose more women to the dangers of pseudoscience.
Responding with science fact
“Science has authority, not because of white coats, or titles, but because of precision and transparency: you explain your theory, set out your evidence, and reference the studies that support your case.”
— Ben Goldacre, The Guardian
As a response to the rise in big-bucks quackery, a number of fact-checking scientists and journalists are going out their way to expose businesses that peddle pseudoscience.
Ben Goldacre, senior clinical research fellow at the Centre for Evidence-Based Medicine, is at the forefront of this fightback. Back in 2007, he debunked the pseudoscientific claims of 'Dr' Gillian McKeith, a primetime British TV celebrity who gave dubious health advice to an audience of millions.
After a regular from Goldacre’s website badscience.net made a complaint to the Advertising Standards Agency (ASA), McKeith — who has no qualifications in nutrition medicine from an accredited institution — agreed to drop the academic title “Dr” from her advertisements.
Another key figure helping to discredit pseudoscientific claims is the aforementioned Dr Jen Gunter. Described as Twitter’s “resident gynaecologist”, Gunter is on a mission to tackle misinformation within the wellness industry and persuade regulators to take such claims more seriously.
In 2018, she reviewed all 161 of Goop's wellness products for pseudoscience. According to Gunter’s methodology, “products were considered pseudoscience if there was scientific evidence advising against the product (or class of product) or if the hypothesis was biologically implausible or non-existent.” Of the 161 products in the Goop store, she found that 90% “cannot be backed by science”.
Though Goop’s stock continues to rise, the intervention of prominent critics like Gunter — who has over 320,000 Twitter followers — have firmly put the dangers of quackery on the public’s radar.
Reframing the narrative
The examples above underscore the importance of good science reporting. Though several political commentators have argued that that we live in a post-truth age, we cannot lose faith in science’s ability to debunk pseudoscience with cold, hard facts.
Writers also need to be on their guard when interpreting the results of scientific research. An irresponsible 2015 article from the Los Angeles Times ran with the headline: "Another reason to drink coffee: It's good for your heart, study says." However, the initial research that the article quoted was grossly misinterpreted and said nothing of the sort. To the casual reader, this article would have been taken as science fact.
Thankfully, various elements within the wellness industry are taking heed. Aghast at the number of unsubstantiated claims being packaged as fact, former public health worker Sarah Greenidge founded WellSpoken, a tool for scrutinising and regulating the wellness industry.
Working alongside wellness brands, bloggers, publishers and ambassadors, WellSpoken aims to provide consumers with the highest level of robust, authentic, evidence-based information. By leading an industry gold-standard for credible wellness communication, Greenidge’s long-term goal is to “future-proof” the industry and stop it from peddling misleading content.
The very nature of the trial-and-error scientific method means that new findings will always emerge to test the status quo. New wellness brands will emerge, and some of them will offer products with legitimate scientific backing. As we have seen, however, this does not stop unscrupulous companies from exploiting their target audience.
The wellness industry is, at least in some cases, not inherently bad. However, within it are a few bad apples that threaten to rotten it to the core.
For more industry insights into the ever-changing world of the life sciences sector, stay tuned to the SRG blog.