Is the Trillion-Dollar Wellness Industry a Wolf in Sheep's Clothing?
Oh, the irony of cracking open 'How to Be Well' while on vacation in Italy. There, on an island off the coast of Naples, a breakfast buffet included three varieties of tiramisu. Wine was poured not to a stingy fingertip's depth but from a bottomless carafe — at lunchtime, no less. And when stores closed in observance of an afternoon siesta, the only people on the streets were American tourists, jogging. (I was on the prowl for a postage stamp because, yes, I still send postcards.)
It was from this place of abundance and balance that I followed Amy Larocca, a veteran journalist, into the hellscape of stringent food plans, cultish exercise routines and medical quackery that have, over the past decade or so, constituted healthy living in some of the wealthiest enclaves of the United States. Blame social media, political turmoil or the pandemic — no matter how you slice it, the view is dispiriting. But Larocca's tour is a lively one, full of information and humor.
The book begins with a colonic, 'the flossing of the wellness world,' Larocca writes. We find the author herself on an exam table, 'white-knuckled and curled up like a baby shrimp, naked from the waist down.' She recalls her doctor's disapproval of the procedure — a sort of power washing of the colon — and its risks, including rectal perforation, juxtaposed with one woman's claim that a colonic made her feel like she could fly, like it was 'rinsing out the corners of her psyche.'
Where did we get the idea that the body — specifically a woman's body — is unclean inside? A problem to be solved? And how did the concept of wellness bloom 'like a rash,' Larocca writes, into a $5.6 trillion global industry?
These are the questions she seeks to answer, using data, history, medicine, pop culture and her own experience. She parses fads and trends, clean beauty and athleisure wear, the gospel of SoulCycle and the world according to Goop. She weighs the advantages and disadvantages of micro-dosing and biohacking. She too goes to Italy, where she attends a Global Wellness Summit featuring a spandex and sneaker fashion show and a presentation on ending preventable chronic disease the world over.
At times, Larocca seems to approach her own subject with the same sweep. The second half of 'How to Be Well' reads like a survey course, cramming the industry's relationship to politics, men and the environment into single chapters when each could fill a whole semester. As for why meditation merits more real estate than vaccines, I can only assume that the book was already at the printer when Robert F. Kennedy Jr. was confirmed as health secretary.
But when Larocca goes deep, as she does on self-care, body confidence and sex positivity, she's at her best — authoritative and witty, personal without being chummy.
She debunks the cockamamie but persistent notion that 'feeling old is not an inevitable byproduct of aging but something easily avoided by paying attention.' (And by forking over gobs of cash; more on this shortly.) After attending an Oprah-sponsored conference on menopause, a subject Larocca has covered for The New York Times, she realizes that 'aging is different from disease' and 'isn't necessarily something to be cured,' let alone through 'neat, tidy, attainable solutions.'
Then there's the sneaky rebranding of old-school dieting for 'detoxification,' another wolf in sheep's clothing. Think fasting, juicing, abstaining from all manner of verboten foods. Even if the professed endgame is 'glow,' Larocca makes clear, 'part of the promise is still, always, to rid us of a bit of ourselves.'
And finally, refreshingly, she's honest about the money at stake for the wellness-industrial complex — not just for stylists turned wellness coaches or models turned nutritionists, but for massive corporations cashing in on an age of worry.
'None of these institutions is nonprofit; none of these institutions is altruistic at its core,' Larocca writes, in a passage reminiscent of Carol Channing's monologue from 'Free to Be You and Me,' in which she reminded us that happy people doing housework on TV tend to be paid actors.
'It is their job to persuade me to come back,' Larocca continues, 'to spend more money on what they've got to give, to serve their investors, to serve themselves.'
And that, as 'How to Be Well' wisely shows us, is the bottom line.
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Associated Press
4 hours ago
- Associated Press
Takeaways from AP's report on financial interests of RFK Jr. adviser who runs wellness platform
ASSOCIATED PRESS (AP) — Calley Means has built a following by railing against the U.S. health system, often hammering on alleged financial conflicts within the medical establishment. Means, a top aide to Health Secretary Robert F. Kennedy Jr., was hired as a White House adviser in March. He has used that position to accuse physician groups, federal agencies and government scientists of financial interests that bias their work. Means, however, has his own stake in the sprawling health system. He's the co-founder of an online platform that offers dietary supplements, herbal remedies, exercise equipment, light therapy lamps and other wellness products. The Associated Press found that Means' heated rhetoric against the medical mainstream dovetails with the interests of his company TrueMed, which features vendors who are prominent supporters of Kennedy's 'Make America Healthy Again' movement. Because of his status as a temporary government employee, Means is exempt from publicly disclosing his financial details. The AP reviewed more than two dozen interviews, speeches, articles and podcast appearances by Means both before and after he joined the government. Here are some takeaways from the AP's reporting: Attacking prescription drugs, promoting wellness alternatives Means' company, Truemed, helps users take tax-free money out of their health savings accounts, or HSAs, to spend on things that wouldn't normally qualify as medical expenses, such as meal delivery services and homeopathic products — remedies based on a centuries-old, debunked theory of medicine. As a top messenger for the administration, Means has been promoting a new government report that calls for scaling back prescription drugs for depression, weight loss and other conditions. By criticizing the use of drugs and other rigorously tested products, health experts say Means is furthering the interests of his company, which offers alternatives to traditional medicine. 'It reeks of hypocrisy,' said Dr. Reshma Ramachandran, a health researcher at Yale University. 'In effect, he is representing another industry that is touting nonregulated products and using his platform within the government to financially benefit himself.' In a written statement, Means said his government work has not dealt with matters affecting Truemed and has focused on issues like reforming nutrition programs and pressuring companies to phase out food dyes. 'Pursuing these large-scale MAHA goals to make America healthy has been the sole focus in my government work,' Means said. Undisclosed interests The full extent of Means' potential financial conflicts are unclear because of his status as a special government employee. Unlike presidential appointees and other senior officials, special government employees do not have to leave companies or sell investments that could be impacted by their work. Also, their financial disclosure forms are shielded from public release. 'It's a big problem,' says Richard Painter, former White House ethics lawyer under George W. Bush. 'I think it's a loophole.' Plugging products and business associates While promoting the administration's accomplishments, Means has not shied away from plugging his own brand or those of his business partners. When asked to offer health advice to listeners of a sports podcast, Outkick The Show, in April, Means suggested they read his book 'Good Energy,' which he co-authored with his sister, Dr. Casey Means. He also recommended blood tests sold by Function Health, which provides subscription-based testing for $500 annually. The company was cofounded by Dr. Mark Hyman, a friend of Kennedy and an investor in Truemed, which also offers Hyman's supplements through its platform. Like dietary supplements, the tests marketed by Function Health are not clinically approved by the Food and Drug Administration. 'It ends up favoring these products and services that rest on flimsy grounds, at the expense of products that have actually survived a rigorous FDA approval process,' said Dr. Peter Lurie, a former FDA official who is now president of the Center for Science in the Public Interest. Steering medical dollars into health savings accounts Means says he has not worked on issues impacting HSAs since joining the federal government. Federal ethics laws forbid government employees from taking part in decisions that could impact their financial situation. But before joining government, Means said the mission of his company 'is to steer medical dollars into flexible spending.' 'I want to get that $4.5 trillion of Medicare, Medicaid, everything into a flexible account,' he told fitness celebrity Jillian Michaels, on her podcast last year. Truemed collects fees when users and partnering companies use its platform. Means also founded a lobbying group, made up of MAHA entrepreneurs and TrueMed vendors, that listed expanding HSAs as a goal on its website. Means said in a statement that the group focused only on broad topics like 'health care incentives and patient choice — but did not lobby for specific bills.' Benefits of HSAs questioned Expanding HSAs has been part of the Republican health platform for more than 20 years. The tax-free accounts were created in 2003 to encourage Americans in high-deductible plans to be judicious with their health dollars. But HSAs have not brought down spending, economists say. They are disproportionately used by the wealthiest Americans, who have more income to fund them and bigger incentives to lower their tax rate. Americans who earn more than $1 million annually are the group most likely to make regular HSA contributions, according to an analysis by the nonprofit Center on Budget and Policy Priorities. Most Americans with HSAs have balances less than $500. HSA expansions in Trump's 'One Big Beautiful Bill' are projected to cost the federal government $180 billion over the next 10 years. 'These are really just tax breaks in the guise of health policy that overwhelmingly benefit people with high incomes,' said Gideon Lukens, a former White House budget official during the Obama and Trump administrations. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
Associated Press
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- Associated Press
Top RFK Jr. aide attacks US health system while running company that promotes wellness alternatives
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'Pursuing these large-scale MAHA goals to make America healthy has been the sole focus in my government work,' Means said. Truemed helps users take tax-free money out of their health savings accounts, or HSAs, to spend on things that wouldn't normally qualify as medical expenses, such as exercise equipment, meal delivery services and homeopathic remedies — mixtures of plants and minerals based on a centuries-old theory of medicine that's not supported by modern science. The business model caught the attention of the IRS last year, which issued an alert: 'Beware of companies misrepresenting nutrition, wellness and general health expenses as medical care.' Truemed co-founder and CEO, Justin Mares, said in a statement the company is 'in full alignment' with IRS guidelines. 'Truemed enables patients to work with providers to use medical funds for root cause interventions like exercise and vitamin D to reverse disease under current law,' Mares said. The full extent of Means' potential conflicts — including his personal investments— are unclear because of his status as a special government employee. Unlike presidential appointees and other senior officials, special government employees are temporary staffers who do not have to leave companies or sell investments that could be impacted by their work. Also, their financial disclosure forms are shielded from public release. 'It's a big problem,' says Richard Painter, a former White House ethics lawyer under George W. Bush now at the University of Minnesota. Painter and other experts have raised alarms over a whirlwind of Trump administration actions to dismantle the government's public integrity guardrails. Still, part-time government employees are subject to the same law that bars all federal staffers from working on issues that could directly benefit their finances. When such cases arise, they must recuse themselves or risk criminal penalties. 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A rising star in the MAHA movement Means' rapid rise reflects the seeming contradictions within the MAHA movement itself, which urges followers to distrust both big corporations and the government agencies which regulate them. Means rails against big pharma and food conglomerates, two industries that he says he spent years working for as a consultant in Washington. Means has no medical training. A graduate of Harvard Business School, he previously ran a bridal gown startup with his wife. He traces his passion for health care reform to the death of his mother from pancreatic cancer in 2021. Shortly thereafter, Means and his sister, Dr. Casey Means, took psychedelics together and had 'a mind-blowing, life-changing experience,' which led them to co-author a wellness book, launch separate health startups and begin appearing on podcasts. Casey Means was recently nominated to be surgeon general and has faced scrutiny over her qualifications, including an unfinished medical residency. 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'If you're sick, most likely you have some kind of nutrient deficiency, some kind of biomarker that you can actually then target with your diet and your supplements,' Calley Means said. Like dietary supplements, the marketing claims on laboratory tests sold by Hyman are not approved by the FDA. The agency has warned for years about the accuracy of such tests and tried to start regulating them under President Joe Biden. Experts say MAHA entrepreneurs like Hyman are following a playbook common to the wellness industry: Identify a health concern, market a test to diagnose it and then sell supplements or other remedies to treat it. 'It ends up favoring these products and services that rest on flimsy grounds, at the expense of products that have actually survived a rigorous FDA approval process,' said Dr. Peter Lurie, a former FDA official who is now president of the Center for Science in the Public Interest. Many of the items sold via Truemed, including sweat tents, cold plunge tanks and light therapy lamps, wouldn't typically qualify as medical expenses under rules for HSAs, tax-free accounts created by Congress to manage medical costs. The IRS generally states that HSA purchases must help diagnose, cure, treat, mitigate or prevent disease. Truemed allows users to request a 'letter of medical necessity' from a doctor, stating that the product in question could have medical value for them. Like other telehealth services, there's usually no real-time communication with the patient. The physician reviews a 'simple survey solution,' filled out by the Truemed user, according to the company's website. Industry representatives say customers should be careful. 'You need to be prepared to defend your spending habits under audit,' said Kevin McKechnie, head of the American Bankers Association's HSA council. 'Companies are popping up suggesting they can help you manage that process and maybe they can — so the debate continues.' Americans have an estimated $147 billion in HSA accounts, a potential windfall for companies like Truemed that collects fees for transactions made using their platforms. Means sees an even bigger opportunity — routing federal funds out of government programs and into more HSAs. 'The point of our company is to steer medical dollars into flexible spending,' Means told fitness celebrity Jillian Michaels, on her podcast last year. 'I want to get that $4.5 trillion of Medicare, Medicaid, everything into a flexible account.' Who benefits most from HSAs? Means' pitch for expanding HSAs echoes two decades of Republican talking points on the accounts, which were created in 2003 to encourage Americans in high-deductible plans to be judicious with their health dollars. But HSAs have not brought down spending, economists say. They are disproportionately used by the wealthiest Americans, who have more income to fund them and a bigger incentive to lower their tax rate. Americans who earn more than $1 million annually are the group most likely to make regular HSA contributions, according to an analysis by the nonprofit Center on Budget and Policy Priorities. More than half Americans with HSAs have balances less than $500. Trump's 'One Big Beautiful Bill' would further expand HSA purchases, making gym memberships and other fitness expenses eligible for tax-free spending. That provision alone is expected to cost the government $10 billion in revenue. 'These are really just tax breaks in the guise of health policy that overwhelmingly benefit people with high incomes,' said Gideon Lukens, a former White House budget official during the Obama and Trump administrations, now with the Center on Budget and Policy Priorities. Expanding HSA eligibility was listed as a goal for a coalition of MAHA entrepreneurs and Truemed partners, founded by Means, which lobbied Congress last year, according to the group's website. Means said in a statement that the group focused only on broad topics like 'health care incentives and patient choice — but did not lobby for specific bills.' In total, the HSA expansions in Trump's bill are projected to cost the federal government $180 billion over the next 10 years. As HSAs expand to include more disparate products and services, Lukens says the U.S. government will have fewer dollars to expand medical coverage through programs like Medicaid. 'We have a limited amount of federal resources and the question is whether we want to spend that on health and wellness products that may or may not be helpful for wealthy people,' Lukens said. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
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