Don’t fall prey to the cult of wellness

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Don’t fall prey to the cult of wellness

Don’t fall prey to the cult of wellness Margaret McCartney Contributed to The Globe and Mail Published January 4, 2019 Open this photo in gallery ALBRECHT DÜRER’S PRAYING HANDS REVISITED / ILLUSTRATION: BRYAN GEE / SOURCE: PUBLIC DOMAIN Margaret McCartney is a family doctor in Scotland and an award-winning writer and broadcaster on Radio 4. Her most recent book is The State of Medicine . As a middle-aged, generously proportioned woman, in the past few years I have discovered that I much prefer running a 10k to an evening of gins and tonics. The revelation that an occupation of sweat and effort can make one feel better rather than worse has also, unfortunately, been my conduit into what can only be deemed the cult of “wellness.” Health-food shops, running and cycling magazines and sports stores welcome the handmaidens of detox and clean eating, who together promote chia seeds, coconut oil, almond milk and spirulina as the supposedly enlightened alternative for the “dirty” diners among us (who are also eating rather cheaper). Vast amounts of technology is marketed through the wellness industry, via apps and fitness devices, promoted as a responsible way to “know thyself” better. But, frankly, it makes something which should be fun – good living – into a miserable, competitive, pseudoscientific morass. Story continues below advertisement The well-being industry is a massive business – for we are not allowed to assume that if we feel well, then we are well. Instead we are told we have to have our hands on the vegetable juicer to “detox,” to do exercise classes to achieve not just physical fitness but spiritual nirvana, all while monitoring our every mouthful and emission for signs that we are impure. This industry invites us to be self-absorbed and obsessed – making us unhealthy while promising us better health. As a family doctor with a keen interest in evidence-based practice, I find our obsession with wellness troubling. This vogue has to be set against a cultural landscape where science is seen as a matter of opinion rather than fact and evidence. Social media have allowed a slew of widely followed celebrities to recommend products and supplements despite having little evidence to justify them. Gwyneth Paltrow’s Goop website is a case in point. Her notorious claims for “vaginal steaming” to achieve an “energetic release” that “balances female hormone levels” a few years ago was debunked by numerous doctors and scientists, but the website is still offering, under “well-being,” such gems as an amethyst crystal in a bottle to put into your glass of water to “infuse water with the power of crystals” and numerous supplements making expensive promises of glowing beauty. Culturally, we don’t seem to appreciate science well enough. The MMR (mumps, measles and rubella) vaccine is safe and effective, yet a fall in vaccination rates has been blamed for 41,000 cases of measles in Europe in 2018 and at least 37 deaths. The wellness industry might seem like a harmless activity that just empties the wallets of the rich – but it is symptomatic of where science sits in society. A breathwork class at 2018’s In Goop Health conference in Vancouver. ERNESTO DiSTEFANO There has always been quackery, but vast swaths of the health and fitness sector, especially online, seem to have been colonized by what I term bollocksology. The rise of the internet has allowed amplification of the cool, trendy and aesthetically pleasing, and science – which does not readily use advertising teams or public-relations companies – has struggled to make itself heard. So there is nothing new about the goodness of exercise as medicine – indeed, there is high-quality evidence that it helps prevent and treat many conditions. The wellness crusade, however, invites people to feel constantly anxious about their health, even when feeling entirely well. This inducement to anxiety breeds profitable markets in the process. Multiple apps offer to monitor how much fluid you drink during the day, even though evidence for the infamous recommendation of drinking “eight glasses of water a day” is lacking. When I went to a new exercise class, I was disconcerted. It ended with the kind of ecstatic exultations I associate with fringe religious groups. We were told that if we felt thirsty, we were already dehydrated – the inference being that we had a serious and sinful symptom of deliberate bodily neglect. Mercifully, though, they had a special offer for a new vitamin-C-infused water. After an hour’s exercise, I should have felt fantastic – instead I was appalled. Why was such a lot of money required to buy fancy flavoured waters when all I needed was a plain glass of tap water and a decent lunch? The worst sin of the wellness movement, however, is “detox.” On an accidental – and single – visit to a “wellness” spa, I was told that the oil was going to detox me of all my impurities and realign my stress and energy levels. It is the kidneys and liver that detox the body, and rubbing fragrant oil – lovely though it is – is not going to get rid of the usual metabolic by-products of the human body. My stress levels were far worse at the end of the massage. Worse are the quasi-medical clinics in spas offering “boosts,” “shots” and “hydration” in the form of bags of intravenous saline and vitamin infusions for a hefty sum. Often overseen by doctors, they commonly use vague claims (such as “boosts well-being” or “assist stress”) when there is no evidence they can achieve anything in healthy people beyond what a good diet would . And while there is no doubt that technology has delivered health benefits to millions – pacemakers, cardiac monitors, artificial limbs – the promise of gadgetry has now exceeded its evidence base. We are now invited to have a “doctor in our pocket” via smartphone apps, and can buy dozens of devices to attach to our wrists or as part of our smartphones, beadily observing our daily step count. It seems like a nice idea, but what seems like common sense often isn’t. That aim of 10,000 steps a day? It isn’t based on science – it’s just a nice, round number. It might be an unrealistically high aim for some people, good for others and not ambitious enough for some. A study published in JAMA (Journal of the American Medical Association) in 2016 examined whether fitness trackers could help with weight loss compared with standard advice. Rather than helping, it found that the group wearing the trackers actually lost less weight compared with the group without them. Another study from Britain, published in 2017, found that teenagers like fitness trackers for the first few weeks, but then complain of feeling guilty and pressured by leaderboards with the most active people. The trackers ended up having the opposite effect – serving to demotivate rather than inspire. Is this kind of self-monitoring actually good for us? We simply don’t have good enough evidence that it is. The idea that we might want to exercise because it is fun and makes us feel good seems somewhat underutilized. Pleasure seems like a sin in the church of wellness. 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