MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

Wellness seems to be everywhere these days – I mean of course the term, not the state or condition. On Medline, we find in excess of 500 000 articles on wellness, just for the year 2022! Wellness is en vogue, sexy, politically correct, etc. It looks good to talk and write about it. Most importantly it is good business. A report by the Global Wellness Institute stated that in 2020 the wellness industry was valued at $4.5 trillion and continues to grow at a frightening rate.

Having studied some of the recent literature on the subject, I get the impression that, for many, wellness is foremost an excuse for waffling utter nonsense. Let me, therefore, today ask just 5 simple questions about wellness that are likely to reduce the wellness of the ‘wellness brigade’:

1.What is wellness?

It is quite evidently a sector that is unable to define itself. Here are just a few of the definitions that have been suggested. Wellness is:

A 2018 review revealed that there is a lack of a uniform definition of wellness and showed that there is insufficient evidence to support the clinical utility of a single particular wellness instrument.

2. How do we measure wellness? 

The short answer to this question is: nobody is quite sure. There simply is no generally accepted, well-validated measure. A few domains come to mind:

  • physical functioning,
  • somatic symptoms, e.g. pain,
  • psychological symptoms,
  • social functioning,
  • needs and satisfaction.

But there is no simple means to quantify wellness. If you think that I am exaggerating, consider this recent review: 79 mental wellness instruments were identified. Most studies did not provide a definition for mental wellness. We identified thirteen mental wellness concepts from 97 studies, namely: life satisfaction, mental wellbeing [general], resilience, self-efficacy, self- esteem, connectedness, coping, self-control, mindfulness/spiritual, hope, sense of coherence, happiness, and life purpose.

3. What affects wellness?

The short answer is: potentially everything. My very own wellness, for instance, deteriorates sharply, if I have to read yet another nonsensical article about it.

4. Which interventions improve wellness?

As we have seen in my previous post, this is where so-called alternative medicine (SCAM) comes in. Since there is no measure to quantify wellness, we just have to take the word of SCAM proponents for it: SCAM improves wellness!!!

It’s obvious!

Which specific SCAM?

Can I see the evidence?

Sorry, no questions allowed!

And if you dare to insist on evidence, the ‘wellness brigade’ would just give you a pitiful smile and say: wellness has to be experienced, not measured.

5. Are there risks?

Yes, of course! Here are just some of them:

  • The treatments advocated for wellness almost invariably cost money.
  • The treatments advocated for wellness almost invariably cause direct and indirect harm, as discussed in many of my previous posts.
  • Wellness treatments tend to give the impression that one can buy wellness like an expensive piece of clothing without putting in any real effort oneself.

Considering all this, I’d like to offer my very own definition of the sector:

Wellness is a fashionable paradise for charlatans in which they are protected from scientific scrutiny and feel at liberty to bullshit to their hearts’ content. 

 

7 Responses to The Wellness Epidemic

  • Dear Edzard,
    Sorry to spoil your day but in 1976 Terry Priestman and I published a paper in the Lancet, Apr 24;1(7965):899-900, describing the first psychometric instrument for measuring quality of life, “Evaluation of quality of life in patients receiving treatment for advanced breast cancer”. We called it a Linear Analogue Self Assessment (LASA) that measured 27 components of wellbeing along a 10cm line e.g. WELL BEING: Worst ever __________________________Best ever.
    Best wishes
    Mike

    • Hello Mike,
      you did not spoil my day at all; quite to the contrary! You reminded me of the excellent and innovative research you did such a long time ago (https://pubmed.ncbi.nlm.nih.gov/58161/). Yours must have been one of the first measures of QoL. However, I don’t think that QoL is not the same as the nebulous concept of ‘wellness’.

  • I especially like that you pointed out the association of wellness with the ability to buy it without any real effort. Supplements, especially, carry this aura–and the marketing of various nutritional claims. GLUTEN FREE! say the corn flakes, NO MSG! says the soup with 30% of daily recommended salt intake (which is way worse than the minuscule chance that the average person is allergic to MSG). Let’s not even get into “healthy” beverages and chips–sorry folks, but the organic chips have the same calories as the regular ones. I have actually had this discussion with people in the chip aisle–they truly believe that they can lose weight by eating the organic chips! A friend who is thin and not diabetic spends a pretty price for monk fruit sweetener because it has “low glycemic index”. The woman eats no sugar but drinks gallons of wine per week–. Saddest thing is she gets most of this advice from her doctor!

    Between rampant and unregulated marketing and quack physicians, the explosion of “wellness” continues unhampered by reason.

    • Well said.

      However if the women you mentioned gets incorrect harmful info from her doctor ( assuming he is a qualified medical doctor ) that makes him a uniformed, possibly ‘bad’ doctor -but presumably one with no personal gain from this – so not necessarily ‘quack’ ? As opposed to charlatans pushing remedy and scam for personal profit.

  • Surely not?! A real doctor (allegedly) suggesting that nutrition is useful in maintaining HEALTH and WELLNESS?
    It seems there are some conventional practitioners who look beyond a ‘pill for every ill.’
    Quote:
    Dr Jen Dooley told the BBC people were choosing the wrong foods to ‘fill up’.
    She said she often saw patients lacking in basic vitamins and minerals.
    Reference: https://www.bbc.co.uk/news/uk-scotland-64518568

    This doctor is obviously practising SCAM and even witchcraft perhaps?

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