The Problem of Bad "Wellness" Advice

I really despise the "wellness" program we are forced to participate in or pay $150 more per year per family member in my employer-provided health insurance. It is presented as all about caring for us and empowering us to improve our own health. But in fact it coercively imposes bad health advice, often relies on surveillance and fear of humiliation, and fails to take into account any but seven health conditions we may actually be dealing with. Mostly it seems to focus on the idea that we all need to lose weight.

Recently as a "gift" I was sent a "WebMD Health and Wellness Coaching Well-Being Journal." I'm supposed to use it to track my progress in achieving my "wellness goals." On the face of it, that's fine, but the implementation is so problematic. For example, there's a small section that shows us how we are supposed to figure out what barriers are keeping us from reaching the "wellness goals" given to us by the journal, so we can remove those barriers and get to the goal. Reasonable advice! But this photo shows what that looks like.

First off, the goal imposed on us is to drink 0% fat milk. We should only eat low-fat cheese, and should never make sauces with cream. This is advice right out of the 1900s, back when the "new food pyramid" told Americans to cut all fat out of our diets, so we could all lose weight and have better heart health. And Americans followed that advice! Collectively, Americans moved to eating low-fat snacks and drinking skim milk and using margarine not butter.

And Americans collectively all gained weight. Schools replaced whole milk with fat-free chocolate milk, Americans deprived of fat ate more food, and corporations sold us sugary, chemical-laden processed foods that were not nourishing, but were labeled "low-fat" and "heart-healthy."

Anyway, the whole idea that you can equate being thin with being healthy is dumb. What improves health is being active and eating a good variety of real, whole foods. People who do that can be fat; people who don't do that can be thin.

And whole milk is a whole food. It turns out in recent studies looking at dairy consumption that the people who are living longest consumed more whole milk and full-fat cheese, not skim milk and low-fat cheese. And the margarine many people dutifully put on their toast in the 80s and 90s turned out to be way worse for you than butter, being made with trans fats that harmed heart health. All that forgoing of good flavor and pleasure had not just failed to help Americans, it had hurt them.

According to Harvard Health Publishing's public health advice, "there never was any good evidence that using margarine instead of butter cut the chances of having a heart attack or developing heart disease. Making the switch was a well-intentioned guess."

That's just what is being implemented by my wellness program decades later. A presumably well-intentioned but outdated and incorrect guess about what we can do to improve our health, now shown to be wrong.

There are some clear and obvious impacts of this advice to cut out all fat from dairy consumption though: a loss of pleasure in life, accompanied by shame and anxiety if we do "cheat" and eat delicious full-fat cheese.

What this journal section is supposed to model for us is how to deal with the suffering its advice imposes on us. In this case, this is presented as the barrier, "I don't like the taste of non-fat milk." But the "well-being journal" doesn't actually address the issue of how to reduce the suffering being imposing on us supposedly for our own good. It doesn't suggest a substitute pleasure. All it does is tell us to taper the joy of fat out of our dairy instead of going cold turkey. A week of 2% milk, a week of 1%, and then in week three we're at the goal of drinking something we dislike.

It gives the impression of improving our wellbeing, but not the actuality of it. The inspirational quotes from supposed users it gives are telling--they could come right out of 1900s fat-shaming diet shake advertising. "It was like a great weight was lifted off me, and I'm not just talking about the pounds," says one wellness-plan follower. What is that metaphoric weight they are referencing? Why, it's the social shame of fatphobia. The "wellness" advice I'm pummeled with by our plan isn't as overt in its fatshaming as 90s diet shake ads, but it's all still there, covertly. This isn't about the best empirical health advice, or feeling well and content. It's just "suffer and lose weight, you resistant unhealthy slob--your health issues are your fault and are due to your indulgence in pleasure" over and over. Complete with periodic employee group weight loss competitions, where employees are put in groups and pitted against one another to see which can lose the most weight, with public weigh-ins and award certificates for the winners, which is just a terrible last-century reality show approach to health. "Shame your co-workers about their failure to lose 3 pounds this week for the sake of team spirit and you'll all be much healthier!"

Meh. I'm going to go eat a piece of cheese. Real, whole cheese. So there, WebMD Health and Wellness Coaching Well-Being Journal.