The Wellness Industry's Conflicts of Interest

“It’s ironic that I am being accused of a conflict of interest by these doctors when, as you are about to see, some of them have their own conflict of interest issues--and some integrity ones also.” 

- Dr. Mehmet Oz  

Conflicts of interest are common, common enough that if there is a way to benefit personally, people are likely to find and take it. People are particularly sensitive to COI in healthcare, and this makes perfect sense; we want to believe that when it comes to our health, everyone claiming to help us is doing so purely out of the goodness of their heart and not for financial gain.

COI in healthcare has been a flashpoint for wellness warriors. Arising above COI is often a cornerstone for wellness platforms. Disagreeing with a wellness warrior on a health-related topic often runs a high risk of being charged with being a shill paid by Big Industry. It's so common; it's trite at this point. 

I do not wish to dismiss COI or pretend it doesn't exist in the healthcare industry (e.g., payments from pharmaceutical companies influencing physician prescription behaviors). What's concerning about the rising class of wellness warriors is that while screaming about COI in healthcare, they more than willingly turn a blind eye to the COIs of their leaders and collaborators. Despite the Wellness Industry's adamance to the contrary, the wellness world is just as susceptible to COI.

Common COI in the Wellness Industry

There are many types of COIs across the Wellness Industry, but we'll focus on four.

• Product endorsement when someone stands to benefit personally. This is a tale as old as time, and everyone has seen it. The wellness world is not immune to it. It should go without saying, but just because it's marketed as “I just want you to be healthy!” doesn't mean they actually do. Check whether the person endorsing a product is on the company board or has other ties. It's often as easy as an online search.

Consider a story involving Dr. Oz, a naturopath, and green coffee beans that has, unfortunately, faded from memory. Before becoming a failed candidate for Senate, Mehmet Oz hosted a TV show where he plugged all kinds of pseudoscience and questionable wellness products. Any time he made a recommendation, it would take off. This was known as the Oz Effect. He invited a naturopath to talk about green coffee beans and proceeded to tout it as great for weight loss. The naturopath then relayed keywords for people to search that would lead them directly to websites that he, the naturopath, owned. He made millions. Dr. Oz was hauled in front of the Senate and questioned about why he didn't check any of this out beforehand and why he was peddling remedies with dubious science in the first place.
 

• Supplement companies recruiting wellness influencers. While pharmaceutical companies attempt to influence physicians to prescribe their products, supplement companies have their version, except there are no laws against it and far fewer regulations around supplements than pharmaceuticals. Supplement companies actively recruit affiliates and influencers to sell more of their products. While many in wellness world demonize pharmaceuticals, they celebrate supplements, which are often peddled as a way to improve your health. Along with the COI, there is an inherent contradiction in these two stances. If you hate that Big Pharma has sway, Big Supplement is no better. 

Many supplement companies, e.g.,  GNC, mindbodygreen, AG1, and Axis Labs, have an open call for affiliates and influencers. When supplements are placed in their proper context, there are largely unregulated drugs; this is horrifying. Big Pharma is not allowed to put out calls for doctors to primarily sell certain drugs. Yet supplements companies are allowed to do just that.
 

• Newsletters and health advocacy The internet has provided a platform for the wellness community to share information. In addition to selling products their review of health recommends, some of these sites require monthly subscriptions - a form of crowdfunding for their advocacy.  “The ideological influence exerted through crowdfunding is less obvious than what might occur from an industry payer, but these payments are influential all the same. Consumers who choose to financially support physician-creators are not a random selection of the population or even of a doctor's overall audience. Paid subscribers represent the most engaged fans, many of whom hold a specific set of strongly held beliefs.” Translation: you write what keeps people's wallets open, and, spoiler alert, that's often not in line with scientific consensus. 

There are plenty of physicians heavily identified with the wellness world that fall into subscription medicine/wellness COI. Consider another MAHA rising star, Vinay Prasad, Vinay Prasad, and Vinay Prasad. He’s famous for his contrarian views and antagonism. Back-of-the-napkin estimates for his income from Substack are formidable, considerably more than a treating physician typically makes. Given the number of Substacks that he has and the number of subscribers, he is the perfect example of why this is a problem. 
 

• Industry/Company sponsored research. There have been complaints about scientists and researchers being “bought” by Big Industry. The result has been overly friendly studies published in peer-reviewed journals, lending credibility to seemingly dubious methods.   

I recently covered a wellness researcher who published an article in a peer-reviewed journal utilizing all kinds of supplements without declaring that he benefits from people buying supplements. It was an obvious COI that wasn't declared, and the journal didn't catch it. As an update, the journal has been contacted and stated that they will issue a correction to the paper around his COI, but as of the date of publication, they have not.

So, where does this leave us? The Wellness Industry has marketed itself as caring about your health and well-being and only having your best interest at heart. However, the wellness industry has dirty hands. Many wellness COIs are the exact same that people claim to hate in the healthcare system. If you rightly care about COIs in healthcare but dismiss those in the wellness world, perhaps it's time to ask why. 

This is an uncomfortable truth. We want someone to have our best interest at heart, and the Wellness Industry has branded itself as exactly that. But it's important to recognize that branding for what it is: marketing. We don't want health and wellness to be all about money, but money makes the Wellness Industry go round like everything else. To pretend otherwise is dishonest. 

Given just how big the business of wellness is (e.g., $6.3 trillion in 2023), this really shouldn't surprise anyone. People buy the illusion of health, wellness, caring, and integrity while actually buying products, services, and images. All are marketed to appear beneficial without proving that those products and services are good for your health. Wellness warriors, influencers, and leaders aren't quite the angelic workforce they've marketed themselves as. The question is, how far are we willing to let them go?