056 | The Profitable Business of Keeping People Unwell

It might seem counterintuitive, but it turns out that keeping people unwell is a pretty damn profitable business.

I’ve got a little bit of a different kind of conversation for you today. I’m going to preface it with the disclaimer that I’m not an expert on any of this, I just did some Googling. So please, don’t take what I say during this episode as gospel. I do, however, want you to use this as a jumping off point for you to think more critically, practice curiosity, and foster a healthy level of skepticism.

So what the fuck am I talking about? Allow me to explain.

A while ago, I was chatting with one of my best friends, Kim, who is also in the health and wellness world. You’ve heard me talk about her on this podcast before. She and her brother run Functional Fitness Solutions. I’ll link to their website and socials in the show notes. 

Anyway, Kim and I were talking and I had made the comment that it’s not in the government’s best interest for people to be unhealthy. Kim jumped in with a “well, actually” argument that I couldn’t deny. This brought up the influence of big pharma and the incredible profit and influence that comes from that industry.

Big Pharma Is Stupid Profitable

For some context, in my day job, there are a ton of conversations about community health and how it’s in our communities’ best interests for people to be healthy and well. Caring for people who are sick is expensive. It’s expensive for health insurers, it’s expensive for companies offering health plans, it’s expensive for government programs, and it’s especially expensive for individuals and families.

So when I say it’s not in the government’s best interest to keep people sick, it’s more that it’s not in communities’, employers’, and community members’ best interest that people are sick. 

But when you inject pharmaceutical companies, lobbyists, power-hungry government officials, and corporate greed, it becomes a very different conversation. And it’s this perspective that Kim brought up.

Now, this isn’t a new argument, right? I’m certainly far from the first person to come out and talk about how greedy, power-hungry people and corporations are influencing public policies, beliefs, and practices in order to keep lining their own pockets.

It’s also not a new argument when you think about it from the perspective of the food industry and propaganda that’s masked as a public health initiative when in reality it’s a money grab. Kind of like the transition from the food pyramid to my plate. Which, side note, is something I want to talk more about at a later time because that’s fascinating to me. 

Why This Is Worth Talking About

If you’ve been listening to Badass Is the New Skinny for a while, then you’ve heard me talk about how this journey to being a healthy, happy badass is a rollercoaster. I tend to focus on the big life changes that are just a standard part of being a human—moving, starting a new job, getting married, getting divorced, experiencing loss, coping with natural disasters—all kinds of things. 

But something that I don’t talk about enough is how heavy of influence there is from other areas of our lives that have nothing to do with the changes that we experience. I’m talking about things like social influence, trauma, mental health conditions, cultural expectations, social determinants of health, and so on. These are not my areas of expertise, so I don’t talk about them much.

Instead, I very intentionally focus on empowering people to take control of their choices, health, well-being, and lives. Where some of these other, bigger topics come into play, I encourage people to work with mental health providers or other qualified professionals. In encouraging them to do that, I’m hoping that the message empowers them to get the help they need to achieve their goals. 

I say all of this to acknowledge that while each individual can do their level best to be healthy and well, there are a lot of things at play that are heavily influenced by other factors. It’s in some of these other areas where individuals are vulnerable and thus susceptible to be taken advantage of by sources who stand something to gain by keeping them unwell. 

Greed vs. Lack of Training

It’s really easy to pick on pharmaceutical companies in this example because, well, they’re notoriously shady and make bookoo bucks from marketing expensive prescription medications and targeting vulnerable people. Not only vulnerable, but ignorant.

Reminder: “ignorant” is not the same as stupid, and it’s not necessarily a bad thing. It’s simply that you don’t know any better. You lack knowledge or awareness. Let me give you an example. 

Let’s say you go in for your annual well visit. These are good things because you and your doctor can identify potential health issues early on and get ahead of things before they’re big health problems. But now let’s say you go to your doctor and your doctor says that your blood pressure is high and they’re going to put you on medication to help you bring your blood pressure back into normal ranges.

Sounds pretty innocent and even common, right? 

Except, you know what’s missing from this exchange? Any reference to how a healthy lifestyle may help you achieve the same goal. I’m not going to sit here and tell you that making lifestyle changes will solve every health problem, or even all high blood pressure concerns. Health is too complex for statements like that. 

But where’s that conversation? How often do doctors provide lifestyle changes as options for addressing certain conditions? And to be clear, I’m not talking about when a doctor just tells someone to lose weight or blames health conditions on weight. That’s an entirely different thing, and it’s extremely problematic.

Medication and Lifestyles

Some doctors are going to provide these options and talk with you about lifestyle changes that you can try before offering to prescribe medication. That’s great. It might not be enough in the long run depending on the health issue, but it’s a really good first step and could potentially keep you from being reliant on medication for the rest of your life.

It’s not really in medical providers’ training to really dive into lifestyle habits and behaviors that can reduce risks for diseases. They’re also not given any in-depth nutrition education to be able to advise eating behaviors and nutrition as an alternative. That’s why there are registered dietitians and health coaches and other support teams to help with that. The problem is that it leaves it up to you to be a savvy patient and understand what questions to ask and what resources to seek out.

That was a lot of words to say that doctors are more likely to prescribe you medication than they are to encourage lifestyle changes. And oftentimes, medications are prescribed for long-term unless it’s for an acute or short-term condition or illness.

The Problem with Prescriptions

When prescription medications enter the conversation, that’s when the greed comes out to play. I did a little bit of exploring on this topic and I learned some things that are really troubling. I’ll keep this part relatively short, and I’ve linked to some additional resources in the show notes.

To give you a taste of what I’m talking about though, here’s an excerpt from an article on CombatThePatentPrices.com:

“There are multiple reasons as to how the pharmaceutical industry is able to hold this much influence over the government. The relationship between these two are rooted in ways that create revenue for both groups, and by doing this it is creating an imbalance of power. Big Pharma is able to hold leverage over the government through patents, lobbying, and advertisements.”

It goes on to say:

“Lobbying is fundamental for the industry, so much so that in the 20 years, over 3 billion dollars have been spent on ensuring that legislation is drafted in favor of Big Pharma.”

What it all boils down to is that while there are some government entities hard at work to help create healthier communities, there’s a bigger force made up of both government and private industries that are profiting big time off of people who remain unwell. 

The Problem Continues: The Wellness Industry

But have no fear! If you’re one of those who is adamant that you don’t want to be reliant on prescription medication, guess what? There are seemingly endless resources to help you live a healthier life.

And that industry is also raking in the dough while you’re trying to improve your overall wellness. In fact, according to the Global Wellness Institute, the wellness industry is a $5.6 TRILLION dollar industry, all of which is playing on your insecurities to give you quick fixes or otherwise keep you engaged in some sort of long-term solution. 

OK, so maybe not ALL of it is doing that, but you get the idea. Wellness is, again, incredibly profitable. 

You might be thinking, “OK, Sabrina. But that industry is to help us be well as opposed to Big Pharma trying to keep us sick and reliant on their outrageously expensive medication.”

There’s some truth to that, but think about it this way:

How much money are you spending on what we’ll call disposable health and wellness products—the things that you have to continually invest in, it’s not just a one-and-done thing? Think about things like supplements, athletic wear, gym memberships, and health and wellness subscription services. When you look at your budget, how much money do you spend to help you achieve a health or wellness goal, even if that goal is maintenance? 

Side note, I don’t actually know anyone who is at a “maintenance” level, because the wellness industry is sort of built on this idea of ongoing improvement. Are you strong enough, fast enough, skinny enough, happy enough? No? Well good news, there’s a program for that, a product for that, and so on.

And yes, I’m very aware that I am part of that 5.6 trillion dollar industry, and I’ve talked about all of this to some extent before. But I guess at this point, what I really want is for my audience to be savvy about how they’re engaging with health and wellness products and services. It’s why I promote feeling like a badass, because you know what? If your version of feeling like a badass is making your bed every morning and taking your dog for a walk every day while you drink plain ol’ tap water and occasionally eat a bacon cheeseburger and a side of fries, there’s nothing wrong with that.

It’s hard though to resist the noise and messages that this isn’t enough and you need to be taking this supplement and wearing this athleticwear product, and buy this subscription service and this piece of equipment, and blah, blah, blah.

I’m a little sensitive about all of this because being trapped in this state of not feeling like you’re good enough is a shitty place to be and unfortunately there aren’t a lot of advocates out there who are helping people find a way to actually feel good inside and out who don’t also have their hand out in anticipation of however much you’re willing to shill out so that you can feel good enough. 

Basically, what I’m saying is that there are people out there getting rich as fuck off of people who are sick and/or who believe they need to do an incredible amount more to be healthy.

Compassion Meets Capitalism

To go back to this whole hypocritical part of me, here’s the thing:

I love working with people to help them feel better and achieve their goals. I love helping people in a way that’s not just feeding into some arbitrary idea of what they think will help them feel better. What happens with this sometimes is we set these goals for something that we think will make us happy, achieve that goal, and don’t feel any better. It’s discouraging, and it’s an ugly cycle. It happens though when we don’t spend the time to really ask ourselves how our lives will be different when we achieve our goal.

But because I love working with people and helping them achieve their goals, I started this podcast. I would love for coaching to be a part of my professional identity. The wellness industry is a crowded space with a lot of contradicting information and it’s loud and it’s confusing. So many people would benefit from having someone in their corner who truly has their best interests at heart. 

Like everyone else though, I need to make a living. That’s hard to do when I feel like health and wellness coaching should be a free service to people. It’s why I’ve never succeeded with business models that focus on pricing and insist that if people really need it, they’ll pay for it. It’s not that I don’t recognize my value and what I have to offer, it’s that when the pricing model is set intentionally high, we—as an industry and as a society—make healthy living inaccessible to a lot of people. And I would argue that the people who can’t afford it probably need it most. 

I want to pause for a moment to acknowledge that the wellness industry really does attract a lot of big-hearted people with good intentions who really do just want to help others feel better and live a healthy life. It’s just unfortunate that there are also a lot of people who are in this industry simply because it’s such a profitable place to be.

What Does This Mean for You? Here’s Your Mission

So what I want to leave you with today is a mini mission. Your mission is to take some time to think about what you think you need for your health and wellness and why you think you need it. 

Who said you needed it? What was the source? 

What kinds of options did this source provide? 

How much money are they asking for? 

Now imagine you’ve achieved whatever goal it is you’d want to achieve. How would your life be different? Would it really be better? Why or why not? 

If you’re on prescription medications, are those medications necessary, or would lifestyle changes eventually eliminate the need for those medications?

(Side note: If the answer to that is that you need those medications, that’s totally fine. Not everything can be addressed through lifestyle changes, and always talk to your doctor before discontinuing any medication.)

I want you to take some time to think about your health and wellness goals and really decide if achieving those goals is really going to help you achieve whatever you’re ultimately trying to achieve. Or, did you get caught up in the flash? Or were you just inundated with the messaging enough that you believe something needs to be different?

Lean Into Curiosity

I think it’s important that we all, on occasion, take some time to step back from ourselves and evaluate what we think we want from an outside or more distanced perspective. This is hard, and it might be worth talking with someone you trust to get some of that perspective. But given that we’re living in an increasingly expensive world and being pitched all kinds of bullshit we don’t really need, it’s important to try to take an objective look at our health and wellness goals and where we’re putting our money and see if things are really lining up. 

And at the end of the day, it’s your money. If you’re satisfied with your choices and you feel in control of your own perspective and not that you’re being manipulated by puppet masters, that’s fucking fantastic. Chase the goals you want, spend your money however you choose, and define “badass” however makes the most sense to you. My only objective for you is that you approach all of this with eyes wide open and make informed decisions. 

I do believe that big changes are needed in government, corporations, and the health and wellness industry. But I also understand that the underlying issues aren’t changing anytime soon, and the best course of action is to be an empowered, curious consumer.

Resources and Articles

Functional Fitness Solutions

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