New Year, Same Toxic Wellness Marketing
Healthism is the Pervasive, Profitable Misconception Shaping Our Resolutions
This year, like most New Years, millions of American will make resolutions, committing to some positive change for our next trip around the sun. The most popular resolutions this year (as with many previous years!) include health-focused commitments to diet and exercise.
The wellness, diet, beauty, and fitness industries love these health-focused resolutions because they provide ample opportunity to sell us items, services, and (increasingly) subscriptions, to meet our self-imposed goals.
The relentless pursuit of health - and therefore financial investment in health - seems intuitive. But is it?
The wellness economy alone is valued at over $6.3 trillion globally in 2023 and showing no signs of slowing down. But changing our diets and physical activities doesn’t have to cost so much. So why do so many of us - year after year - fork over so much money to these industries? Even more worrisome is, when we live in a society fueling this level of spending on health, who is being left behind in the wellness economy?
At its core lies an ideology that most of us don't even realize we are subscribing to: healthism.
Health as the Superior Value
Healthism is a belief system elevating individual health as superior to other values, framing personal well-being as not just a choice but a moral duty. Healthism is highly focused on individuality and personal lifestyle modification.
Robert Crawford coined the term in a 1980 paper Healthism and the Medicalization of Everyday Life. Crawford recognized that placing responsibility for the achievement of health at the level of the individual person, rather than as part of a larger societal system, solutions are ineffectively limited to the individual as well.
In other words, if you’re not doing your ethical responsibility to get healthy - especially becoming healthy in an idealized way, you’re a morally inferior person.
If you’re like me, you’ve heard and perpetuated common healthism ideas like:
“I won’t eat that - I’m being good”
“Cheat day” or “cheat foods” - implying that eating, doing, or not doing something on a particular day is cheating
“I’m being bad” by not exercising, or by eating something
Focusing solely on foods for health properties
Making judgmental comments about other peoples’ bodies, diets, and movement habits
Believing idealized health can be assessed by external factors like body size and muscle tone
Believing health is all about willpower
Being a kid of the diet-crazed 80s and 90s, these ideas were woven into many of my ideas around health and wellbeing. Once I started noticing how healthism was deeply woven into my thinking about bodies, food, and disability, I began the laborious work of picking at the threads.
With healthism, personal health as always within your control, entirely attainable, and morally good. When we see the world this way, we can judge ourselves and others based on how we perceive idealized health. People who engage in deprivation behaviors like dieting, juice cleanses, “detoxing,” complex skin care routines, and fasting can be viewed as inherently good and moral, irrespective of other values.
While healthism might sound like common sense, it leads to stigmatizing individuals for illness, disability, pollution, poverty, and random chance. Healthism further erodes the ability to recognize the inherent human dignity in people who don’t achieve these arbitrary health standards. Harmful views perpetuated in ableism, fatphobia, ageism, diet culture, and obsession with youth rely on this fallacy.
Healthism is an insidious ideology, quietly aligning with American individuality and bootstrapping, and getting in the way of collective approaches to health promotion. Healthism primes us for the commodification of lifestyle and the hyper-consumerism of self-care.
Perhaps most ironically, is that many of us espousing heathist views see ourselves as anti-medicalization - believing that focusing on individual health will protect us from illness and the need for medical care. But healthism is an extension of medicalization. I think about how many things I was taught in medical school that solely focus on individual patients and choices, often without the social and cultural context for how both patient and physician ended up together. Both are overly focused on individual health over systematic changes that could benefit the broader population.
“As an ideology which promotes heightened health awareness, along with personal control and change, it may prove beneficial for those who adopt a more health-promoting life style.
But it may in the process also serve the illusion that we can as individuals control our own existence, and that taking personal action to improve health will somehow satisfy the longing for a much more varied complex of needs.
As such, healthism functions as dominant ideology, contributing to the protection of the social order from the examination, critique, and restructuring which would threaten those who benefit from the malaise, misery, and deaths of others.”
- Robert Crawford, 1980
It’s easier to believe that individual actions can solve problems rather than grappling with the messy reality of genetics, environment, and social determinants of health.
The Wellness Industry’s Cash Cow
The wellness industry capitalizes on healthism by selling products, services, and lifestyles that lean on individual duties and promise a path to “optimal health.”
From supplements to boutique fitness classes to expensive face creams, the message is clear: health is a purchasable commodity.
Diet culture is a major example of healthism in action. Controlling one’s diet and body is promoted as the way to achieve moral superiority. Weight loss is often considered a moral good in our society - from the grocery store to the hospital. This is used to sell supplements, magazine, exercise classes, etc.
White, wealthy women influencers have become central to this messaging, both as consumers and ambassadors. Their privileged access to resources allows them to embody the aspirational ideals of a specific health brand, reinforcing social and class hierarchies and excluding marginalized groups, especially people with disabilities.
Weaponized Autonomy
Through the lens of healthism, the causes of poor health are rooted in an individual’s failure to make healthy choices and therefore poor health is that person’s fault. One must be sturdy enough to overcome any obstacle on the road to optimum health.
“For the healthist, solution rests within the individual’s determination to resist culture, advertising, institutional and environmental constraints, disease agents, or, simply, lazy or poor personal habits.”
- Robert Crawford, 1980
Crawford points out how social practice and public policies that rely on willpower and lay blame at the feet of individuals, then they actually leave us powerless to control our own fate. By adopting the healthism approach, we tend to deny or ignore the structural forces that produce the behaviors and attitudes that negatively impact overall wellbeing.
One of the most pervasive myths fueled by healthism is that health is entirely within an individual’s control. If the person just tried hard enough - and spent enough money - they too could achieve this mythical status of healthy.
When health is something you can buy, those lacking the financial capital to spend are left behind.
Poverty? Racism? Pollution? None of that matters if it’s up to you and only you to strive to achieve a standard that is unrealistic, unattainable, and unsustainable. It’s up to you to have enough money to buy! buy! buy! your way to wellness.
The short-lived nature of this misconception becomes apparent when factoring in any illness or disability. The veneer of control shatters, leaving individuals or their families who deeply believed healthy living would protect them from illness, feeling guilty, ashamed, or even ostracized. Think of the constant moral signaling early in the covid-19 pandemic about who was sick and why. Were they fat? Were they old? Were they poor? Did they shelter in place? By framing health as a moral obligation, healthism unfairly assigns blame to those who face challenges beyond their control.
Seductiveness of Healthism
“Common sense” arguments are attractive and comforting, even though they may be wrong. Healthism promotes a simplification of complex issues into something manageable - something up to each individual person. When self-proclaimed experts, influencers, and institutions frame individual choices as good old-fashioned common sense, it becomes harder to question.
Healthism is seductive because it promises agency and control in an unpredictable world. It tells us that if we eat right, exercise enough, and make the “correct” choices, we can avoid illness and hardship.
But the brutal truth is that health is not entirely within our grasp based on individual willpower. Genetics, accidents, systemic inequities, and plain old bad luck play significant roles, often overshadowing choices by any one person.
Understanding this reality allows us to see how healthism feeds the wellness economy: a toxic blend of privilege, profit, and prejudice.
Happy New Year, 2025
As you head into 2025, I invite you to consider the role of health in any resolutions you may make.
Health is not a commodity.
Health is not a meritocracy.
Health is not what makes you a good person.
Health is not required for our human dignity.
This year, take a look at how healthism is being used to sell you products and services that you probably don’t need - and maybe don’t even really want. Will these really lead to the health outcomes you seek?
I hope 2025 brings you true health - but also so more than that. I hope you find joy and happiness and fulfillment, connection with people you love and respect, deep meaning in your role in the world. I hope that we can find more ways to focus on big picture systemic issues that negatively impact our health, and lean away from the false promises of individualism.
References
AP-NORC Center for Public Affairs Research. “Republicans are expecting 2025 will result in an improvement in their own lives and for the country” (December 2024).https://apnorc.org/projects/republicans-are-expecting-2025-will-result-in-an-improvement-in-their-own-lives-and-for-the-country/
Global Wellness Institute. 2023 Health, Happiness, and the Wellness Economy: An Empirical Analysis.
Crawford R. Healthism and the medicalization of everyday life. Int J Health Serv. 1980;10(3):365-88. doi: 10.2190/3H2H-3XJN-3KAY-G9NY. PMID: 7419309.