The Sneaky Insidiousness of 'Wellness Diets'

The goal of “getting to the root cause” that is so pervasive in the wellness industry is alluring to us all, but some of the tactics used to get there are restrictive eating in disguise.

In the summer of 2020, Jaime (who asked that I use just her first name) was struggling with irritable bowel syndrome, depression, headaches, and acne. She paid a visit to the primary care physician she’d been seeing for years, who recommended an elimination diet that she said would help get to the root of all these concerns. Jaime trusted the doctor and didn’t think to question her. After reading over the elimination diet materials her doctor provided, Jaime embarked upon the recommended restrictive meal regime “wholeheartedly,” she says. She removed seven broad categories of foods, plus “anything processed,” from her diet—and kept this up strictly for about four weeks.

Jaime’s digestive issues proceeded to worsen over the course of the month that she was following the elimination diet, including “severe simultaneous diarrhea, constipation, and constant bloating,” she says. She also lost weight quite rapidly on the restrictive diet. Alarmed by the sudden change, Jaime went back to her doctor to discuss how to start reintroducing some of foods she’d eliminated and determine whether she had sensitivities to any of them. The doctor, however, told Jaime that revising the “plan” was unnecessary, and that she never needed to eat any of those foods again because she was getting “all of her required nutrition” from the restrictive diet.

That advice is a complete falsehood. In reality, even evidence-based elimination diets aren’t meant to be continued long-term—particularly if a patient’s symptoms or their relationship with food are worsened by the diet.

Today, all manner of health problems are blamed on an “unhealed” gut microbiome, an “imbalanced” hormonal state, or other immeasurable-yet-discouraging-sounding metrics—as we’re reminded every time we use social media or innocently Google a symptom. It’s easy to default to blaming a person’s diet and lifestyle for physical issues that are otherwise challenging to diagnose (especially in fields where research is still limited, like gut and hormonal health). Many corners of the wellness industry rely far too heavily on these assumed “root causes.”

The goals of “getting to the root cause” and “treating the whole person” that are so pervasive in wellness culture are understandably alluring to many people. But these concepts can be particularly appealing—and potentially damaging—to those coping with chronic health conditions. The same can be said for anyone who’s historically struggled with disordered eating and/or felt dismissed or unheard by the conventional health care system.

Yet these so-called “healthy” habits are leading many people down a dangerously unhealthy path. For one thing, these “wellness” diets generally aren’t backed by sufficient evidence for widespread use; instead, they’re often based on early-stage research in animals, cell cultures, or very small, non-randomized groups of people—not the kind of robust science that’s needed for making clinical recommendations. What’s more, the dietary changes popular in the wellness world can trigger or exacerbate disordered eating in vulnerable people, which in my experience is the majority of the population (though of course not everyone).

Why “food-first” approaches to resolving health issues can be appealing

It’s easy to see why natural-sounding, harmless-seeming, food-first approaches to wellness are so popular in a conventional health care system where many people don’t get the care they need and deserve. But eliminating entire food groups is not the panacea it’s made out to be, as Sarah-Jane Garcia learned the hard way.

Garcia is a pharmacist who struggled with binge eating for years. When she saw a doctor for help with her disordered eating, all she got was a prescription for an antidepressant, because the doctor said she had anxiety and chronic fatigue (although exactly how those were related to her bingeing was unclear).

Garcia wanted to understand the underlying reasons for her disordered eating and felt dismissed by the doctor, but she tried the meds anyway—to no avail. After trying another medication that didn’t work to stop the bingeing, Garcia was at a loss. She confided in a coworker about her issues with eating, and the colleague told her about a wellness influencer she should follow on Instagram for tips to help her with bingeing: a naturopathic doctor (not an MD) who claimed to have healed his own health problems through detoxes and certain protocols from "functional medicine" (an alternative to conventional medicine that often prescribes diets and supplements) that have little scientific backing. His content immediately resonated with Garcia. She felt hopeful, inspired.

“[The Instagram naturopath’s] story tracked so closely to mine. He went for conventional help, he couldn’t get the answers he needed, and finally he just ‘did his own research’ and found the answers in naturopathic-based medicine and other wellness components,” Garcia says. “And so I started to really buy into him.” From there, she got into Paleo diets, fasting, detoxes, herbal supplements, and more—and her binge eating only got worse.

The longer Garcia spent prioritizing these restrictive methods, the more her mistrust and wariness of the conventional health care system grew, even though she was a part of it herself as a pharmacist. Much of what Garcia was learning in wellness spaces was new to her, which made her think that her doctorate program in pharmacy hadn’t taught her “the latest research” on how to treat various conditions. She began looking to integrative and naturopathic medicine for all of her continuing education, and eventually got a certification as an integrative health practitioner—which only strengthened her distrust of conventional medicine. “I started to become a pharmacist who was anti-drugs,” Garcia says.

As Garcia’s experience reveals, problematic aspects of wellness culture such as restrictive diets and a rejection of evidence-based treatments have increasingly begun to filter into conventional health care spaces, from retail pharmacy counters to regular doctor’s offices. Jaime’s doctor had been a general practitioner at a local low-income health clinic, with a specialty in family medicine. Jaime had no idea that her longtime doctor was interested in using food restriction as a way to resolve health issues like depression until she gave her the reading materials for her prescribed elimination diet. The doctor left that clinic shortly after this, and Jaime heard it was so that she could practice functional medicine more openly in her new job.

Social media feeds into the problem

The reasons why conventional health professionals begin recommending risky approaches like restrictive diets are varied, and sometimes include preexisting disordered eating, as was the case for Garcia. But social media can also play a role, and sometimes health professionals can be just as vulnerable to online wellness misinformation as anyone else.