America Can’t Break Its Wellness Habit

In 1829, the Presbyterian minister Sylvester Graham invented a cracker made from coarse wheat that he believed would help restore American health. He lamented the “miserable trash” that made up the average diet, especially white bread, and thought his eponymous crackers would curtail masturbation, which he deemed deleterious to both moral and physical well-being. (As someone who condemned sweet treats, he would have seen the s’more as an abomination.)

Graham was, in many ways, what we might today call a wellness influencer. Nineteenth-century Americans opened Grahamite boarding houses so that travelers could eat his chaste and bland foods, and catch up on that week’s copy of The Graham Journal of Health and Longevity. And like many of today’s wellness influencers, he advocated for an ideology that mixed truth and nonsense. Yes, it’s healthy to eat fiber; no, pleasurable foods are not linked to deviant sexual behaviors. Robert F. Kennedy Jr., a wellness influencer who is also President-Elect Donald Trump’s pick for secretary of Health and Human Services, is similarly inconsistent. Kennedy has correctly identified an association between the ultra-processed American diet and high rates of chronic disease, but he’s also an anti-vaccine advocate who has suggested that AIDS deaths are caused by poppers and that seed oils are poison.

Over the past weeks, journalists, doctors, and scientists have rushed to correct Kennedy’s false statements. More than 75 Nobel Prize winners signed a letter this week asking senators to oppose Kennedy’s confirmation, given his “lack of credentials” in medicine, science, and public health. But a better way to understand his appeal is to situate him, with Graham, in a long lineage of American wellness figures waging a battle against conventional medicine. For more than a century, alternative health practices—what we now call wellness—have seduced Americans not because of the accuracy of their claims, but because of what else they offer: a sense of certainty, an outlet for mistrust, a pseudo-religious belief in the “natural,” and an affirmation of modernity’s limits. Because it satisfies those needs, wellness has a pattern of success in presenting itself as a replacement for the failures of medicine, even though the goals of wellness radically diverge from those of public health. The history of wellness suggests that the best way to defuse Kennedy’s power is not by litigating each one of his beliefs, some of which are irrefutable health truisms, but by understanding why the promise of being well has such lasting appeal.

Our Goop-ified world may seem fundamentally modern, but there is a direct line between today’s wellness industry and the 1800s, when what was then called “irregular” medicine exploded in popularity. Through the early 20th century, people sought out homeopathy, osteopathy, naturopathy, water cures, and chiropractors. Religious and spiritual movements such as New Thought and Christian Science promoted the idea that bodily health came from the right state of mind, not medicine.

[Read: I Gooped myself]

These health interventions were largely a response to disillusionment with 19th-century medicine, which was, by today’s standards, painful and ineffective. Doctors depended heavily on bloodletting, vomitive drugs, and other “heroic” treatments that shocked the body into purging its contents. A commonly used drug, calomel, was made of a mercury compound and caused the gums to bleed, the mouth to swell, and teeth to fall out. Irregular medicine offered another option, with conspiratorial undertones: There was a gentler cure that conventional doctors weren’t telling you about. (And unlike calomel, irregular treatments wouldn’t cause your teeth to fall out.) A 1903 osteopathic text decreed, “The world is becoming too intelligent to be drugged and hacked in a search for health when more agreeable methods can be obtained at the same price.”

In response to the unregulated health products being distributed by irregular practitioners and conventional physicians alike, as well as uproar over the unsafe food-handling practices revealed in Upton Sinclair’s The Jungle, the contemporary American public-health apparatus was born. The FDA was created to enforce the Pure Food and Drug Act of 1906, which, among other things, required safe practices for manufacturing food, drugs, medications, and liquors as well as labels that included a product’s dangerous ingredients. Laws limiting the practice of medicine to those with proper licenses became more widespread and more consistently enforced; Benedict Lust, the father of American naturopathy, had to pay hundreds of dollars in fines and legal fees after giving one of America’s newly minted medical detectives an electric-light bath, a treatment that involved sitting in a cabinet with incandescent lights pointed at the body.

As part of their advocacy for the natural, Lust and other irregular doctors also vehemently opposed vaccines. Lust called compulsory vaccination the “most heinous of all crimes.” He even helped nominate a chiropractor for president in 1920 and joined him to promote what they called the American Drugless Platform. Lust was remarkably similar to Kennedy, who decries pesticides, opposes fluoride in tap water, and has long stoked baseless fears about vaccines. Kennedy has said doctors should recommend gym memberships and “good” food to diabetic patients. He has proposed that people who are dependent on antidepressants or opioids could recover on “wellness farms,” an idea remarkably similar to Lust’s well-known naturopathy retreat in New Jersey, which opened in 1896. “His arguments are variations on the same theme that’s been present in public discourse about health in the Western world for a long time,” Colleen Derkatch, a rhetoric professor at Toronto Metropolitan University and the author of Why Wellness Sells, told me.

Many of Kennedy’s most popular crusades are easy to debunk—just as irregular medicine was at the turn of the 20th century. Horace Fletcher, a trendy nutritionist in the early 1900s, told Americans to chew their food until it was liquid before swallowing, and proposed that this would be the solution to starvation and poverty. He inspired the celebrity doctor John Harvey Kellogg, whose name still graces our cereal boxes and who promoted electric-light baths and 15-quart water enemas. Bernarr MacFadden, another immensely popular health figure, and a bodybuilder, thought that the 1918 Spanish-flu pandemic was caused by poor diet. Even at the time, these ideas were fringe among experts. But they caught on because they spoke to people’s real concerns: about rapid urbanization’s effects on health and lifestyle, and about medicine’s inability to prevent widespread death.

The concerns of modern wellness adherents are no less valid than their 20th-century counterparts. Medical treatment in general has become more effective, but still has sins to atone for: The pharmaceutical industry fueled an opioid epidemic that has killed 800,000 Americans and counting, all while drug prices in the U.S. are nearly triple what they are in other well-off countries. Most of the food available at the average American grocery store is ultra-processed. Some aspects of the public-health response to the coronavirus pandemic, such as shutdowns and school closures, led to distrust of public-health officials—just as happened after the flu pandemic of 1918.

“Low institutional trust is central to RFK Jr.’s popular appeal,” Stephanie Alice Baker, an associate professor at City St George’s, University of London, and the author of Wellness Culture, told me. Kennedy provides what irregular medicine did: an outlet for feelings of betrayal at medicine’s failures, plus the promise of reclaiming control through “natural” means, such as the right diet and supplements. “It’s an empowering message,” Alan Levinovitz, a religion professor at James Madison University and the author of Natural: How Faith in Nature’s Goodness Leads to Harmful Fads, Unjust Laws, and Flawed Science, told me. “It means you don’t have to be scared of getting sick if you eat the right foods.”

Irregular medicine began to fade out only once the U.S. entered the “golden age of medicine,” when conventional treatments became more effective and less terrifying. The first antibiotic was discovered in 1928 and was widely available after World War II. The polio vaccine was released in 1955, and two years later, annual cases had dropped almost 90 percent, making older arguments against “germ theory” far less compelling. Practices like homeopathy and osteopathy took a back seat to “wonder drugs” that could address infectious diseases such as smallpox and tuberculosis. But after these successes, medical and public attention shifted to chronic, noncommunicable ailments: cancer, diabetes, heart disease, and the like. The golden age of medicine was ill-equipped to counter these maladies, and once again, as the luster of conventional health expertise waned, wellness surged.

Halbert L. Dunn, the chief of the National Office of Vital Statistics, coined the term wellness in 1959 when writing about health-care providers’ dissatisfaction with the ability of medicine to care for the “spirit.” He helped to reignite interest in alternative medicine, and its emphasis on vegetarianism, exercise, and natural living. Alternative medicine became a national trend in the 1970s, entwined with the antiauthoritarian countercultural movement. Crucially Dunn considered wellness not a replacement for or foe of medicine, but its complement. Medicine was a reaction to illness; wellness was a practice you engaged in when healthy. But doctors rushed to defend the ways of conventional medicine. In the late 1970s, the prominent physician Lewis Thomas wrote a commentary in The New England Journal of Medicine warning that the new field of lifestyle medicine was “wide open for magic.” Today, an evidence-based cohort of conventional doctors are still set on debunking wellness practices, while wellness figures decry the failures of medicine and the corruption of Big Pharma.

The pull toward the “natural” can be especially enticing when the world seems designed to make people sick. There’s concern about “forever” chemicals while food comes wrapped in plastic, and wildfires send smoke pouring across continents. Levinovitz has argued that, in the wellness world, the term natural assumes a pseudo-religious status. It provides comfort, ritual, and community. If wellness is a church that views “clean” or “natural” food as sacred, and additives or vaccines as profane, then Kennedy fits neatly within it. Religious beliefs famously cannot be dispelled through arguments over evidence, which does not bode well for anyone who wishes to wrest the American public out of Kennedy’s grasp.

[Read: The sanewashing of RFK Jr.]

Like religion, wellness doesn’t captivate by empirically proving its truth to adherents. But it does meet certain psychological needs. By contrast, the crucial project of the U.S. public-health apparatus is not to soothe its citizens’ existential woes, but to make policies that address the health of the masses. An administration that prioritizes the sacraments of wellness above all—especially if it undermines the efficacy of vaccines, cuts funding for infectious-disease research, and reduces regulation around raw milk—won’t make Americans healthier. This country reckoned with the limitations of wellness’s promises in the last century; perhaps, in this one, Americans can resist substituting wellness for what public health has to offer.