The unsavory history of the wellness industry

When most people hear the name Kellogg, they think of breakfast ce­real. Corn Flakes, Rice Krispies, maybe even Eggo Waffles and Pop-Tarts. Misogynistically removing the clitoris as a punishment, masked as a treatment for female sexual promiscuity and masturbation, is not top of mind. Yet these kinds of moralizing ideas about health—embraced and perpetuated by a health authority of Kellogg’s significance—gave birth to the modern wellness industry and have become rooted in alternative medicine.

In 1878, John Harvey Kellogg and his brother, Will Keith, built some­thing called the Battle Creek Sanitarium. It was once a world-famous med­ical center, spa, and grand hotel, attracting the wealthy and preeminent celebrities of its day. While Will helped run the sanitarium before starting the now multi-billion-dollar Kellogg cereal company, John went on to be­come one of America’s most popular physicians and bestselling authors. The advice dispensed by John in his books, lectures, and Good Health magazine was followed by millions, and in 1921, his research on digestion and diet was nominated for a Nobel Prize.

But amid his brilliance was also folly. He was on a self-appointed, messiah-like mission from God to make the world healthier and was derided by colleagues for his grandiose personality. Many of his ideas blended medical concepts with Seventh-day Adventist Christian beliefs on health reform. The result was a philosophy that natural, wholesome living combined with faith in God made the best medicine.

The term wellness wasn’t even around yet. Instead, to obtain the lifestyle he idealized, John prescribed the precursor to wellness—what he called biologic living. It meant striving for health in mind, body, and spirit to prevent illness, but doing so with three panaceas: physical exercise, adequate sleep, and a diet replete with fruits, grains, vegetables, and milk. Literally every health condi­tion could be treated with that trifecta recipe.

He warned patients against sedentary lifestyles, meat, sugar, caffeine, to­bacco, alcohol, sex, and obesity—the latter of which was considered both a slight against physical attractiveness and a health hazard. He referred to mas­turbation as “self-abuse,” advising that it could lead to mental illness, cancer, and moral destitution. In boys, it was to be treated by circumcision if band­aging their hands didn’t work; in girls, he recommended pure carbolic acid to the clitoris, as well as its removal along with the labia minora of the vulva.

According to medical historian Howard Markel, John was obsessed with cleanliness and virtuous eating. He believed that digestion could be aided by chewing food to oblivion and would guide his dinner guests in a round of the “Chewing Song,” with the chorus beginning, “Chew, chew, chew, that is the thing to do.” He also told his patients they should have four or five odorless bowel movements a day. Occasionally, he would leave social gatherings, only to return with a container of his most recent fecal specimen, and then place it under the noses of his friends to brag about its sweet and odorless quality.

Quirks aside, John was developing and promoting his ideas at the dawn of modern medicine in North America. Something called the Flexner Report of 1910 ushered in this era. The book-length report written by Abraham Flexner embraced rigorous science and its advancement as the new ethos of health care. Although the report raised the quality of medical education, it simultaneously hurt disadvantaged communities by shutting down rural and historically Black medical schools and revising entrance requirements to medical schools that worked against those who were economically un­derprivileged by making them more arduous and expensive. Schools that offered training in alternative medicine—such as naturopathy, homeopathy, and chiropractic—were told to drop it from their curriculum or shut down as well.

By the time John died in 1943, modern medicine was an entrenched sci­entific enterprise. But the aftermath of the Flexner Report left something to be desired. As Thomas Duffy, a professor at the Yale School of Medicine, put it, the hyperfocus on excellence in science was not well balanced by a com­parable push for excellence in clinical care. In other words, some physicians became coldly distanced from patients in a way that allowed nurses and alter­native medicine practitioners to step in and fulfill the warm art of listening, comforting, and humanizing.

In parallel with John’s widespread promotion of biologic living, a man equally eccentric named Bernarr Macfadden was becoming the 20th century’s first celebrity health influencer. He made millions selling Americans a bill of health that consisted of fitness, fasting as a cure-all, and hostility to medical science. Staunchly opposed to vaccination, he would strut around New York barefoot so his soles could absorb the Earth’s energy, and he slept on the floor so his blood flow would align with its natural magnetic rhythm.

In 1899, Bernarr launched Physical Culture magazine, an assortment of articles about health advice alongside photos depicting scantily clad people (often him) showing off their physique. The magazine was a hit, leading to a New York-based publishing empire, and cementing Bernarr as an acclaimed health guru who sold the idea that “a person could exercise un­qualified control over virtually all types of disease” given the willpower to live righteously.

I spoke with family physician and adjunct assistant professor Michelle Cohen, who has written about the legacies of John and Bernarr. “They were two of the most important health promoters of the 20th century and their influence continues into our time,” she told me. “They brought 19th-century ideas of health moralism into a new era of mass marketing and celebrity cul­ture, championing the fantasy that your health could be controlled with a virtuous lifestyle.”

Eating nutritiously and exercising regularly certainly matter for all aspects of health, including mental health and illness. But as Cohen brilliantly articulates, “There’s a huge difference between lifestyle counseling and sel­ling a cure-all based on lifestyle change. The former makes you a healthcare provider, the latter makes you a grifter.”

Cohen also reminds us that “health is not a moral virtue.” It’s damaging when we hear disparaging comments about “lazy” people who “pop pills” and who use medication as a substitute for the hard work of eating “clean” and exercising.

These views especially apply to the nature and treatment of mental illness. Stigma festers and grows in the minds of those who unwittingly internalize the idea that mental illness is a sign of weakness or that taking medication is a personal failing.

The modern wellness industry inherited John’s and Bernarr’s moralizing attitudes toward health. Other historical and cultural threads too wove to­gether to create the juggernaut of an industry that we see today. The fallout from the Flexner Report lingered into the advent of the counterculture move­ment of the 1960s and 1970s. These two social forces synergized anti-medical establishment societal attitudes that propelled patients into the welcoming hands of alternative medicine. Simultaneously, in late-20th-century North America, people were increasingly identifying as consumers and demanding a wide range of choice whenever they spent money. This catalyzed a shop­ping cart approach to health care that magnified the role our own behaviors play in molding our health and led people to downplay the role of genetics and social factors, including plain old bad luck.

Sixteen years following John’s death and 4 years after Bernarr’s, the term wellness, as we use it today, was born. That’s when the so-called father of the wellness movement, biostatistician Halbert L. Dunn, first used the term in the Canadian Journal of Public Health, in 1959. Reminiscent of the distinc­tion between mental illness and mental health, Dunn distinguished between good health—freedom from illness—and high-level wellness, defined as “an integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable, within the environment where he is functioning.”

Dunn’s thoughtful definition didn’t stick. “Wellness” quickly took on a life of its own.

Nowadays in many parts of North America, wellness has sprouted on every corner. Across from your local Starbucks, you’ll see yoga and medi­tation classes interspersed with spa, weight loss, massage, acupuncture, and chiropractic clinics. Employee wellness programs offering subsidized gym memberships for work-life balance and mental health are a click away.

In her book The Gospel of Wellness: Gyms, Gurus, and the False Promise of Self-Care, journalist Rina Raphael laments how there’s no agreed-upon definition of wellness, noting that it’s one reason the industry has grown so big: “Wellness has devolved into an ambiguous marketing term that can just as easily mean activated charcoal toothpaste as it does mindfulness.” It has seemingly ballooned to include anything and everything. Ask one guru what they mean by wellness and receive a different answer from the next.

Within its disorder, there’s paradoxical order. In her analysis of the way that wellness promoters use the rhetorical power of language, associate professor Colleen Derkatch has caught the industry red-handed. In Why Wellness Sells: Natural Health in a Pharmaceutical Culture, she beams a light on two opposing messages that bombard marketing materials and drive sales: On the one hand, we’re told that we need wellness to enhance, boost, and optimize our health; yet on the other, we’re sold products and services designed to treat health conditions and restore what we’re missing. We hear something like “maximize your mental health” by “treating your energy blockages and diet deficiencies.” The term wellness has drifted from Dunn’s definition and morphed into dollar signs, drawing us into a never-ending cycle of enhancing our health by treating problems we didn’t know we had.

The wellness industry is currently valued at a breathtaking $5.6 trillion worldwide, which includes earnings from bona fide resources for healthier living (e.g., sports and exercise classes) as well as alternative medicine products and services. It also includes what’s been dubbed the $181 billion global mental wellness economy, to capture money spent on sleep serv­ices and monitors, meditation and mindfulness resources, supplements for “brain health,” cannabis and psychedelics, and self-help delivered by gurus, coaches, organizations, and apps.

Most perniciously, wellness has come to represent a wonderland free from the constraints of scientific scrutiny. The beating heart of the industry flows with pseudoscience, and to say that it’s lucrative would be an understate­ment. It’s the commercial home to the alternative medicine industry itself, estimated to be worth nearly $200 billion worldwide in 2025. In the United States alone, Americans spend over $30 billion per year on alternative med­icine, and even the homeopathy industry is valued at $1.2 billion, used by an estimated 5 million adults and 1 million children.

The wellness industry owes a great debt to its forefathers. Celebrity doctors and wellness influencers of today resemble modern-era John Kelloggs and Bernarr Macfaddens, reincarnating many of the same tropes that moralize our health and berate mainstream medicine. Undue blame is laid at our feet if we don’t eat right, feel right, or live medication-free.

Both misplaced and well-earned distrust in modern medicine contribute to mental health misinformation and sustain the wellness market. People are willing to turn a blind eye to the pitfalls of alternative medicine in part because it offers the warmth and human comfort that they may not be getting from the health care system.

As personalized and attentive as alternative medicine might seem, the mechanics are faulty. The term lemon is used to describe a newly purchased car that turns out to be defective: It may look pretty and might even get you to your destination a few times, but it has manufacturing issues and malfunctions that make it unsafe to drive. Alternative medicine is a lemon composed of pseudoscientific parts that jeopardize your mental health.