Casey Gueren, award-winning health journalist and author of It's Probably Nothing, joins us to discuss how to deal with health anxiety, strategies for recognizing and avoiding wellness misinformation online, how to develop greater media literacy, and more.
Casey Gueren is currently the Head of Content at Wondermind and the former Executive Editor and Health Director at SELF Magazine. An award-winning journalist and fierce advocate of accessible health information, she was also an editor and writer at Buzzfeed, Women's Health, and Cosmopolitan. She graduated from Rutgers University in New Brunswick, New Jersey with a dual degree in Journalism and Psychology. She lives in New York City. Find her online at caseygueren.com.
Resources and References
Casey Gueren’s book, It's Probably Nothing: The Stress-Less Guide to Dealing with Health Anxiety, Wellness Fads, and Overhyped Headlines
My upcoming book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being
Transcript
Disclaimer: While every effort has been made to provide a faithful rendering of this episode, some transcription errors may have occurred. The original audio file is available here.
Christy Harrison: Welcome to Rethinking Wellness, a podcast exploring the diet culture, disinformation, dubious diagnoses, and disordered eating that are so pervasive in contemporary wellness culture--and how to avoid falling into these traps so that you can find your own true well-being.
I’m your host Christy Harrison and I’m a registered dietitian, certified intuitive eating counselor, journalist and author of the books Anti-Diet, which is available now, and The Wellness Trap, which comes out on April 25th. You can learn more and pre-order the book at christyharrison.com/thewellnesstrap.
Hey there! Welcome back to Rethinking Wellness. I’m Christy, and my guest today is Casey Gueren, award-winning health journalist and author of It's Probably Nothing. We discuss how to deal with health anxiety, strategies for recognizing and avoiding wellness misinformation online, how to develop greater media literacy and deal with fearmongering nutrition headlines, and lots more.
I’m really excited to share this conversation with you in just a moment. Before I do, a few quick announcements.
This episode is brought to you by my upcoming book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being, which is available for pre-order now!
The book is deeply personal to me, as someone with a host of chronic health conditions that wellness culture constantly pushes me to “fix” with food, supplements, and various alternative practices that my reporting and research, and my own experience, has shown me are at best unproven and often downright dangerous.
My hope with this book is to illuminate the damage wellness culture is causing, and to explore how we can reimagine our collective relationship with well-being for the better.
If any of that sounds interesting to you, I’d love it if you pre-ordered the book! Just go to christyharrison.com/thewellnesstrap to learn more and pre-order for its release on April 25th! That’s christyharrison.com/thewellnesstrap, or ask for it at your favorite independent bookstore. And, once you’ve preordered, you can get a special bonus Q&A with me about the book by uploading your proof of purchase at christyharrison.com/bookbonus.
If you like this show and want to help support it, I’d be so grateful it if you'd take a moment to subscribe, rate, and review it. You can do that wherever you’re listening to this, and you can also get it as a newsletter in your inbox every other week, where you can either listen to the audio or read a full transcript, or both! Subscribe to that at rethinkingwellness.substack.com. That’s rethinkingwellness.substack.com.
Now, without any further ado, let’s go to my conversation with Casey Gueren.
Christy Harrison: So Casey, welcome to the show! I’m so excited to talk with you today. And I’d love to start right off by asking you to tell us a bit about who you are and how you came to do the work that you do.
Casey Gueren: Thank you so much for having me! Of course, I am a writer, editor, author (most recently), and right now I am the head of content at WonderMind which is a mental health media company. And how I got into this, I actually got my start in magazines, in women’s magazines. In print actually. Right out of college, I always knew that I wanted to be writing in women’s magazines—they just fascinated me growing up. And then I ended up finding my niche in health editing and health writing. And that actually happened at my first job out of college at Cosmo. I was an editorial assistant and just kind of helping with a little bit of everything. And really dove into the health section because I always had my own questions answered in magazines in the health section. So that definitely was where I was gravitating towards. And it just kind of snowballed from there. Every job after that I would end up diving a little bit deeper into the health and wellness space. I went from Cosmo to Women’s Health, from there I went to BuzzFeed as their health editor. And then at SELF magazine overseeing health and wellness, again there’s a theme. And eventually ended up writing my first book, which is of course around health and wellness but really explores what it’s like to be a health editor who also deals health anxiety. And a health editor’s views on how to navigate all of those wellness messages that we’re getting all the time. Because I’m obviously understanding of how that content gets out there but also I’m very familiar with how it can make you kind of go spiral a bit. You can go down some rabbit holes online.
Christy Harrison: I would love to get into that a little bit, because you share in your book that you have a lot of health anxiety yourself. And I can totally relate to that too, and I think there’s probably many health and wellness journalists out there who are attracted to the profession because of their own anxieties or their own health issues and concerns, and kind of wanting to master that. I know that was true for me certainly. So I’m curious to hear about the role that health anxiety played for you in bringing you to this career and also how it’s effected your career as a health writer and editor.
Casey Gueren: I mean I think it is one of those things that you see this in other professions, where people do gravitate towards professions where they have some either personal interest questions about it (I mean I know I’ve heard psychologists say that you get into this profession because you are fascinated with what’s going on in your own head) and I think for me, again I was consumed with magazines growing up. I loved women’s magazines and teen magazines and I felt like that’s where I was getting a ton of my education on things like health, and sex and dating and relationships and emotions. And so when I was looking into journalism schools, I was also sort of gravitating towards the psychology departments too because I realized a lot of these magazines are quoting psychologists, they’re quoting doctors. I want to have some understanding of that. But I definitely think that my own personal health questions really got me into writing in the health sections at Cosmo. I mean I know that I ended up just pitching a whole more for those sections because those pitches came easy. I had a lot of questions about my own health and body, and so again, this way like 2011, 2012, we didn’t have all the data that we have now on Google to see what people are searching, what people are clicking on. This was when I was working for the print magazine, it was a lot of times like what questions do you have, what are you and your friends talking about. So I think I ended up gravitating towards the health sections because I always had so many questions about my own health and my own body. And I wanted to be a part of creating content that kind of demystified that. And not in a scary way because I was definitely guilty of, I’d open up an article in magazine, or see something online and immediately think “Oh I have that.” Or I’m definitely going to die from that. And so, I wanted to of course be part of the solution, not the problem. I didn’t want to create content that made people think oh my gosh I have that! But I wanted to be part of creating content that made it a little less scary. Which is a really fine line in creating that content. But that was I think what got me into it, what the health anxiety did for my career, I would say being a health journalist is not necessarily the job I would suggest to people who are already anxious about their own bodies because day in and day out, you’re having to consume so many health headlines and so much health news. It’s often things like whatever disease is trending or whatever disease is in the news, celebrity health scares, things like that, that you then just have to like dive deep into and find out everything about it and I would find myself putting together a package on whatever health condition or covering a story of a celebrity’s health news, and going down these rabbit holes and thinking ok do I have this? Could I have this? I have maybe one symptom, I probably have it. And the thing that I am panicking over, and of all the things that I thought I had, I don’t think I ever really identified with being a hypochondriac which is really interesting. And then one time I was editing a piece at BuzzFeed, about hypochondriasis and learned about how it’s not actually in the DSM anymore, and about how it’s not necessarily people going to all these doctors all the time, there are different ways that it can present. And that kind of had the light bulb moment for me, where I realized ok maybe this has a name, maybe this is a thing that I’m dealing with. So that’s kind of what made me understand that health anxiety is more a of a symptom of certain mental health conditions and that’s it’s something that we can experience kind of on a spectrum. So for me, it was definitely influencing the way that I showed up in my job, the way that I did my job. But it also made me, hopefully a more thoughtful and empathetic editor in how we covered certain things and the topics, and the ways that we packaged content to make sure that it wasn’t going to be really fear monger, and not something that’s going to keep someone up at night.
Christy Harrison: That is so interesting. There’s so many sort of tangents that we could go off of that. But I’m curious just with your reference to the DSM—like what you found in that and sort of why, I know you mentioned in your book too, why the term hypochondriac is stigmatizing, that it’s not something that’s used these days. And like you said, it looks different now than maybe it did in the past where people would go doctor shopping and there are reasons for that too, even with people who don’t have a lot of health anxiety. Going from doctor to doctor is unfortunately part of the reality of our healthcare system in a lot of cases. To try to find the care that you need for particular conditions, especially if you have something that is undiagnosed or not well understood. So I’m curious what you found in researching that in terms of mental health labels for health anxiety and how helpful they are or not. And kind of some of the reasons why people develop health anxiety.
Casey Gueren: Yeah, when I was researching for my book, I found that, thinking about what’s the best way to even get into the topic of health anxiety because it’s obviously something so many people experience and can relate to, that feeling of you read something you think you have it, or you’re Googling your symptoms late at night, or you’re panicking some weird symptom, or mole, or mark or pain or something. But then there is obviously that spectrum there where you might be doing it more to an excessive or irrational level. And so, a lot of people think of that as being a hypochondriac but that condition actually hasn’t been in the DSM since 2013. So in the fifth edition of the DSM, they replaced hypochondriasis with two different mental health conditions. Illness Anxiety Disorder and Somatic Symptom Disorder. And so the two are pretty related, there can be some overlap between the two. Illness Anxiety Disorder is more when you are afraid of developing or having a particular medical or mental health condition, you may not have any of the symptoms, you may just have this excessive worry about developing or having a condition. And that condition can change, that you’re worried about. Whereas Somatic Symptom Disorder, it does require you to have some symptoms that are, they could be part of a condition that you have been diagnosed with. But your level of concern or level of worry that you have, how much it’s consuming your day-to-day life and thoughts is a little bit more excessive than someone might assume with that. Which again, that’s so vague and subjective. But that’s how it’s outlined in the DSM. But this excessive concern and worry and just preoccupation with your health and your body, is a symptom that can show up as a part of other mental health conditions too, is what I learned from various experts when I was interviewing people for the book. It could be a facet of OCD, it could be a facet of just having generalized anxiety disorder, depression. You might just relate to this feeling of that preoccupation with your body or your health, every once in a while. Like when we’re dealing with the pandemic, like the past two years I’m sure so many people can relate to really honing in on certain symptoms and having that kind of consume your thoughts for the day. So yeah, I think a lot of people think of it as being a hypochondriac, but I learned from some of the experts that I talked to that it was thought of as a pretty stigmatizing term. People automatically assumed that that meant that you are freaking out about these symptoms and you’re going to all these doctors and there’s just no basis to your concerns. And one, that’s really harmful and stigmatizing because there could absolutely be validity to your concerns and even if you don’t have the thing that you are thinking that you have—again the history of dismissing people’s health concerns and medical concerns runs deep in our society. So I think that that was also part of why that was so stigmatizing. But in terms of even just illness anxiety disorder, the criteria for being diagnosed, it actually is separated between care-seeking and avoidant behaviors. So some people might go from doctor to doctor and look for that reassurance whereas others might present in avoidant type behavior, they might be avoiding the doctor because you don’t want to get that fear confirmed. So you might still have that reassurance seeking, you’re Googling your symptoms, you’re focusing on it, you’re trying to check your body for certain things. But then you might actually be avoiding care and that was what I related more towards and I think that’s why I didn’t really relate to the term hypochondriac at first. So I think it’s just an interesting, it seems like oh its all semantics but it also just starts an interesting conversation about the way that we think about mental health conditions as being these distinct categories that you have to check off all these boxes to fit into. Whereas health anxiety seems like one of those things that so many people can relate to and to say that you have to check off all of these boxes to have this conversation around it just kind of seems like it’s missing the point.
Christy Harrison: Totally. And I think especially in this day and age, with the pandemic like you said, I think that’s ratcheted up so many people’s health anxiety. As well as the difficulty of getting compassionate, competent care for so many reasons. For larger bodied people, people of color, people who’ve been historically dismissed, women being dismissed as “hysterical” in the past or today even still that term is used in certain corners. And that idea, even if it’s not the terminology that’s used, that idea is still there, that women are overblowing their symptoms or that their pain has somatic roots. And I think it can be so tricky talking about that right because I’m someone who has many different health conditions, both physical and mental, one of which is PTSD and that definitely can have some physical manifestations. Also generalized anxiety disorder, that can have some physical manifestations. And that can also increase my health anxiety, making me think that I have different diseases or ratcheting up concern about symptoms that are maybe, a little bit more formative or symptoms that a lot of people might experience but that heightened anxiety can take them to a level that feels really extreme. And so it is really complicated, sort of sifting through what is coming from health anxiety, what is coming from real structural problems with the healthcare system, and what might be actually physically going on that needs to be addressed.
Casey Gueren: And I think that’s where there is that disconnect, there’s not a ton of data on how many people, the prevalence rates of health anxiety or even illness anxiety disorder and somatic symptom disorder, because so many people—if you’re identifying with this, if you’re struggling with this, you’re probably going to a bunch of doctors. Medical doctors, not necessarily a therapist. But also, who has the time and the resources, and the money to be going to a therapist and say hey I’m concerned with how much I’m Googling my symptoms. There are so many barrios to accessing good, quality care, that it’s so hard to determine if the way that you are questioning stuff going on with your body, either seeking care or avoiding care, is “excessive” or part of health anxiety or if it is a byproduct of just your circumstances. If you don’t have time to be dealing with this, if you haven’t gotten compassionate care, if you’ve gotten very stigmatizing care. It’s really hard and I think it’s something that providers should just really be aware of that the fine line between explaining to a patient how their mental state, their stress, their anxiety and other conditions can manifest in very real physical symptoms. And negating what they’re going through as just being “in your head” or “oh that’s just stress.” Because having your concerns dismissed is certainly something that happens a lot, and disproportionately to women and disproportionately to people of color. So I think that it’s just a really fine line, between what’s excessive and what’s not. But I think what I wanted to tackle with this book, was just letting people realize that there is a name for this and that connecting to the fact that we’re presented with so many messages around our body and our health all the time, that it’s just kind of no wonder that we stress out about it a little bit more and more lately.
Christy Harrison: Absolutely. And I want to turn to that, talking about the messages we get, talking about our body and our health. On one hand, there’s the fear-mongering headlines that sort of amplify health anxiety for people. And then, there’s also the misinformation, the rampant misinformation that we see online that circulates on social media. And there’s research showing that misinformation spreads farther, faster, wider, deeper than the truth. Because the social media algorithms amplify things that have a sense of novelty or provoke a sense of moral outrage. And so misinformation hits all those notes. So I’m curious to know from your perspective, how should people navigate this online environment where we have all of this mis and disinformation flooding our system. We also have articles that may be accurate but have headlines that are fear-mongering or that sort of ratchet up the anxiety in a way that maybe isn’t necessary. Or you know, that there’s so much subtlety, because there’s also reporting on recent studies that just came out and they are technically correct, they’re technically reporting some of the facts of the study but they’re missing a lot of context or they’re drawing causal conclusions where none exist. And the research is really clear that it’s correlation and not causation. So how people navigate this environment that can be so anxiety producing and fraught.
Casey Gueren: It’s so hard, I mean you listed a few really, really tricky parts of just consuming media these days. We are inundated with so much information that it is really hard to decide what sources to trust but also how to, which ones you really want to go deep on. And see, am I getting all of the context of this story. Who has the time to go in and do that off of every single story? But something that I try to get across in my book is that when it comes to content that is going to impact how you live your life, like changes that you’re going to make to your life, your health, your body, things like that—it really does pay to do a little bit more digging. And just to be a little bit more discerning about the content that you’re letting in, the messages that you’re getting exposed too. And then just asking more questions when we’re confronted with stuff like that. So something that I’ve heard from a lot of experts, that I try to practice, is having a shortlist of trusted sources that you go to for health information. So the past two years that’s been really hard to do because obviously every brand and every company, organization, everything, you would be doing a disservice to not be talking about a reality in this pandemic. There’s been everyone shouting whether it’s advice, or insights or takeaway or theories around how we should be living right now. So really drilling into a shortlist of trusted sources that you feel like that’s who I trust for health information or information about the pandemic or parenting or pregnancy or so on. So that could be whatever healthcare provider you have access to, it could be the CDC or your state health department for certain things, it could be a publication or two that has a strong track record on reporting on health or the pandemic or whatever topic you’re looking for information on in a really responsible way like maybe they have beat reporters that really are thoughtful about their coverage of this topic. But again, understanding the limitations of those big organizations like the CDC, any of those organizations that are setting those big guidelines for the masses, understanding that is for public health and not necessarily focused on all the personal use cases that you’re going to come up with. So like you said, you might be saying oh I need to only tune in to the CDC but then you go to their site and feel like well my situation of this week and who I want to see and if I’m at risk or if I tested positive on this day, my question isn’t being answered. And that’s a really frustrating spot to be in, and it can kind of contribute to you losing faith in the big organizations that you’ve been told to trust. So I do feel like having that shortlist of sources of information, especially around health information, is really helpful. I think there’s also just so many things that you can do to be a little bit more discerning of the messages that you’re getting. So some of things that I say should be kind of red flags in my book would be things like if often a publication or an article or blogger or anyone on Twitter or anything, often throws around the phrase “research shows,” without actually showing the peer-reviewed research, I feel like we see that a lot with wellness fads, a lot with health information or health advice. Like oh this is “evidence-based” or this is “research-backed,” “doctor based,” but you can’t actually see that research? That would be a red flag.
Christy Harrison: Or you see the research, like I’ve noticed this in some of the functional and integrative medicine spaces that I’ve been looking at lately for the book—they’ll say “studies have shown” and link to one study that’s in like nineteen people or that’s in rats or something. And it’s like ok, is that you showing your research, because research also doesn’t actually support that conclusion.
Casey Gueren: Exactly! You had talked about this before, correlation versus causation. So yes, click on that research, do that clicking and click on that research and see was it in mice? Was it an invitro study, so not really in people at all. Is it something that they found an association or correlation but not necessarily enough definitive research to say X causes Y. And is this one study that found something a little weird in nineteen people, but it goes against the broad body of evidence on this. And that’s I think the same for people too. We often see someone who has really impressive credentials and they’re saying something that’s totally against the grain of the major medical organizations in a certain field. When someone’s in total opposition to the rest of those recommendations—I would just be a little wary because especially if they’re promising “this is it! This is the secret for it!” I promise you, the broader medical organizations would have wanted you to know that secret too. We would all probably be out of something like this a whole lot faster if that were the case. So just kind of always asking where is this information coming from and to your point then asking how? Show me your work. If X causes Y, how? I think you see that a lot with things like supplements or other kind of wellness fads that, something like celery juice or something that has purported a ton of benefits to every health system in your body and has basically has no barrier to entry—you just take this thing and everything is going to get better. I think the first question should be like ok how? If you can show the mechanism or action that would link how this is curing whatever condition or how it’s lowering blood pressure or how it’s helping you sleep. Being able to show the work shouldn’t be a high bar in the market meeting strategy of stuff like this. So those are just a few of the tips, but there’s so many. There’s so many ways that we can be a little bit more discerning of this stuff but I understand that again, we just don’t often have the time, or the resources. And you shouldn’t have to do all of this digging for every little thing. It should more be on the content creators and the people giving more airtime to these topics to be doing that research for you. So that’s again why I’m so passionate about creating accessible, responsible health content because I felt like the ownership should be on the reader all the time, but it unfortunately is. So I think it’s worth understanding how to do a little bit more digging and to google a little bit more smarter around these topics to just kind of understand where this content comes from.
Christy Harrison: I mean that’s so important, and I think I’m also so big on scientific basis, understanding the evidence behind things. And when you mentioned if something goes in the face of established medical research or the scientific positions of major organizations, yes that’s me for most things except for when it comes to like food, and weight loss and diet advice. Not food per se, but weight loss and diet culture basically. I feel like I, and many people in the intuitive eating space, and sort of general anti diet space, which really is a lot of people in the eating disorder community as well. And people who’ve done research around eating disorders, I think this is where some of this comes from. This understanding that a lot of what is put out by the CDC about weight and weight loss, and other major medical organizations—is really problematic and doesn’t address weight stigma, weight cycling and the harms of those things that we see in a vast body of scientific research. Doesn’t address disordered eating which is so rampant, which is often triggered by weight loss advice. And when you kind of dig into the politics of how the CDC guidelines on “healthy weight” got developed, it’s super messy and influenced by pharmaceutical industry money. And pharmaceutical industry money specifically around diet and weight loss drugs, these people who are doing consulting for pharmaceutical companies on the development of diet and weight loss drugs were the people who were creating the guidelines. And calling “obesity” a disease, that whole thing of that label being applied to larger body size in 2013 against the American Medical Association’s own committee’s recommendations. They had a committee researching whether that label should be applied to higher body weight, and the committee said no, and the organization overruled it and labeled so-called obesity a disease anyway. So when you look into that stuff, I think it can be really frustrating and make a lot of people wary of institutions like the CDC, if they’ve experienced weight stigma or if someone is struggling with an eating disorder and weight loss advice has been really harmful to them, I think seeing that stuff being pushed by an otherwise fairly trustworthy organization—I think some of their communication in the pandemic has been problematic as well. But it’s messy, it can be messy to sort of discern and from the outside, I think people looking in on me and some of my colleagues in the anti-diet space, dietitians, therapists, some doctors, some people in other professions that were putting out this information that’s going against maybe this sort of larger body of the medical establishment. I’ve had people say to me “well how is anti-diet any different than anti-vax?” Which I mean, I have thoughts on, but I’m curious to hear your thoughts too on how to sort of determine what is a valid area of scientific debate, or disagreement within a field that’s based on valid evidence. And what is something that’s totally fringy or wellness fad, like celery juice, a wellness fad that isn’t backed by science—where in that case, the guy who promotes celery juice literally says “There is no science! I was told by a spirit that this is…”
Casey Gueren: That’s red flag number one usually. It’s so tricky and I think again, to your point, it really comes back to if people didn’t know where those recommendations and guidelines around BMI, around weight, around terms like that, I think that they would be outraged to understand how far back that goes. And often that was just like in a few old white men, how un-diverse and how limited our research is that governs those guidelines and recommendations. So I think that’s kind of another example of yes if someone’s going against the grain of the established guidelines that when you look into those guidelines there’s not a whole of, there’s not really a leg to stand on with the research that went in to them. I think having a better understanding of where those recommendations come from, where the guidelines come from. Actually understanding the research that went into that, and who the sample size was when this research was done—an example I always come back to is the birth control efficacy rates. That research was done so long ago, and it doesn’t seem to be continued research every year. To me it feels like yes of course it’s the same birth control method, but we’re still using data from the 1990s? It just, I think a lot of people would be outraged when they see what research goes into the guidelines and recommendations that are coming out of these big organizations. So it does make you lose a little bit of faith in that, but I think again, understanding the limitations of when the organizations are doing things from a public health standpoint versus personal health standpoint. And then with something like weight, with something like diet culture, should we really be going to those big organizations and saying yeah, tell me how to eat. No, that shouldn’t be the same for every person, we shouldn’t necessarily be taking their advice on that. So yeah, the parallel—well not even parallel, I wouldn’t say that, but the note that you got about is anti-diet like anti-vax? Wow. I wouldn’t even know where to respond to that other than with again looking back at the research that you and your colleagues are going against in the anti-diet movement, is to shed light on the limitations of that research. And so I think that that is where the healthy scientific debate comes in. If there are huge limitations of research that we’ve been overlooking for many years, we should be looking into that. That should be a more transparent discussion. But then understanding “I did my own research” is not the same as the broad studies, the large peer-reviewed studies on something isn’t necessarily the same as someone Googling around, so I guess that would be how I respond to that. But it’s tricky.
Christy Harrison: It’s tricky yeah, and I mean, I would also say I’ve been thinking a lot about misinformation and the anti-vax movement for this new book. And one interesting distinction between conspiracy theories and actual conspiracies that I’ve come across, in people who’ve studied conspiracy theories and are experts on conspiracy theories, have made this distinction between like the type of thinking that can uncover a genuine conspiracy versus the type of thinking that characterizes conspiracy theories. And they say that genuine conspiracies, which are things like Watergate or the Tuskegee Experiment, the true nature of that being covered up and things like that where it’s sort of a pretty narrow scope, it’s not something wildly far-fetched like Bill Gates wants to inject you with a microchip in order to control your brain and/or kill you, and keep you from reproducing or somehow, there’s just many weird ideas piled on top of one another there. But genuine conspiracy is something like much narrower in scope and the kind of thinking that can uncover that is what they call “conventional thinking,” using critical thinking and rigorous inquiry, but also not overinterpreting all data you find in service of theory. Which is where you get conspiracy theories finding things that are wildly unconnected and connecting them. Or not using really established methods of researching but kind of going on these weird, deep internet dives and stuff like that. I think there is actually a lot of conventional thinking, ironically, in the anti-diet space where it might seem like it’s a really unconventional approach to weight and health but actually there’s rigorous research happening, there’s people looking at data in critical ways, thinking critically. Not overinterpreting, not making wild leaps. Versus in the anti-vax space, unfortunately there is a lot of that kind of conspiracy, conspiracist thinking there. Which is making these wild connections and things that don’t have scientific backing, people like Andrew Wakefield who were sort of the basis of the movement at first, being totally discredited and having their research undermined and retracted. And of course then, the conspiracy mindset with that is to say “well they pushed him out and retracted his stuff because he was onto something real, and big pharma wanted to shut it down to keep their profits.”
Casey Gueren: Yeah, and it also just reinforces again for us to investigate our own biases, and the way that we look at information, the way that we seek out information. And we’re always going to gravitate towards brands or content that dose validate our own previously held beliefs. I think just being aware of that, and being aware of when you are investigating something, that has to do with your health or a choice that you’re making about your health, are you just constantly seeking out information to kind of confirm what you’re hoping to confirm? Or, are you pulling from a broad range of—who’s to say what’s the responsible brand or publisher about a certain topic but yeah, are you pulling from a larger pool of evidence than just things that are validating the belief that you already have? Then understanding how the content that you’re consuming might have done the same. Like you talked about before, seeing some headlines or seeing some stories that you look into it and it’s like ok that does seem like they are commenting on a valid study that just came out, it does seem like there’s kind of an angle, maybe it’s telling bacon is going to kill you or something. And they’re linking to a study so it seems pretty legit, maybe bacon’s going to kill you. But then understanding ok, are they telling the whole story? Digging into that research and kind of taking a bit more of a critical lens. It’s hard with conversations like the anti-vax conversation, to not say that it’s not just a personal health choice. In some things I think too, if you have a conspiratorial world view and you feel like, I’m just making this decision for me with something like being anti-vax, we have very good data showing how it does affect at the population level as well. So I think those conversations are just harder to have, and then just say well do what you feel is right.
Christy Harrison: Totally. Yeah, it’s other people are being affected by your choices as well. It’s not just you do you. And I think, unfortunately the way that our healthcare system is today, and the way that the internet and social media have influenced the discourse around health and wellness. There is so much of that, like “you do you” like pick and choose what works for you and creating your sort of pastiche of personalized wellness practices and things like that. Which, I think on one hand, who am I to begrudge, I would never begrudge someone something that works for them. But on the other hand, I think there are a lot of things that are purported to work that are actually doing harm. And that’s what really frustrates me, both as someone who is a health professional now myself, and a journalist covering health, and also someone who has all these health conditions and has personally been through so much in trying to figure out diagnoses and treatments that worked for me and who was so susceptible at one time. And you know, even still, who knows maybe one day I’ll fall another rabbit hole with one of these things. I feel very empathetic towards people who get pulled in by these promises or feel like they have nothing else to turn to, no other options. So they’re trying things that are really unproven, that are wild and out there, and feel like that’s the last ditch effort because nothing else has worked.
Casey Gueren: It’s something I talk about a lot in my book that I don’t think that anyone should feel bad or dumb or silly for trying these things. Or for liking these things, talking specifically about things like wellness fads, supplements, things like that. The latest trend that you’re seeing on TikTok around your health, I don’t think it’s the fault of each person trying these things. I do think that people need to understand that this is kind of the wellness industry is kind of predatory in a lot of ways. Because it is all about commercializing wellness, commercializing how you take care of your body. And giving you options that are easy and simple and have tons of promises. And I think the target audience for a lot of these things are people that really can’t’ afford to keep trying things that don’t work honestly. They’re often targeting people that maybe don’t have access to a primary care provider who and that’s why they’re looking for something that’s easier or at home. They may be targeting people that are not able to, maybe are uninsured or underinsured and are thinking that this is an option that’s going to be the same as what they might get with traditional medical care. And sometimes if it is actually increasing the accessibility of any kind of, certain health aspects—that’s great. But often, it is overpromising. So that’s what really frustrates me too, I don’t obviously think that people shouldn’t try things that they want to try. I think if they want to experiment again with something, it's more so if you are trying a wellness fad, trying a supplement or trying some DIY health thing, in lieu of getting the care that you need. And again, that might be because you don’t have access to the care that you need. So that’s more of a systemic problem than a personal one—it’s not a personal failing by any means. But that’s where I think wellness fads get into the more dangerous territory.
Christy Harrison: I agree. And I mean especially thinking about supplements too, I think it’s worth mentioning and highlighting to people that supplements are a largely unregulated industry. They’re not regulated before they go to market. The regulators can only pull them from the market because of a law that was put into place in the 1990s, based largely on supplement industry lobbying. The FDA can’t regulate these things before they go to market and can only pull them off if there’s enough consumer complaints to make them look into something. And the regulation there is so sparse, I think both because of lack of funding for that sort of regulation and perhaps more problematically there are people who have worked in the supplement industry and have been supplement industry lobbyists and worked for supplement industry groups that have then go into regulation at the FDA and then go back to the supplement industry. There’s a lot of cross pollination there, so super problematic. But it’s been interesting, talking to some journalists about my new book and some of these ideas, I’ve had a couple of people ask me about various diet supplements recently and I mentioned this idea that the supplement industry is barely regulated and they were sort of floored. Even journalists reporting in this space didn’t realize this. And I think this is something that the general public, really has very little awareness of. I think it’s super dangerous and super potentially harmful because there are things that end up in supplements like literal drugs, that nobody knows about until something gets reported to the FDA. And then its like, comes out that this adrenal supplement actually has thyroid hormone in it, and that’s why it feels like it’s working or it has steroids. It’s wild.
Casey Gueren: I think that also just shows like kind of our mindset around “mainstream” medical care or something maybe that’s more woo or something like supplements or alternative remedies because as much as I can of course understand the distrust with pharmaceutical industries and mainstream medical care, there are studies, there are researches and claims to back up the claims of FDA regulated, FDA approved medications. Whereas with the supplements, you don’t actually know what’s in them. You know what the marketers are saying is in them, and so that’s just an interesting thing that like because this has really safe and conversational packaging and has a nice feel to it, and feels like this is something that is supposed to help you more than, in a more empathetic way than mainstream medical care. But does it have any research to back it up or any regulation for you to know what you’re putting into your body.
Christy Harrison: Right, like I definitely empathize with people who are concerned about the pharmaceutical industry’s influence too, because I’ve seen the problematic nature of that influence in the weight loss and diet industry. And also, I think for all its problems, it’s regulated. The pharmaceutical industry is regulated, and things have to be shown to be effective and safe before they go to market. And will get bumped back for further research if they’re not versus supplements that claim to be “natural” and like you said, it sort of has a nice feel to it, it feels safer to people. And I think that’s the marketing, that’s the way that they sort of hook you, it doesn’t feel like a drug. Even though there might actually be literal drugs in what you’re taking.
Casey Gueren: Right and I think understanding that “all natural” is marketing. That’s also, even just the term natural on a label, isn’t regulated. So that just is shocking to me too, anything that you see on the front packaging of anything whether it’s probiotics or supplements or skincare—that is marketing and they can put whatever they want on there. So I think just understanding that, that you can still have a nice warm, fuzzy feeling about a product and I certainly have too, and I’ve tried it and it either worked or didn’t work. It’s more understanding that the marketing is not necessarily what you should be looking into if you’re really trying to decide is this something that belongs on, or in, or near my body. It should be where is the evidence behind the claims that they’re making.
Christy Harrison: Well yeah, thinking about that too, I’m curious to hear your thoughts on how certain things become wellness fads while others don’t. Because I’ve noticed that we have these fads that in some ways kind of keep getting recycled in different forms. But also, there might be something that is kind of low-key popular in like naturopathic circles or whatever but it might not rise to the level of wellness fad for years. And then suddenly it’s everywhere. Do you have a sense of how that happens?
Casey Gueren: I think a few things—I would say the first, the media does play a huge role there. There’s such a fine line too, working in a space between wanting to debunk something (like a current wellness fad that’s trending) but also knowing that you’re giving that trend more of your time, you’re allowing that kind of snowball into the site guides. We actually had a rule after I was at SELF for a while that we wouldn’t debunk a garbage wellness trend if they were really niche. Say our friends and family outside of New York City and LA hadn’t heard of them yet, if this didn’t seem like it was something that was super pervasive, we just wouldn’t write a post on “Oh no don’t buy into that!” just to enter that conversation because it really was like you said at the beginning of the call, misinformation often does travel faster. Just because you see it more, you have that availability bias. So I think just weighing it, the media weighing in, in a responsible lens is one huge thing. From a personal perspective and just kind of covering this space for a long time, I would say that the things that I noticed usually became wellness trends were things that had a huge list of benefits attributed to them. Again, not necessarily saying that those were all evidence-based. But something that someone said, this can affect every and any one of your health systems in your body. Which is again, usually your first red flag but something celery juice, like turmeric, probiotics—these are ones that we saw kind of rise to the top recently. Even though of course, turmeric has been being used for so many different uses and different cultures for forever. But making it this wellness fad of add it to your latte and now your latte is healthy is something that was like where did this come from? And I think it is from people, whoever those people are, that have a lot of influence (usually on the internet) attributing just a ton of benefits to something. And that something being something that doesn’t really require a ton of behavior change on your part. Taking a supplement or drinking a drink first thing in the morning, this doesn’t change your life in a huge way or it doesn’t require a ton of behavior change. I think it catches on because it has kind of that like why not factor. People think like “oh why not, what’s the harm?” So that was something I saw and you know once something has that halo effect, it seems like it doesn’t really matter if there’s any real science to it at that point to some people because it might, you might be getting benefits just from participating in this thing. And seeing yourself as a person who drinks celery juice first thing in the morning or a person who puts turmeric in their latte. The placebo effect is very real too. And again, not to say that is what’s at stake for every wellness trend or anything like this. But I think that these trends kind of catch on when they don’t require a lot from you, but you think that you might get a lot of benefits from them.
Christy Harrison: That’s really interesting. And I feel like the marketing of it does kind of make it seem like it’s this one magic thing. It’s almost like the magic pill, right? I think a lot of wellness culture and alternative medicine criticizes mainstream or conventional medicine for being pill-popping or pill-pushing. It’s like take this pill, you’ll fix your symptoms and it doesn’t get to the root cause, that’s sort of the going line about conventional medicine. And yet, I think there’s a similar spirit in how a lot of food cures or even elimination diets—I’ve actually seen low-fat map be that for some people too. Where it’s like do this difficult elimination diet or whatever but then it’s going to fix all of these symptoms, it’s going to have these effects across all of these different body systems. Or even if it is just something like drink this drink in the morning first thing and all of your ails will be cured or whatever, there’s an accumulation of those things because the type of person or the person who’s susceptible to that or who’s in a place where they’re vulnerable to that, is (and I speak from experience here as being that person in different points in my life) is also vulnerable to many other things selling that solution. And then suddenly it becomes I’m not only drinking this thing first thing in the morning but I’m also doing these ten to twenty other daily behaviors that are supposed to be like one magic thing and it sort of piles up to where I think it can take over people’s lives. And that’s where the concept of orthorexia I think comes in, but I think even people who don’t really identify with the idea of orthorexia—which I didn’t when I was very much in it, I actually wrote a brief blog post about it back in 2006 for CHOW, this food magazine. I came across a piece on orthorexia and posted something about it and totally didn’t register that that’s what was going on for me. So I think it’s easy to sort of miss that that’s what happening when you’re accumulating all these different behaviors and wellness practices and being susceptible to all these wellness fads.
Casey Gueren: Yeah and it also, sometimes aligns your identity with a certain group or identity. Kind of our desire to fit in to different groups or to align ourselves with the pack. For safety, for community. I think a lot of times you see these wellness fads take off within certain groups or communities—like keto diet being big in the CrossFit community, or biohacking in Silicon Valley. I think there’s also an aspect of this that is wanting to align with a certain identity so you’re changing kind of your behaviors in that way. So, again who’s to say if that one behavior caused xyz benefits or if it was kind of what you said, an accumulation of many of them. Of aligning yourself with a certain group that made you act, behave, feel, and think differently.
Christy Harrison: I mean I also think too about the idea of regression to the mean. That over time, people’s symptoms are going to wane naturally, that’s the case for many different diseases or even for autoimmune conditions of which I have a couple. It’s like you have flares and then remission and flares and remission—sort of without really doing anything. And you can be on medication and have that happen, or you can not be on medication and hae that happen. So when you’re not on medication, often the flares are worse. So there’s sort of cyclical nature to a lot of symptoms and I think the marketing of wellness culture really does a great job of taking credit for the remissions or the waning of symptoms. And has all these ways of deflecting blame for when the symptoms come back. It’s like, you didn’t do it hard enough or you didn’t do it long enough or you didn’t take a high enough dose, or you have to add this other thing or you have to spin around three times while you’re drinking it or whatever it is.
Casey Gueren: But again I just feel like I again, the autoimmune disease community that is like a duck community that is targeted so often by predatory wellness practices. I think for that reason, because that target consumer is somebody who is always at your wits end. You’ve tried everything, and you feel like or are being dismissed by your medical providers, you just want something to work. You do have that like why not factor. So I think just really being discerning of the messages that you’re exposing yourself to when you are at that vulnerable state. But also the things that you do choose to spend your time and money and resources on because just because something is not part of mainstream medical culture, just because something says its natural or alternative, does not mean that it is necessarily going to be safe or going to be that magic pill.
Christy Harrison: Totally. Very well said. Well I’m curious as sort of a final question, just what would you leave people with as some ways of spotting misinformation online and especially on social media. And protecting themselves against this predatory wellness culture targeting that happens.
Casey Gueren: So one of my favorite tips that I always go back to is this idea of looking out for fear-based finger pointing and fear-mongering in these wellness fads and just even wellness companies in their branding and their marketing. What I mean by fear-based finger pointing is that their whole marketing strategy kind of hinges on this thing that you’ve been doing is killing you. Or like this thing is toxic, our thing is better. Our thing is natural and we’re transparent and we get you, we have science. We are built by women, something that they’re just trying to get at, we’re better, what you’re using is harmful. And not to say that they don’t necessarily have an argument. Sometimes they’re very much in an industry where yeah there should have been better research in that industry or better regulation in that industry. But sometimes there’s not. And it’s just a lot of marketing. And I think a good example of this is the all-natural, or organic tampons and saying the regular tampons are like—who knows what’s in them! That’s actually a pretty regulated industry and they do have to pass multiple checks in the manufacturing process and all of that. And yes, there were some shady practices back in the day, but we’ve allegedly eliminated those. And if you’re not having any issues, any sensitivity, your tampon is not killing you. And so we think we see that a lot with skincare, we see it a lot with supplements, and just kind of anything that has that all-natural label. I think this really can be said of the anti-vax movement too to some extent, like it’s a lot of preying on people’s fears that this thing that they’ve been unknowingly or knowingly putting into their body, is harming them. And that they just didn’t know better but now they do. So I think is a huge red flag to look out for if the whole marketing kind of hinges on like finger pointing of this thing that you’ve been doing is wrong. Or anything that makes you feel like crap when you’re reading and its’ kind of about making you feel insecure or highlighting some aspect of your body that needs changes because their product or the angle of their story that they’re going after is around putting you in that vulnerable state that you do feel insecure about this thing already. So anything that makes you feel like shit or makes you feel like what you’ve been doing is killing you, if you have no evidence to state that, it’s probably a red flag and I would a do little bit more digging, be a little bit more discerning of that.
Christy Harrison: I think that’s great advice, I love the idea too of just like being aware of how you feel when you’re consuming something. That’s been such a helpful guiding force for me in terms of connecting to my body, and connecting to how the anxiety might be getting triggered by certain headlines or certain ways of framing things and stuff like that. Because I think there’s a real difference between offering a solution or something that’s helpful for a problem that exists and offering something really valuable versus playing on people’s fears and saying like this product is the one and only thing that can solve your problem.
Casey Gueren: Yeah and like you said, if you’ve been scrolling through your feed and realizing that there are a whole lot of stories from a particular brand that is often something that you’re either clicking on and getting anxious about, or like scrolling past because you’re like oh my gosh, I can’t even read that right now. It’s probably time to unfollow that brand. You do not need to be subjecting yourself to those kinds of messages all the time.
Christy Harrison: Yeah, unfollowing is such a great tool for keeping yourself less effected by those things.
Casey Gueren: Oh yes, team unfollow!
Christy Harrison: Or team delete your social media is another one now. I know that’s a far bridge for many people, and I haven’t actually deleted mine, I just don’t spend any time on it. But it still feels like I have to be there, there’s some amount of necessity. But yeah, I think whatever you can do to expose yourself to that stuff less is helpful.
Casey Gueren: Sadly you can’t just get away from those ads on the subway, they’re like “this thing that you need that you didn’t know you needed for this thing on your body that you didn’t know you were supposed to be embarrassed about.” It’s with you for your whole 45-minute ride.
Christy Harrison: Yeah you can’t even get away in the real world. It’s a challenge. Well thank you so much Casey, this was really lovely and would love to know where people can find you and learn more about your work and get your book.
Casey Gueren: Yeah thank you so much Christy. I am so honored, and you can find me on Instagram or Twitter @caseygueren and you can find my book on Amazon or anywhere that you buy books. It’s Probably Nothing: The Stress-less Guide to Health Anxiety, Wellness Fads, and Overhyped Headlines.
Christy Harrison: I love it! That’s such a great title too because I think many of us have the experience of like, ok, it’s probably nothing but what if it’s not?
Casey Gueren: But what if it’s not? That’s my internal monologue always. So it was the first title I gravitated toward.
Christy Harrison: I love it! Well thank you again so much, it’s great talking with you.
Casey Gueren: Thank you so much.
Christy Harrison: So that’s our show! Thanks so much to Casey Gueren for being here, and thanks to you for listening.
If you liked this conversation, I’d be so grateful if you’d take a moment to subscribe, rate, and review the podcast wherever you listen. You can also get new episodes delivered to your email inbox every other week by visiting rethinkingwellness.substack.com.
If you have any questions for me about wellness and diet culture, you can send them in at christyharrison.com/questions for a chance to have them answered in my weekly newsletter, or possibly even on this podcast at some point in the future.
This episode was brought to you by my upcoming book The Wellness Trap, which will be out on April 25th. You can learn more and pre-order now at christyharrison.com/thewellnesstrap, and after you pre-order you can upload your proof of purchase for a special bonus Q&A with me at christyharrison.com/bookbonus.
Rethinking Wellness is executive produced and hosted by me, Christy Harrison. Mike Lalonde is our audio editor and sound engineer. Administrative support from Julianne Wotasik and her team at A-Team Virtual. Album art by Tara Jacoby and theme song by Carolyn Pennypacker Riggs.
Thanks again for listening. And until next time, I hope you don’t come across too many fear-mongering nutrition headlines.
