Researcher Maxine Ali joins us to discuss how wellness micro-influencers and practitioners construct “authentic” online personas to spread misinformation.
We explore the ways that creators with smaller platforms build trust in seemingly less commercial ways than macro-influencers, including: personal stories of illness, medical encounter memes, and hyper-simplified straw man formats. Then Maxine explains why these ways of sharing can lead to powerful parasocial influence that undermines the perceived expertise of medical professionals worldwide.
Behind the paywall, Christy and Maxine unpack what influencers are doing when they’re “truth-telling,” why conspirituality and conspiracy theories thrive online, and how the rise of “mythbusting” has warped into insidious platitudes.
The first half of this episode is available to everyone. To hear the whole thing, become a paid subscriber here.
Maxine Ali is a researcher and teaching fellow of sociolinguistics at King’s College London. She is currently completing her PhD, and holds an MSc in Medical Humanities, and BA in English Language and Communication, also from King’s.
Maxine’s research broadly concerns the intersections between language, culture and health, with a specialist focus on social media contexts. In particular, she is interested in interactional dynamics and practices within online alternative/holistic health and wellness cultures, as well as the significance of these dynamics for the circulation, amplification and legitimation of health mis/disinformation and conspiracy theories. In addition to her academic responsibilities, she is a writer and public speaker, focusing on the language of wellness.
Resources and References
Christy’s second book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being
Subscribe on Substack for extended interviews and more
Food Psych #208: Media, Wellness-Diet Culture, and the Power of Language with Maxine Ali
Food Psych #121: The Truth About Diet Culture with Emily Contois
Christy’s online course, Intuitive Eating Fundamentals
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Transcript
Disclaimer: The below transcription is primarily rendered by AI, so errors may have occurred. The original audio file is available above.
Christy Harrison: Maxine Ali, welcome to the show.
Maxine Ali: Hi. Thank you so much for having me. I’m really excited to be here talking to you. It’s been quite a few years since we last caught up.
Christy Harrison: Yeah, we’ve been connected for a while. We first met, I think, or had our first conversation way back in 2019 when I had you on my other podcast, Food Psych. And then later I interviewed you for my book, The Wellness Trap. So those were really great conversations about your history and experience with wellness culture. And people can check those out for your full story. But for the purposes of this interview, I’d love to start off by having you tell us a little bit about your history with diet and wellness culture and how you came to do the work you do today.
Maxine Ali: Sure. So we’re now going back maybe like two decades. So kind of around the time I was like 12 years old, I was diagnosed with a chronic illness called ulcerative colitis. And I had a really difficult time getting a diagnosis. Firstly, I was experiencing kind of a lot of pushback from kind of medical professionals who are saying this is just a normal kind of thing of you growing up, experiencing kind of normal feminine symptoms like period pains and such. And so when I finally got a diagnosis of ulcerative colitis, I was already incredibly unwell. I’d been off from kind of school and sort of life for quite a few months and had a really, really bad time coming to terms with this new reality that I was kind of unwell. Being a young girl, it’s not a kind of reality that I think a lot of people expect to come up against.
I spent a lot of my teen years taking medication, but also kind of experimenting a little bit with sort of the natural and alternative approaches. I had been really exposed growing up to a kind of mentality that natural approaches were much better than medical approaches and there’s no side effects, there’s no downside to trying to control things with diet and diet and kind of lifestyle changes, and did that for kind of a long time until I was about 18 years old and that was when social media was starting to kind of really take off. People were kind of on Instagram and creating health blogs and such. And that was when I encountered wellness culture on Instagram. I guess
I just got really swept up in the aesthetic of it all, the promises of wellness being this pathway to self management and self healing outside of this kind of medical sphere that I’d had a really challenging experience with. And so I went hard into this kind of wellness and alternative health culture type activities. When we spoke last, I think I talked about how I did the whole kind of dairy and gluten free, refined sugar free, all of the free froms that they tell you in wellness culture absolutely needed in order to kind of optimize your health. Initially I was like, this is really working for me.
And also was the thing about wellness is it also offers you this kind of support and community almost because I was living in London at the time where wellness was taking off and I was making friends and meeting people and was like, this is really exciting. I kind of have this community of people with a shared interest to me. But it all just took a really horrible turn when I started to get even more unwell. My symptoms were not improving and I realized that actually a lot of the things that I was doing for wellness was actually making me a lot more sick.
So I lost my period for, I think almost four years. I, of course, as many people do with wellness culture, developed really, really disordered eating habits. So I became absolutely terrified of eating anything that was not deemed clean or healthy, which of course severely restricted my kind of social life as well, being in my late teens, supposed to be kind of experiencing all these new things, all these new adventures with this newfound independence. And I was terrified to kind of go out with my friends and do these kind of all very normal things you’re supposed to be doing at that age. I just really descended into this kind of horrible spiral of being so all consumed by this pursuit of optimal health and meanwhile not actually getting healthier.
Christy Harrison: Yeah, it sounds like the pursuit of wellness made you profoundly unwell, like it took you away from what you were actually looking for. But it’s seductive, right? Because at first it seems like it’s working. And so then when it doesn’t work and when you feel worse, you sort of tend to blame yourself. At least that’s what my experience has been and so many other people I’ve talked to. I’m curious if that was the case for you too, where you just sort of felt like, well, if it worked at first and now it’s not, then it must be that I need to do it more harder or be more diligent about it or something.
Maxine Ali: That is exactly it. Whenever you kind of run into these issues of, why am I not getting better? You turn to social media, you turn to the Internet, and you look for what am I doing wrong? What have I missed? Maybe I’ve just not found the perfect diet yet. And it just pushes you further down this rabbit hole. And there were a lot of different factors going on besides me kind of having these struggles with wellness but the big turning point, I think was really started with the kind of big incident of Belle Gibson being exposed as having lied about having cancer and selling her kind of wellness lifestyle and products off this platform of having healed herself from cancer. And I think that caused this bit of a snowball of realization that wellness was not all it was painted to be.
I started to kind of think a little bit more critically about the kind of information that I was consuming and engaging with, and also started kind of looking at other sources of information. So I think that was around the time as well that I found your podcast at the time, Food Psych, which was honestly, transformative in so many ways. Just kind of getting these experts talking about these wellness trends and actually dissecting them. That was kind of my exit from wellness culture.
Christy Harrison: And you were working in wellness journalism at the time too, right? So it sort of became tied up with your professional life as well.
Maxine Ali: Yeah, it really, really did. After I left university, I started working at Women’s Health magazine and was ecstatic to kind of straight out of uni get this kind of, what I saw, as my dream job of getting to work in the wellness industry. It’s such a well known magazine that so many people in this space, this wellness space, read, engage with, and I thought I’ve hit the jackpot. But I think as I was getting a lot more critical about wellness culture, I was also wanting to kind of use this platform that I now had at Women’s Health to kind of incorporate a bit more evidence based expertise and kind of have a bit more of a responsible conversation about wellness.
So I was kind of trying to use this approach to have a more responsible conversation about wellness, bring in more experts. And what I found was such pushback from editors from the space in general, and this kind of realization that unless it wasn’t profitable and trendy and sexy, it wasn’t going to sell. And they didn’t want this to be part of the conversation.
So I left that space shortly afterwards. I wasn’t there for very long. And I think largely through kind of engaging with your podcast and sort of some of the experts that you had, some of the academics that were really interrogating wellness and diet culture, through this kind of really highly intellectual lens that resonated so strongly with me. So people like Emily Contois, I remember, was one of those podcast episodes that I remember going on a walk and listening to and being just blown away by these kind of perspectives on wellness and diet culture and connecting it to kind of broader social issues.
And I just realized that was something that I really wanted to pursue and kind of learn more about. So I went and did my master’s between 2017 and 18, my master’s in medical humanities, and then from there started doing my PhD partway through the pandemic, which I’m sure we’ll talk a lot about in coming times. But it was really these critical conversations that I was getting exposed to that transformation transformed my perspective on wellness and brought me to what I’m doing today.
Christy Harrison: Yeah, it’s such a fascinating story, and it has a lot in common with, I think, the way so many people come to be critical of wellness culture, where they’re bought into it for a time, and there’s maybe a personal connection there, and with the chronic illness piece, too, that makes you so susceptible. I think that’s one of the areas of real vulnerability that people have when there’s a chronic illness that’s not being addressed effectively by conventional healthcare. It’s totally understandable to get sucked into wellness culture and wellness approaches, especially if your family also is very pro that, you know, “natural” healing and things like that. So, yeah, I can understand that would be fertile ground for you to get into wellness culture.
You’re now completing a PhD in, essentially, critiquing wellness culture and especially on social media, which is so up my alley. So I really want to talk about that and I’d love to hear first just how you came to focus on that in your PhD research and what some of your findings have been.
Maxine Ali: I set out with a kind of really broad aim when I started my PhD. I wrote my proposal back in 2020, so actually slightly before the pandemic even kind of took hold all that much, and I really wanted to just look at the overlaps between wellness culture and cultural notions of femininity. So looking at how the diet fads that are wrapped up in wellness culture just perpetuate age old ideas of what women should be doing to self discipline their bodies, right? Even things like the “strong, not skinny” trend. I think Emily Contois talks about this a lot in her work as well, the kind of abundance diet where we’re not talking about restriction, we’re talking about kind of eating healthily in abundance and just seeing how a lot of this kind of discourse and rhetoric and wellness was just re-perpetuating existing ideas of what women should be doing and looking like with their bodies.
But just because I think the timing of the research really shaped it, starting into the pandemic, when people in general were just intensively online to a much greater degree than before, and also health being so front and center in people’s minds and people sharing their own experiences of health, their own understandings and ideas. And we just saw this huge, huge proliferation of misinformation and conspiratorial thinking within these online health and wellness spheres. And that is essentially kind of the shape that my thesis ended up taking.
So I had my initial focus on chronic illness spaces in digital wellness culture and just seeing how women who had had terrible experiences with doctors in general were engaging with alternative health, kind of what their rationale and motivations were. And it ended up transitioning into, okay, how are these women in wellness culture, these wellness practitioners? I call them influencer healers. I see them as kind of a combination of your traditional sort of influencer role, but they also take up this kind of rhetoric and discourse of healing and self optimization and curing chronic illness.
And I was just interested in how they constructed their own ideas about health and wellness as truthful and authentic. And conversely then positioning kind of established scientific consensus and research and evidence, positioning that as misinformed, not truthful, unreliable. All of these different kind of ideas that we’re seeing really take hold since the pandemic.
Christy Harrison: So fascinating. And I’m curious what you found because you focus specifically on like ten of these influencer healers in your thesis. I don’t know if you want to name any names or get into sort of who they are, but in broad strokes, what type of influencers are these? You said that they’re alternative healing type of people too, but just curious to know more what their deal is and how they are positioning themselves as arbiters of truth or as being very authentic in a space where they’re then denigrating conventional medicine and expertise and science as maybe inauthentic or not telling the whole truth.
Maxine Ali: So I can name some of them. It might not even be kind of all that relevant. There were 10 influencer healers in particular that I looked at. And just to kind of have it kind of some control across the sample, I was looking specifically at kind of micro-influencers. So people that didn’t have your sort of macro level following. I wasn’t kind of thinking about that sort of hyper commoditized version of wellness that is really important to look at.
But I was in particular looking at sort of these more low level practitioners that use social media as a way to kind of market their services. A lot of them were kind of nutritional therapists or kind of different sorts of wellness practitioners using all sorts of, let’s call it arbitrary titles, because a lot of the time these titles didn’t really have a whole lot of meaning, things like “accredited functional nutritional practitioner,” that kind of thing. A bit of a word salad, almost.
Christy Harrison: Right, there’s not really an actual degree or licensing procedure that goes along with that.
Maxine Ali: Exactly, yes. And they all had the same chronic illness, which is also the chronic illness I had. I felt like that gives me a kind of better insight into the specific kind of repertoires of communication that they’re using. So they were talking a lot of the time very specifically about the context, of IBD care.
Christy Harrison: Inflammatory bowel disease.
Maxine Ali: Right, exactly, yes. Which maybe is not so kind of prominent in the wellness space. But I saw it as relevant in the sense of gut health being a big trend at the time as well. And these influencer healers really latched onto that, were kind of trying to promote themselves as kind of gut health experts. Those were my focus and it was so interesting to kind of look at it from this sort of almost micro-influencer level because actually I think the tactics that they engage in are slightly different to what you see in sort of macro wellness influencers who are kind of more often pushing products and apps and brand partnerships, where that’s a very explicitly kind of commercial element to what macro-influencers are doing.
But micro-influencers, it’s so much more subtle. You almost can’t sort of see the product placements and the self branding as well, being interwoven into the kind of everyday sharing of their life as a wellness participant, a wellness enthusiast.
Christy Harrison: Yeah, and I feel like I’ve heard and read about recently that brands want to work more with micro-influencers these days because they are seen as more authentic, they are seen as less sort of commodified or commercialized and they have that sort of authenticity of the early days of the influencer economy maybe when people are just coming to them for advice and feeling connected to them and have this parasocial relationship maybe. I’m curious what you found in that, in terms of how their audiences relate to them and how they sort of invite their audiences to relate to them in a way too.
Maxine Ali: Yeah, definitely. I mean that was one of the big motivations as well for looking at micro-influencers was there has been this kind of recognition now almost as a bit of a backlash against the kind of mass influencer industry of, oh well, these people with smaller followings, they’re more likely to kind of give their authentic perspective on things and that almost makes their influence a lot more powerful.
They’re also highly under researched as well because of that, because there’s such a kind of focus on know big influences and how people like Kim Kardashian and such are kind of shaping cultural discourse that quite often, the people with kind of less followers get less attention in the research despite having such a significant influence on people’s ideals and perspectives when it comes to health as well as every other area that influence is kind of now participate in.
Christy Harrison: A lot of their posts tell stories about systemic failings in conventional healthcare and the healing power of alternative and complementary and integrative and functional and whatever you want to call it, all these buzzwords, practices and obviously they’re selling their own services in there as well. But it’s sort of couched in this personal narrative it seems like.
And there’s definitely a grain of truth to all that in that there are some major systemic problems with the medical system and we’ve both experienced that. I know many listeners have experienced that where we haven’t felt taken seriously necessarily or it’s taken a long time to get a proper diagnosis or if we’ve gone down rabbit holes of misdiagnoses and it’s not a perfect system by any means. So I think critiquing it is valid. And then yet there’s also this sort of shift or twist that happens where it’s like this valid critique, but then it’s kind of being used in service of selling something that is maybe not so evidence based or helpful or just could lead people in another totally wrong direction.
How have you sort of looked at that process, first of all, of influencers leveraging these problems with the conventional healthcare system to sell alternative medicine and how accurate are their narratives around that? How much have you seen sort of misinformation being spread under the guise of this is what the failings of the conventional healthcare system are and here’s this alternative?
Maxine Ali: So I mean, the short answer is it’s so, so much. And actually one of the biggest chapters from my thesis, I was looking at kind of wellness memes. And so I’m sure if you’ve kind of been on Instagram or TikTok, you’ve kind of seen this big rise of meme videos where people will import sounds into their content and quite often tell a story. So when X happened or POV X, and I can share some examples of that from my kind of wellness data, where I started to kind of first really see this kind of positioning of medical negligence being a really serious, salient kind of storyline in wellness culture was with these memes and in particular kind of medical encounter memes.
So people would be kind of creating these memes of when I went to a doctor with symptoms for three months and they told me it was all in my head, or when my doctor told me that my chronic fatigue was just stress, these kind of stories, which of course, are real stories. There is a very significant issue of medical neglect, disregarding women’s symptoms. Absolutely. But what I found really fascinating was this kind of memification of these experiences. So putting them to kind of funny sounds and audios using this sort of very generic language of memes in general, which are built around kind of familiarity and relatability.
So what gives memes a kind of visibility and currency on social media, it often taps into these kind of shared cultural touch points, whether that’s a well known song or a well known piece of dialogue. And then of course importing that into this shared story of horrible medical encounters. And what I ended up finding from these kind of medical encounter memes, which were really formulaic, they all kind of had the same patterns, they told the same stories, was how over time and through this kind of repetition of these similar kind of accounts, they were basically creating this very homogenized experience of whenever you go to a medical doctor, they will disregard you, they will tell you that your symptoms are all in your head, positioning this experience as a universal truth. And of course it is a real experience.
I’ve experienced it, many people have. But also many people have experienced good experiences with medical professionals. I can conversely say that I have had some very positive experiences. And I think the thing is with social media is it amplifies the negative in a lot of ways. It is these kind of bad stories, these bad experiences that gain traction, that gain visibility through people repetitively sharing them. And so the good experiences don’t get shared, they don’t get that same kind of traction. And so what this ends up cultivating is a kind of a more general consensus about the medical profession as untrustworthy. And that of course is fueling this, now, crisis that we have of distrust in expertise in medical professionals.
And to kind of tack onto that, one of the things I really found with these memes as well was again, memes being these kind of hypersimplified sort of formats of interaction. What I noticed was misinformation was manifesting through them through something called the strawman fallacy. It’s an argumentation strategy that basically relies on misrepresenting a claim or argument in order to kind of render it easily irrefutable. So it quite often happens through kind of quotation or selective quotation and also kind of decontextualizing a particular argument. So it basically relies on attacking a kind of fictitious opponent to bolster your own claims.
So in a nutshell, what I was finding with these wellness memes was how they were taking supposedly claims associated with the medical sphere. So they would say things like, you can’t heal yourself through lifestyle and attribute that to medical professionals or say the body can’t heal itself, that’s the belief of medical professionals, which is an oversimplified statement. Of course, we know in medical spheres there is a recognition of things like immune systems which are directly involved in self repair mechanisms. Similarly, there is a recognition in medicine of lifestyle interventions. They’re just not the be all and end all.
It’s these oversimplifications of a very complex kind of medical idea that get taken up into wellness and then used to say, well, these are clearly ridiculous ideas. It’s ridiculous to say that lifestyle has absolutely no influence whatsoever. And basically these fallacies were brought in in order to say well, the medical industry is stupid. They don’t know what they’re talking about. And so wellness, we’re talking sense, we’re talking the truth and kind of bolstering the legitimacy of this sphere whilst delegitimating that of the medical profession.
Christy Harrison: Yeah. It’s so insidious and the repetition of it and the memeification of it, like you said, which is so simple and surface level and there’s no nuance to it. Whether it’s saying, “Doctors: ‘You can’t heal yourself through food’,” or “POV: That feeling when your doctor just misses all your symptoms and tells you it’s all in your head.” There’s just no unpacking, there’s no critical thinking, there’s no individualization of it. It’s being sort of flattened into this universal truth or made to seem like a universal truth when the reality is so much more complex.
Maxine Ali: Actually, yeah, absolutely. And that’s the kind of real issue with this sort of memeification trend. It creates this sense of kind of everyone has the same experience because it’s rooted in kind of tapping into kind of familiar touchstones and things that are recognizable and makes it seem like there is a sense of resonance when in reality everyone’s experiences are different.
Christy Harrison: And it’s sort of inviting people to discount or negate experiences they’ve had that have been opposite to that because it turns up the salience on the experience of being dismissed or feeling unheard or feeling like doctors don’t get it and turns down the volume on all the memories you might have of doctors actually being compassionate and helpful or offering you something that was effective. So it selectively shines a light on these things that then get people sort of enraged and make them then prime targets for the sale of alternative medicine and other practices outside of the conventional system.
You’ve been writing this during such a weird time. And I also wrote my book, The Wellness Trap, during the pandemic and sort of a weird time in wellness culture and now it’s just even more pronounced with the rise of RFK Jr. and the MAHA movement in the US and just the kind of explosion of wellness misinformation online and the widespread denigration of expertise and of science and medicine and things like that, I’m curious to know if any of that has intersected in writing the thesis or if that’s shown up in the influencer healers you followed, if any of them have been sort of vocally embracing of MAHA or conspiratorial philosophy.
Maxine Ali: Absolutely. The cases that I was looking at, they spanned different kind of global contexts. I did have naturally some participants in the States and again beginning my kind of data collection just in that sort of late Covid period, so kind of late 2021 into 2022, the anti-vaccination content in particular was just absolutely rife. More so I think in particular in the States because that was just such a big conversation there around kind of mandates in terms of working, it was just amplified on such a big level. And so a lot of the data that I ended up kind of collecting was around anti-vaccination as a big point of focus for the wellness. And of course that’s now spiraled well beyond sort of just the COVID vaccine into all forms of vaccine. And of course now with RFK and his big push against vaccinations, it has gone a little bit wild.
Christy Harrison: It is. Can you share some of your findings on how anti-vaccination rhetoric gets sort of woven into this content? I’m curious what the sort of typical content is and then how the anti-vaccine content is woven in, because I can imagine from influencers that I’ve seen are these sort of influencer healer types, oftentimes there’s the denigration of conventional medicine, the pitching of alternatives, especially diet, restrictive diets and supplements and things like that and then sprinkled in is this other kind of more extreme stuff.
Maxine Ali: Yeah, it’s always difficult to know where to start because I think there was a lot of interesting identity work that was going on around this anti-vaccination positioning. For instance, I had a lot of the influencer healers I was looking at who were really tapping into that kind of maternal discourse. The natural mom, not quite trad wife, but certainly having slight overlaps with that kind of movement and seeing a lot of their feminine intuition as having a higher place in healthcare decision making than science and evidence.
And yet conversely, against that we saw a lot of, actually, the co-optation of feminist rhetoric as well. So I had a lot of instances of data with #mybodymychoice, #bodilyautonomy, these hallmark feminist slogans now becoming something that these wellness and alternative health spokespeople draw upon in order to make a case against scientifically backed vaccinations.
Christy Harrison: That’s so scary.
Maxine Ali: And it was one of those things that really, as a researcher, kind of makes your blood boil. It’s so hard. I’m sure you have this too, with your work when you’re kind of trying to engage with these spaces just to be informed, but it affects you so much mentally because it is awful. It is awful to see the influence and power that these people have and how they weaponize movements, ideas, values that were supposed to uplift people to basically further harm.
Christy Harrison: Yeah, it’s so upsetting. I mean, I was gonna ask what it’s been like for you to follow these influencers so closely as someone who was once a devotee of alternative and holistic practices, but is now so critical of them. Are there ever moments when you feel yourself getting pulled back in,
