Amy Larocca, author of a big new book on the industry, separates the harmless from the hoaxes

By Cindi Leive

One of the many developments of the last decade—along with the rise of AI, Trumpism and tradwives—is the vast and varied world known as “wellness,” which includes everything from that meditation app on your phone to billion-dollar biohacking. Journalist Amy Larocca has spent seven years making sense of it all, and her book, How to Be Well: Navigating our Self-Care Epidemic, One Dubious Cure at a Time, is out today. Despite its skeptical subtitle, Larocca understands that “wellness culture is too big for us to be either completely for or against it.” So where did she land? I wanted to know.

Your book investigates the recent rise of wellness culture. But back in the ‘80s, there were grapefruit diets and aerobics classes and all kinds of physical expectations. What’s different now?

A lot of it in the 80s was about looking good, or slimness—I can still picture the Dexatrim box! But there wasn’t a lot of thought about health in mainstream culture. I really started to notice the rise in wellness culture when I was working as a fashion editor [at New York magazine in the 00s-10s]. Fashion was becoming more democratic—you could stream the shows, you could shop online. But at the same time, health was becoming more and more expensive and out of reach. Basic healthcare was not being treated as a right in the United States, but as a luxury commodity. And I could see that it was being marketed using all of the same language as the fashion industry that I’d been covering. And how weird is it that the new luxury good is our health, something that isn’t extra, right? A handbag or a pair of shoes or a lipstick is something that’s extra, but our health shouldn’t be extra.

You started writing this book seven years ago—when, yes, there were colonics and juice cleanses, but you could still go to the CDC for solid information about what worked or didn’t. Now our top public health leaders are trafficking in disproven myths about vaccines and cancer and birth control and fluoride. Did you see this coming?

I feared that it would get as bad as it has gotten. And one of the reasons that wellness culture has been able to rise in the way that it has, especially for women,  is there’s a real absence of experts. The writer Maya Dusenbery [has] said that it drives her crazy when women seeking wellness care are described as seeking “alternative solutions.” Because these aren’t alternatives: We don’t really have other choices! Women are going online looking for advice from other women for managing their autoimmune conditions because autoimmune disease and other diseases that have disproportionately affected women have been very underfunded and understudied. So when women are using this relatively new resource called the internet to speak to each other and discuss what has worked for them and how they’ve managed—that’s not alternative. That’s just us actually trying to find some relief because the mainstream channels have let us down. [And] given the current political situation, I don’t see that getting any better.

Your book makes it really clear that progress and bullshit are really intertwined. Meditation is incredibly helpful to a lot of people and it’s being oversold as a solution. Our health-care system does need to focus more on menopause and there’s now a lot of menopause-related crap being sold to us with cutesy names. So is there a wellness development that you find really promising, and one that feels particularly BS-laden at the moment?

For years, there was a conversation about [hormone replacement therapy] HRT being very, very, very dangerous for women, so women stopped taking HRT. Then NAMS re-released its research and talked about HRT being safe for women—that coincided with the rise of telehealth [in COVID] and suddenly you had a number of telehealth startups making HRT very, very, very easily accessible. So you combine all that in a perfect storm and you get a lot of women with very high expectations for what HRT is going to be able to do for them during perimenopause—and all this is doing exactly what wellness culture has the potential to do in the worst possible way: It oversimplifies matters with a profit motive behind it all.

The real story of HRT is: Here’s a treatment that can help some women with some symptoms some of the time, but the only narratives that seem to gain any traction are “It will kill you!” or “It will save you, hurl down your crutches, Oh Lord, I can walk!” And neither of those stories seem to me to be the correct story of HRT, but no one seems to have any tolerance for anything in the middle.

Part of that seems to be driven by how much money there is to be made. Part of it seems to be driven by the appetite for a good story. Part of it seems to be driven by a lack of patience for complexity, and how boring medicine can actually be. But it really started to freak me out—the expectations that people seemed to start having for what HRT was going to do for them, and the amount of money that a number of business people were excited to suddenly make. And that’s wellness culture in a nutshell.

I’m breaking the rules of this column with a fourth question. Is there one particular wellness habit you’ve picked up while writing the book that you will keep? 

Breathing. It’s free. I do 4-7-8 breathing. I’m big on all the free stuff: I walk everywhere, and I sleep. Sleep as much as you possibly can, and never, ever, ever feel guilty for going to bed.