Deb Cohen is an award winning investigative journalist and correspondent who trained as a physician and has worked with the BBC and BMJ. She just published BAD INFLUENCE, a book which takes us deep into the wellness-industrial complex—the confluence of the supplement, testing, tech, and pharma industries, and how they sell health anxiety to healthy people.

Here are some of the points we discussed:

—The big market in healthy, well people. Tests, wearables, imaging, supplements, etc

—Algorithms feed the health anxiety in an amplifying, vicious loop on the social media platforms. When the algorithm knows you better than you.

—The special qualities of influencers, likable, relatable, vulnerable, appearance as friends, certainty, cultivating parasocial relationships. “I understand you, I see you, I hear you.” Often with financial conflicts of interest. Plus hidden financial benefits.

—The inverted pyramid of evidence and displacement of trust. Anecdotes believed and accepted as best evidence instead of rigorous randomized trials. A big flip, doctors losing trust to influencers and the sponsors of influencers.

—The Nocebo effect of harm through expectations

—The epidemic of neurologic tics during the pandemic traced back to TikTok, a viral contagion with 5.8 billion views (Figure made with Notebook LM)

—Potential for regulation of patient/consumers/prosumer influencers

—Celebrity influencers and the recent NEJM paper

—Many ideas for how we can mitigate this mess )Graphic by Notebook LM)

—Many illuminating patient examples: Femtech, silicon breast implant illness (BII), beta blocker experiment, a bogus bioresonance of hair test in a woman with GI symptoms, full-body MRI of brain lesions (transmitted to the patient by an automated message) that were a false positive.

—The term “wellness”

—Concierge physicians

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Deborah Cohen: The Wellness-Industrial Complex

Ground Truths

Deborah Cohen: The Wellness-Industrial Complex