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Phoebe Neidl: Hello, listeners. I'm Phoebe Neidl, an editor here at Audible. Today I’m thrilled to be chatting with journalist Amy Larocca. Her new book is a funny and sharp critique of the wellness industry called How to Be Well: Navigating Our Self-Care Epidemic, One Dubious Cure at a Time. Welcome, Amy.

Amy Larocca: Hi. Thank you for having me.

PN: Thank you so much for joining us. I have to tell you, as soon as I heard about this book, I was very excited, because I, and I assume this is true for a lot of our listeners, get really bombarded with all sorts of ads and messaging on different wellness products, exercise systems, supplements, you name it, and it's hard to know what to make of it all. I learned in your book that in recent years wellness has ballooned into a $5 trillion industry. So, to start things off, I'd love for you to talk about some of the factors behind this explosion in wellness.

AL: I started working on this book when I was still working as a fashion editor at New York magazine, and I realized that wellness is most conveniently thought of as a luxury good. I think it helps if you think of wellness as a luxury commodity. It's not that surprising to think of what a valuable and lucrative business it is, because it's being sold and it's being marketed primarily and chiefly to women. I think if you start thinking about it as not terribly unlike a handbag or high-end fashion or cosmetics, it's not that surprising that it's bringing in as much money as it is because it is the nexus of aspiration, want, longing, and, in a lot of cases, fear that drives a lot of consumer spending in this country.

PN: Right. Speaking of fear, how much of this exponential growth in the wellness industry in recent years was due to the pandemic, do you think?

AL: What's going on now is driven definitely by the pandemic, definitely by social media, definitely by factors that maybe you wouldn't necessarily at first associate with the wellness business, like climate change and a lot of the fear that we have about how chaotic and frantic and out of control the world seems—and the desire we have to control what we can within the little, small sphere and bubble of our own bodies or our own homes and our own families, to try and exert some level of control over what we feel we might be able to manage.

PN: Yeah, absolutely. It was interesting, you talk about [how] you wrote this book for women, and it's very much about women. You do touch on men and how things are marketed for them in the wellness sphere, but it's very much about women, because so much of wellness is aimed at them, and how that is a little bit rooted in how conventional medicine often neglected women's health. So many studies were only about men. You point to even a menopause study that was conducted entirely on men, which, someone's going to have to explain that one to me [laughs]. But it's sort of not surprising that women look to other spaces or wellness ideas, right? Because they'd sort of been dropped by conventional medicine for a lot of history.

AL: A lot of wellness businesses describe their clientele as pretty consistently 80:20 female to male, and I think that's pretty consistent across the board. There's so many things to say about the gender divide in wellness. And when you look back, historically, one of the funnier stories about the gender divide in medicine is that the United States Organization of Obstetrics and Gynecologists used to have its annual meeting at the Yale Club, which didn't even admit women, even as guests, for many, many years. So here was this convention to discuss women's bodies held inside a club where women were not welcome.

Now, fantastically, female OB-GYNs outnumber men, so there is tremendous progress being made in terms of women's health. But, historically, drug studies, disease studies, have been conducted on white male bodies and on conditions that primarily affect white male bodies. So, there's been a lot of progress, but still the great history of Western medicine is based on research that wasn't done for women or for people of color or for a lot of different populations.

"I think one of the ironies of the way wellness works in America is if you're in a position to be accessing any of these things, you're probably pretty far along in the game of health. Because wellness is being treated like a luxury."

Someone I interviewed and read for the book has this quote that I really think about all the time. This is a writer named Maya Dusenbery. She said she's really tired of this conversation that wellness was about women looking for alternatives. She's sort of like, "Alternative to what?" There was no information about, in her case, it was autoimmune disease. So, it wasn't that she was looking to undercut or find something other than established medical information, it was that there wasn't established medical information for her condition. So, that's a huge aspect of the wellness industry, these communities springing up to help one another among underserved populations.

PN: You definitely really explore in the book how the class divide is painfully apparent in the wellness industry. And what I feel like I hear you wrestling with is that line of, of course we should all feel entitled to take care of ourselves, but when does self-care become selfish, self-indulgent? Where is that line where it just starts to get silly and it's people with the means to do so just finding more and more amped up ways to pamper themselves?

AL: It's ultimately the narcissism of small difference, right? Like, the question of whether or not you're healthy and well in America is a question of privilege, and whether you choose Pilates over yoga is not really the deciding factor of whether or not you're going to be a healthy person. If you're in the position to be making that decision, odds are you are probably a pretty healthy person to begin with. I think one of the ironies of the way wellness works in America is if you're in a position to be accessing any of these things, you're probably pretty far along in the game of health. Because wellness is being treated like a luxury, the people who have access to the things that we call wellness are already quite well.

PN: Right. If you have the time and money to pursue these things, you're in good shape.

AL: You're far along in the game. I think that's one of the things that we really learned during COVID is that health is so fractured, like so many things in this country. Access to health care is really so fractured. I think before COVID when I thought about this [book] project, I thought, "Oh, God, this wellness thing is happening and it's kind of absurd and silly,” and this was going to be a kind of romp of a project. Then COVID happened and you started to see who is getting sick and how stark those divides are, and it was like, "Oh, no, treating health like a luxury good is actually quite dangerous, it's a quite dangerous position for a society to adopt."

PN: So, one of the sections of the book that I probably most identified with was the stuff on “clean” products, “natural, non-toxic.” I'll definitely spend more money on the cleaning products or the self-care products that promise me they're free of this and that, parabens or BPAs or what have you. Which, honestly, I'm not even 100 percent sure exactly how much of a danger these things represent. But assuming they do represent a danger, it does make you think, "Well, how come everybody doesn't get the safe option? Whether you're buying the $6 shampoo or the $40 shampoo?” It's that age-old thing of: money buys you health and safety. Would you say the wellness industry is exacerbating that inequity, or just magnifying it? Or almost concealing it?

AL: I would say all of the above. It's very confusing and I think there's so much conflicting information about this. One of the most interesting pieces of research I came across was interviews with a lot of the chemists who are hired away from the big Procter & Gamble-sized companies to work on some of the clean alternatives, and feeling that because of the lack of regulation in the so-called clean beauty space, they're often very uncomfortable with the products that they make for a lot of smaller companies. Because there's very little regulation; because they aren't given the kind of time and resources they are for a lot of the larger companies to develop and research the products that they bring to market; because what defines those terms is very murky, what it means to be a “clean” product or an “organic” product; because chemicals get renamed, so it might be BPA-free but it's not something else-free that just doesn't have the name recognition.

Also, there is such exposure outside of your control that the ratio of exposure that's within your control is sort of minute compared to what you get just in the ambient environment. So, it's really kind of an illusion that the unique consumer has much control over her exposures, but it's an illusion that gives people a lot of comfort.

PN: So, you mentioned your background, you were a beauty and fashion editor for a long time, which I think put you in a great position to quickly pick up on the fact that a lot of the same pressures that have always been put on women in terms of beauty and their bodies and their appearance are still being fed to us, but just now in the guise of wellness. Can you talk about some of the ways that wellness culture is mimicking these age-old unfair standards for women? But I'm also curious, do you think there is improvement in the rhetoric? Does wellness-speak represent progress at all to you on this front?

AL: I mean, I would like there to be, so much. It's like the body positivity thing, just as soon as the semaglutides and GLP-1 medicines appeared on the mass market, body positivity appears to be just finished, from what I can tell. Size inclusivity appears to be gone from marketing. I think the emphasis is always on youth. I think the emphasis is always on appearing young and fit. And there's a huge emphasis in wellness culture on the idea of getting back to something. Every time a woman reaches a sort of transition, a transitional milestone in her life, wellness is pushing this idea that you should return. So, if you've had a baby, "Let's get you back to the person you were before you had a baby." "Oh, it's menopause? Don't worry, we can get you back to what you were before menopause."

"I think we really have to be conscious about what we teach the younger women in our lives about how much self-improvement needs to be a focal point of the female experience."

I think wellness pushes the idea that there's these kind of ideal states where women are supposed to remain suspended in them without the kind of evolution or potential discomforts or apparent physical changes that come with the natural evolution of a woman's life.

PN: Another thing that your book opened my eyes to was just how much the gospel of wellness had seeped into so many aspects of our culture. I think you sort of make a case that people's spiritual lives, political lives, work lives, are being informed by the rhetoric and goals and tools of this idea of wellness. Do you think that is because of a growing distrust with institutions, such as maybe in government or health care or organized religion? People used to look to these places for answers, but less so nowadays, and there's sort of this vacuum that's being filled by wellness.

AL: Definitely. I think fitness is definitely a place where you can see that happening a lot. We all know that people don't go to church in anything like the numbers they used to. And if organized religion provided a place to gather, a sense of community, a sense of comfort in difficult times, it's not that the longing for those facets in life disappeared, but organized religion just doesn't fit into modern people's lives in the same way.

People are getting married later, moving away from their families. So, the longing for community, the longing for belonging and ritual and places to gather exists, and in a lot of people's lives, that's become fitness, that's become gyms. It's a third space for a lot of people. And a lot of gyms have answered with very, very, very religious-resembling experiences: charismatic leaders, dark spaces, music, sort of ecstatic movement. The parallels can be very striking, especially as these characters have moved into preacher-like roles, talking about community, talking about spirituality, talking about evolution, transformation, our obligations to one another, our obligations to the community.

These are very, very, very common themes and topics that are brought up in a lot of fitness spaces. There's SoulCycle classes that are called Sunday Service. And there's some back and forth in it. Like, a lot of the megachurches have fitness as an aspect. So, it's not just New York City and SoulCycle or Los Angeles and SoulCycle, it's the megachurches will have fitness as an aspect of what's offered in a membership. There's things called Praisercise. So, it goes both ways, it goes in sort of secular communities that resemble a religious experience, and in explicitly religious communities, fitness can be brought in.

PN: It's important for the listeners to know, also, that you very much put yourself on the front lines here. Amy shares in the book about trying everything from colonics to juice cleanses to meditation courses. You are not judging anybody and make it very clear that you are just as susceptible—

AL: No, no, no. Do what you gotta do [laughs].

PN: Yeah. Do what you gotta do. But it did make me wonder, what is your sort of personal philosophy of self-care that maybe you've come away with after thinking so deeply on all of this? Have you put up any mental guardrails for yourself to help weed out the nonsense from the actually helpful?

AL: I like to think I have, and then I’m like, "Yeah, I'll try it." I really don't do supplements, but I say that and then I had influenza A this year and I was so sick and it was totally terrible. I was talking to a friend of mine, she was like, "Oh, yeah, everyone's got it." And she's telling me at her kid's school all the people who have it, and I was like, "Well, why don't you have it?" And she's like, "Oh, because I take bovine colostrum." I was like, "Bovine colostrum? Do I need to take bovine colostrum?" And then, all of a sudden, I'm ordering bovine colostrum. I took it for like a week and I was like, "This is disgusting, it gives me a stomach ache. I'm not taking bovine colostrum. Don't I know better?! Haven't I learned?!"

So, I like to tell myself that I am immune, but of course I'm not. I'll click on any email that is like, "The solution is in here," and I'm like, "Is it?" And then I find out it's not [laughs].

PN: Because I think we've all probably tried or made some changes to our diet, or our exercise, or tried a supplement that actually did feel like it helps. And that's what makes it so hard—you can't write it all off!

AL: It’s so hard.

PN: It's tough. But is there any particular lesson that you hope listeners take away from the book overall?

AL: Well, in the end, I really sort of dedicate this book to my daughters. I mean it when I say I think we really have to be conscious about what we teach the younger women in our lives about how much self-improvement needs to be a focal point of the female experience. Can we just try a little harder to be like, "We're okay. We don't have to spend such an enormous part of our lives trying to be better.” I think even if people just come away from this book with an awareness of how much time and energy women are expected to spend on the project of improving ourselves, that would be enough. Just to say, "That's a lot of time and effort and money that women are just absolutely expected to spend on the project of self-improvement.”

PN: Yeah, absolutely. I do also want to ask you, of course, about the narration of this. You narrate the audiobook, which was great.

AL: I did. I did the audiobook. Took a long time.

PN: I'm curious, how was that process for you?

AL: It was interesting, it was fun. I've never done anything like that before. I'm married to a theater director and he was like, "You don't know how to use your voice." And I was like, "I don't" [laughs]. Definitely had to stop a little bit early every day because I sort of ran out of steam. But it's interesting to read the book in that way. I'm not used to reading my own words aloud.

PN: Well, it was great. I always love hearing books in the author's own voice. Because, also, this book was funny, I mean, just to be clear. I also found myself sort of chuckling out loud.

AL: Oh, good.

PN: I think you have a way of putting things that makes you realize how silly some of the [product] claims are. So, it was really great to hear that in your voice.

AL: Oh, good. That makes me very happy. That makes me really glad.

PN: Yeah. I loved it. Well, thank you, Amy. I am really excited for people to listen to your book.

AL: Thank you so much.

PN: And listeners, you can get How to Be Well: Navigating Our Self-Care Epidemic, One Dubious Cure at a Time, by Amy Larocca on Audible now.