The Paradox of Wellness Syndrome

How has the idea of wellness penetrated so deep into the cultural mainstream of the modern society?

The obsession of contemporary society with wellness – the mounting inventory of ‘100% organic’ labels in food stores, the skyrocketing sales of fitness gadgets, the skincare routines, wellness influencers, yoga gurus, keto diets – has never been so evident. The global wellness economy reached a massive $4.5 trillion in 2020 which is more than the combined GBP of the United Kingdom and Canada.[1] How has the idea of wellness penetrated so deep into the cultural mainstream of modern society? What is influencing the public to spend fortunes on fitness and beauty products? And most importantly, how has a seemingly pleasant notion of wellness transformed into a dangerous obsession known today as the wellness syndrome?

Parallel to the notion of wellness, another trend that has seen a dramatic rise in the last many decades is that of media consumption. A recent study showed that adult internet users in the UK spend an average of 25 hours a week online.[2] As health and physical wellbeing a core interest of society, communication for health has remained an integral part of media and communications. Admittedly, media plays a big role in how ideas are conceptualised and how they affect behaviours in societies. Effective communication is central to our ability to function as a member of society.[3]

Is there a correlation between health communication and wellness syndrome? I argue that health communication has played a significant role in the rise of wellness syndrome in modern Western society. The prevalence of wellness syndrome is not an abrupt development, but a gradual build-up of simultaneously occurring phenomenon accelerated by health communication over the last many decades. The first phenomenon, that occurred in the latter decades of the 20th century, was the public attention to science. During this period, health communication gained considerable attention and authority which consequently increased the attention and consumption of health and science news in the mainstream media. Secondly, with the advent of new communication technologies, health communication facilitated a landscape where two opposite cultures - ‘a culture of fear’ and ‘a culture of perfection’ – were communicated simultaneously through health and media campaigns, which aided in the development of the wellness syndrome.

What is wellness syndrome? The term ‘wellness syndrome’ can be an oxymoron with wellness having a positive meaning while the term syndrome ascertains a negative implication. Wellness generally indicates to “reach beyond physical health to encompass a more holistic mind-body approach that also is associated with a good mental and emotional health”.[4] A syndrome is defined by a group of symptoms that occur simultaneously. The wellness syndrome, then, is a collection of symptoms that arise as a result of a particular obsession, anxiety, self-blame, and guilt, for instance.[5] Wellness syndrome largely represents how the idea of wellness has taken a new meaning from generally feeling good to obsessively trying to control how one feels and looks.[6] It is a behaviour, the result of a changed attitude towards the idea of wellness.

Does a certain type of communication persuade an individual to change behaviour? In this case, how has the content aimed at the promotion of health and wellness produced a counter effect of wellness syndrome? As an explanatory framework, the ‘health belief model’ (originally proposed by Rosenstock[7]) might help develop an understanding of the process. Admittedly, the model has certain limitations like the lack of admitting temporal dynamic aspects, however, it can still help us paint an overall picture of the behavioural change in which the idea of wellness evolves into an active obsession from a passive activity.

According to the model, an individual's health-related decisions are a result of his or her subjective view of a perceived health hazard and relevant behaviour.[8] Further, the threat is operationalised in terms of expectations of the seriousness of a specific health condition as well as beliefs of a person's vulnerability to that health issue.[9] The behaviour of an individual is driven by beliefs and both internal and external cues can enable a change in attitude. (figure 1[10]). In the case of wellness, the external cues are provided by the plethora of health campaigns and promotions of a certain idea of wellbeing across all channels of communication.

The evidence shows that there is indeed a dramatic rise in the trends surrounding wellness, but how has health communication facilitated these upward trends? To get to the root of the question, it is important to examine how the public attention to science in the media has progressed over the decades. A detailed examination of the public’s interaction with the scientific news in media will help us understand how health communication has played a role in shaping the behaviour of the public towards wellness. Because, despite minor differences, in certain circumstance, health communication is essentially science communication. Of course, science communication can at times cover stories outside the sphere of health and illness, but science news equally contains much that is relevant to health[11].

So how has public attention to science shifted over time? In one ambitious project, Bauer has analysed the trends in public attention to science over a period of 200 years.[12] An overall sense of fluctuation in the global system of science news in the west is mapped using a cliometrics approach to public attention to science.[13]Admittedly, the framing and the positioning of science news in public discourse is not a constant, however, a general trend of increase in science news related to biology and biomedicine can be seen on the rise after the 1970s.[14] In the later decade of the 20th century, as a result of this developing trend, a new agenda emerged in the USA and Europe to bring scientific activities closer to the public through the ‘public understanding of science.’[15] The term ‘public understanding of science’ simultaneously “refers to activities that bring science close to the public as well as the research that tries to determine what the public’s understanding of science may be.[16]

The upward trend in public attention to science is crucial because it helps us understand how the masses have interacted and engaged with health media. Since the general public is not involved directly in scientific research, the mass media becomes the primary source of scientific knowledge. Catching on with the interest of the public in science, that mass media used the opportunity to publish more and more material related to science, particularly biomedical science. For instance, in the UK, all major newspapers including Times, Guardian and Independent had a high proportion of biomedical news covered consistently throughout the 1970s and 1990s.[17] Similar trends were seen on UK television with medical sciences getting the second-highest airtime on television surpassed only by natural sciences.[18] In the British media, “medicine and public health have often enjoyed their own specialist strands in addition to featuring withing mainstream science broadcasting”.[19]

Similarly, the framing of biomedical news in the mass media in the UK during the era between the 1970s and 1990s is interesting to observe. The examination paints a picture of the backdrop upon which health communication operated and contributed to the wellness culture that prevails in all aspects of modern life today. Particularly noteworthy is the trend of risk-only stories in the media which serve as a pathos maker in the collective imagination of the public.[20] For instance, the overall trend of alarm stories related to biomedicine sharply increased from 27% to 36% over thirty-six years between 1966 and 1992(Figure 1).[21] Based on the evidence, it is safe to argue that the anxieties and fears regarding health and wellness were well on the rise in mainstream media during the latter decades of the 20th century.

In the same way, health communication generously used various representations and images to emphasise the riskiness of modern life.[22] The consistent portrayal of violent and frighting stories in the media - which are an essential part of the health-scare agenda - in return gave rise to a ‘culture of fear ’.[23] The scary stories in health media around food, for example, show how “ the depiction of ordinary objects whose ingestion is essential for life presented a highly entertaining juxtaposition of opposites for the media health producers”.[24] One of the earliest food scare stories in the British press, for instance, was ‘the salmonella in the egg affair’ which was hysterical in respect of its high emotional nature, the vast magnitude of Press coverage, and its sweeping generalisation to the "poisoning of our planet".[25]

Another key aspect of the scare culture that helped the emergence of ‘wellness syndrome’ is the representation of infection in health media. In contrast to food scare, infection scare evoked even more attention and panic as the threat appears hardly under anyone’s control or can be avoided as a function of personal choice. For instance, the portrayal of Cancer as an infectious disease in the media, even though Cancer is not essentially an infectious disease.[26] “The media's cultivation of the notion that anything, possibly, causes cancer, as well as the exaggeration of the degree to which it causes death, has resulted in cancer being constructed at the very least as a 'contagion, from which the disease may be caught”[27]. Depiction of cancer as if it were an invading force, starting a war on cancer cells, using combat symbolism in treatment details, and, ultimately, associating cancer with death itself are all themes that have pervaded the popular culture of representing cancer.[28]

With the turn of the century and the rapid explosion of new media technologies, the scope of health communications changed entirely. The internet disrupted the conventional vertical system of sharing information from scientific authority to the public. In the new landscape of media, receiving and dissemination of information took shape of several channels simultaneously. It was in this dynamic landscape in which ‘the culture of fear’ and ‘the culture of perfection’ came face to face. Consumers, now bombarded continuously with the risks of unhealthy habits were also consistently exposed to the idea of perfect body image at the same time.

The interaction of the internet and health communication directly aided in the rise of wellness syndrome. To understand the link, it is vital to understand how the internet affected the traditional landscape of health communications. With the popularity and easy access to the internet, more and more people started to engage with the widespread availability of health-related information on the internet.[29] Only in England, there are more than 50,000 organisations that provide web-based assistant in health and social care.[30] Clearly, the internet has evolved rapidly over the last few decades and continues to attract health information seekers. For instance, a UK survey of over 2000 people by Statista found that 73% of individuals use or have used the internet to search for health information.[31]

How does the abundance of information affect user behaviour? the abundance of information on the internet is not a negative thing per se. There is evidence that suggests that the internet can be an effective source to get reliable information about health conditions. However, the plethora of information on the internet has also given rise to the anxieties associated with wellness so much so that it has developed into a syndrome of its own called cyberchondria. The term cyberchondria, a derivative of hypochondria, is used to define the aggravation of anxiety because of excessive or frequent searches on the internet for medical information.[32] For example, a study that examined the effect of internet health showed that more than 40% of respondents reported a behavioural change based on the health resources they researched on the internet.[33]

Another factor that has fuelled wellness syndrome is the depiction of health information on the internet, a good part of which revolves around the attainment of a certain body shape and physique. Health messages on the internet are loaded with celebrity fitness standards, depicting virtues of slimness, stigmatise obesity and have a tremendous focus on weight loss and physical beauty. The negative influence of featuring the slim model body image is well-documented, with a meta-analysis of studies in this field showing that exposure to such media is continuously associated with body dissatisfaction.[34]

Similarly, the rise of the internet for the promotions of health campaigns has created a heightened sense of awareness about wellness. These promotions - the majority of which is done with the right intentions - have produced a culture “where personal obligation and self-expression are transformed with an attitude of a market economist.[35] The cessation of smoking now is not so much about health benefits but a necessary strategy to increase one’s personal market value.[36]Similarly, the fitness programmes religiously promoting by corporate industries to employees are not so much about the health of the employees but more about the image of the corporate organisation or about cutting insurance expenses. Eventually, the pursuit of wellness has become an effort to gain recognition in domains outside of exercise, such as our work and sex lives.”[37]

Finally, the overabundance of health information available has caused a significant ‘medicalisation of the society’ where health issues and science-related information are continuously put in public attention.[38] With the medicalisation of society, new authorities and social norms replace the traditional. For instance, the terms such as sin and redemption are replaced by behaviours norms such as fitness and a healthy diet.[39]As predicted by Illich[40] and reiterated by Baur[41] several decades ago, the overproduction of health services might not always be beneficial and can have associated unintended consequences. Wellness syndrome is one such consequence of the extreme production and distribution of health information through health communications in modern society.

When Dan Rather, the CBS journalist and the host of the show 60 minutes, introduced the United States first wellness centre in 1979, he remarked “Wellness, there is a word you don’t hear every day,”. [42] Almost 42 years later, his remarks seem anything but relatable. Wellness has literally become one of the words that anyone living the modern western society comes across daily in some form. The obsession with wellness surrounds and shows itself in several forms throughout the day, it may be in form of a morning yoga routine on TV or a google notification about the number of steps taken on the walk toward work. The idea of wellness has continuously evolved over the last many decades into an individualistic idea where staying healthy and fit is not only a necessity but a moral and social obligation.

Among several factors that have contributed to the rise of wellness syndrome, health communication is one of the most significant ones. What is interesting to see is how the health campaigns done in the best of intentions have counterintuitively produced paradoxical results. Rallied behind the public’s interest in science and biomedical news, health communication provided a landscape of rampant individualism paired with a culture of fear. As a result, even before the popularity of cyberspace and social media, the anxieties related to health issues were hitting the roof. The framing of certain health news and the plethora of health information as a result of new information technologies only added to these anxieties and obsessions around the pursuit of wellness, which in return gave rise to the wellness syndrome.

References:

Assoc, Wellness. Wellness Resource Center With Dan Rather On 60 Minutes. Video, 2008. https://www.youtube.com/watch?v=LAorj2U7PR4.

Bauer, Martin W. "Public Attention To Science 1820–2010 – A ‘Longue Durée’ Picture". Sociology Of The Sciences Yearbook, 2011, 35-57. doi:10.1007/978-94-007-2085-5_3.

Bauer, Martin. "The Medicalization Of Science News - From The “Rocket-Scalpel” To The “Gene-Meteorite” Complex". Social Science Information 37, no. 4 (1998): 731-751. doi:10.1177/053901898037004009.

Bauman, Zygmunt. Life In Fragments. Reprint, Oxford, UK: Blackwell, 2004.

Berry, Dianne. Health Communication. Reprint, Maidenhead, Berkshire, England: Open University Press, 2007.

Boon, Timothy, and Jean-Baptise Goyun. "The Origins And Practice Of Science On British Television". In THE ROUTLEDGE COMPANION TO BRITISH MEDIA HISTORY, 470. Martin Conboy and John Steel, 1st ed. Reprint, London: Routledge, 2021.

Cederström, Carl, and André Spicer. The Wellness Syndrome. Reprint, Cambridge: Polity Press, 2018.

Consalvo, Mia, and Charles Ess. The Handbook Of Internet Studies. Reprint, Malden, Mass.: Wiley-Blackwell, 2011.

Fowler, Roger. Language In The News. Reprint, London: Routledge, 2007.

Kreps, Gary L. Health Communication. Reprint, Los Angeles: SAGE, 2010.

McElroy, Eoin, and Mark Shevlin. "The Development And Initial Validation Of The Cyberchondria Severity Scale (CSS)". Journal Of Anxiety Disorders 28, no. 2 (2014): 259-265. doi:10.1016/j.janxdis.2013.12.007.

Rosenstock, Irwin M. "The Health Belief Model And Preventive Health Behavior". Health Education Monographs 2, no. 4 (1974): 354-386. doi:10.1177/109019817400200405.

Seale, Clive. Health And The Media. Reprint, Oxford: Blackwell, 2004.

W. White, Ryen, and Eric Horvitz. "Experiences With Web Search On Medical Concerns And Self Diagnosis". AMIA Annu Symp Proc. 3, no. 1 (2009): 696–700.

Wash, Bill. "America's Evolution Towards Wellness". Journal Of American Society On Aging 39, no. 1 (2015): 23-29.

Wellings, K. "Help Or Hype: An Analysis Of Media Coverage Of The 1983 “Pill Scare”". Health Education And The Media II, 1986, 109-115. doi:10.1016/b978-0-08-032000-7.50022-2.

"Which Health Websites Can You Trust?". The Guardian, 2021. https://www.theguardian.com/lifeandstyle/2014/dec/14/which-health-websites-can-you-trust-experts-recommend.

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