Why Wellness Programs Don't Work - And What Does

Corporate wellness programs were supposed to solve everything.

The logic was impeccable: Most of our healthcare costs are directly attributable to lifestyle-related chronic diseases. Prevention is much cheaper and more effective than after-the-fact disease management. We know what lifestyle and diet factors contribute to disease risk. So let's get employees active and eating right and managing stress effectively and sleep enough, and we can save boatloads.

Strangely, this didn't work out. Wellness programs are famously bad at producing any kind of ROI that the C-suite can get excited about. Not only is the R (return) really low, but the I (investment) is quite high -- if not in cash outlay, at least in the amount of attention and effort required of employees who are already overworked and overwhelmed.

At WellStart, we're totally into lifestyle as medicine. The science couldn't be clearer; our Menu, our Movement, and our Mindset protocols blow even the best pharmaceutical and surgical options out of the water if they're deployed with a commitment from our employer clients and their employee participants. So it it is a major bummer that the Wellness industry has come so close to invalidating "lifestyle as medicine" as a viable solution to our healthcare crisis.

The thing is, lifestyle medicine is the only thing that can spare our families, our companies, and our economy from healthcare-driven collapse. So we've got to figure out why it hasn't fulfilled its promise, and fix it fast.

The standard answer provided by HR managers, benefits brokers, and CFOs is a lack of "engagement." Wellness would work if people actually participated in the wellness programs. If they logged on more, downloaded more low-fat or low-carb recipes (or whatever is popular at the moment), took the stairs instead of the elevator, and stood up and stretched at their desk every 90 minutes.

But we beg to differ. Lack of engagement is not the cause of problem. Rather, it's a symptom of the three real causes: Sand Shlepping, Pixating, and the Toy Chainsaw.

Sand Shlepping

Since Wellness programs typically are voluntary perks, the employees who take advantage of them tend to value health. Who wants to track steps with a wearable or get a discounted gym membership? By and large, those who already have pretty good health habits.  And those are the folks for whom improvement moves the needle the least. 

There's a saying, "Bringing sand to the beach," which refers to an effort that produces no value because it's unnecessary. Wellness programs that offer incentives to those who would likely do those same things anyway are prime examples of sand shlepping. 

WellStart is not a wellness perk, but a serious medical intervention for your company's sickest employees - your highest utilizers of health care. 


Imagine a visual of a blue sky on your computer. Zoom in enough, and you'll quickly realize that not every pixel that makes up the sky is blue. Some are green, some are black, some are yellow. Heck, some of them are even orange! If you remain aware of the big picture, you can zoom in to the orange pixels and still recall that you're looking at a representation of a blue sky. 

If, however, you see that orange pixel and decide that the entire sky must therefore be orange, then you've falling into the trap of Pixating (fixating on a pixel; get it?).

In the context of health and wellness, Pixating occurs when we mistake the outcomes of a small number of studies (or a single study) for the preponderance of evidence. It's not being able to tell the difference between poorly done studies and good ones; between marketing masquerading as science with true science; between statistical significance and actual significance.

I'm not just blaming Wellness companies here. Pixating starts with the media, and percolates into industry and government and popular culture. 

Lots of industries (I'm looking at you, junk food and animal agriculture and pharmaceuticals) make lots of money off of this scientific Pixation by the media and their downstream mouthpieces, the blogosphere, so those who practice it assiduously typically get rewarded for their work. A prime example is the low-carb fraud perpetrated on the public by a handful of journalists who ignore or misrepresent the overwhelming evidence that low-carb diets hasten death.

A Wellness program based on Pixated science cannot produce positive long-term effects. Our competitors who offer the ketogenic diet for diabetes reversal, for example, are able to conjure the illusion of diabetes reversal by highlighting sleight-of-hand metrics like fasting blood glucose, rather than actual insulin resistance through a true glucose challenge. This is like the plumber telling you that the only way to treat a clogged drain is to stop using your toilet. 

So at WellStart, it's crucial that we begin and end with real science; not pixels, but entire canvases of data. We look at large, long-term studies with clinically meaningful endpoints (typically deaths, disability, and incidence of disease). We reject the idea that nutrition and lifestyle can be meaningfully understood only through reductionist, randomized, controlled clinical trials. We reject the assertion that since correlation isn't causation, we will stick our heads in the sand and ignore the vast and coherent data on diet and lifestyle provided by epidemiological research.

WellStart promotes, teaches, and supports evidence-based protocols that do not shift with the fickle winds of social media fads.

At WellStart, we recommend lifestyle and dietary shifts that are high-powered enough to generate real results. Meaningful improvements in weight and other biometrics. Reduction or elimination, in many cases, of medications that our clients have previously been advised to stay on for life. 

Our protocols have to satisfy two criteria: they work, and they're sustainable as a lifestyle. 

Fulfilling the Promise of Lifestyle Medicine

The core assumption fueling lifestyle medicine is that our unhealthy lifestyles and diets are the root cause of our chronic disease epidemic. The true cure, then, is not to be found in a bottle or at the end of a scalpel, but in choosing lifestyles and diets that promote health rather than disability, disease, and premature death.

Healthcare of the future will consist of evidence-based information, and coaching to implement that information. Current treatment options will be relegated to last resorts, and in extreme cases. The phrase "chronic disease management" will sound as ridiculous as "strep throat management" or "blocked toilet management." When you can totally resolve a problem, there's no reason to "manage" it.

Until this sentiment becomes common knowledge, WellStart and other enlightened companies will continue to slug it out in the marketplace. The good news is, until this sentiment becomes common knowledge, you can get a wicked-powerful competitive advantage in your industry.

  • Imagine cutting your annual healthcare spending by 30-50%.

  • Imagine employees no longer missing work or dragging their sick and tired bodies into the workplace because they've mitigated and reversed their chronic illnesses.

  • Imagine reinforcing an organizational culture of excellence through personal responsibility for health outcomes.

If you like what you're picturing, give us a shout.