American Health X
The Failures of Big Food, Fitness & Pharma

By Kevin Mullins

american health

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The Preventable Downfall of American Health

It does not take much effort to see that the health of western culture, and specifically America, has problems. The fabric of the world’s leading power is potentially torn beyond repair. The shreds are deeper than the expanding political divide, a crippling global pandemic, and carefully crafted narratives that fuel civil unrest and a revolting distaste for humans lacking identical ideology. The damage is even more devastating than gross injustice, a widening socioeconomic gap, and the failures of a misguided educational system that cares more about test scores than knowledge retention.

Yes, the biggest problem facing America is bigger and more dangerous than the justifiable, albeit exhausting, talking points of the evening news and every election cycle. 

What has truly thrown a nation of some 382 million people into a state of chaos and emergency is our collective failure to acknowledge that our approach to health and wellness is nothing short of F.U.B.A.R.(1). 

From the misinformed mindset of the average citizen to the directive policy voted upon and encouraged by elected officials – every level of the American healthcare system is devastatingly inept; dangerous even. And this is before we factor in the $1.3 trillion worldwide pharmaceutical industry (2), a $42.6 billion (U.S. Only) food supplement industry (3), both of which posture themselves as necessary elements of your health, wellness, and fitness regiments. 

And each of those industries hire brilliant minds and pay them handsome salaries to market these products in a way that makes them necessities in our virtual and real-world shopping carts. As a country, we’ll say “yes” to a product even when we know we can do better.  

And we’ll say yes to HOPE.

But Who Do We Trust With Our Health?

Which leads us to sign up for gym memberships at the facility closest to our homes, often with the lowest price point per month, an absurdly low upfront commitment (initiation fee), and little interest in ensuring that we know what we are doing once we are within their four walls. Like our foods – we’ll trust the BIG BRANDS with commercials too. 

We’ll drive past the small gym or box in that industrial center and towards the strip mall with the brand that has the big colorful sign you can see from the highway. Clearly, they have the answers if their neon can paint the asphalt different colors when it rains…

We surrender control to the brands we trust… and we trust the brands we see, hear, and can’t ignore. Marketing has changed our decision making processes. 

And that lack of control leads to big profits for some and big problems for us, the consumer, especially as it pertains to our health. Keep eating the chemically-engineered and calorie-dense foods long enough, taking chances on random weight-loss pills found in the supplements section of your local grocery store, and ignoring your body’s basic needs for movement and whole foods and you’ll be right where they want you…

Sick, Broken, and In Need of Medical Intervention

The expected decline in your health has graduated you within the big-business model that governs far too many of our lives. Your consistent investment in the food and supplement industry has paid its dividends in the form of preventable diseases, obesity, and other health failures that require you to begin a new investment strategy. 

Now it’s time for you, or your health insurance carrier, to begin shuttling thousands of dollars into the pharmaceutical, medical technology, and facilities fees that run the healthcare system in America. For example, a single dose of insulin only costs (about) 32 cents per dose thanks to regulation and legislation after the debacle caused by Martin Shkreli (4). Meanwhile, a single ride in an ambulance cost $1,000 – $2,000; a heavy cost for someone in clear danger (5).

The system is double and triple dipping into your pockets by getting you to buy the foods that can make you sick, the supplements and gym memberships to appease your vanity, and the life-saving medications and services to keep you ticking.

And so, the wheel turns.

This article is going to explore, at the deepest level, how America got into this tragic, preventable, and completely irrational epidemic of obesity and other preventable lifestyle diseases. There will be history, statistics, conjecture, and projection.

obesity rates

This is your opportunity to truly understand the war you are fighting as a fitness professional.

The Western Viewpoint of Food

America is an interesting place to observe regarding its attitude and approach to food production and consumption. The practice of overconsumption has spread to other parts of the world, but the epicenter of the obesity epidemic is right here in America. 

The American mindset about food is fascinating when you consider that the typical family spends 25-35% of their income on foods (dependent upon socioeconomic stratification) (6). Yet, the average American only earns a medium income $34,250.00 per year (in 2019) (7). Thus, an individual earning 35 thousand dollars a year is likely to spend about $8,000 on food and beverage.

It’s even crazier when you realize collectively, Americans spend an average of $232.00 per month on eating out (8). That’s nearly three thousand dollars per year in restaurants, fast-food establishments and beyond. 

The problem with food consumption is not only fiscal. It’s physical. 

The typical meal at a restaurant is above one thousand calories, often loaded in fats, sugars, and salts, and served with beverages that also contain calories (sugar and alcohol). Meanwhile, the average home cooked meal is probably closer to 750 calories for families, and 500 calories for health-minded individuals.  

This is the exact recipe for unintended weight gain…

The funny thing is that it wasn’t always this way. It’s also not a conscious choice. History demonstrates exactly how the American diet (and the Western diet at large) got this way. 

Here we are in the year 2021. A time in which it has never been easier to survive disease, famine, and war (if you are born in a developed nation). We exist in a period of history where individuals don’t perish from a lack of calories and sustenance, but instead from a lack of nutrients and overconsumption. The obesity epidemic and all its related diseases are a product of America’s growth into a food producing powerhouse, and the inevitable devolution of the American diet from whole foods to processed junk.

Currently, 74% of Americans are considered overweight. Of that group, 43% are considered clinically obese (a BMI over 30) (10). Even once we factor out those who have high muscle mass (in kilograms) at shorter heights (in centimeters) – we will still be left with at least 30% of the population being dangerously overweight. 

obesity rate

To better understand our current plight, it is imperative that we peel back the curtain and look at the journey that has been food in America over the last century. 

The takeaway?

We didn’t get here overnight, and we didn’t get here on purpose…

The Evolution and Devolution of the American Diet

Prior to the economic, technological, and industrial boom that occurred after the cessation of World War 1 – most Americans had to legitimately work to find their next meal. Even then, acquiring a meal from a local market in town, or even from your own land, ran the risk of serious, and potentially fatal, disease. This was the early 1900’s and nearly all things could still kill you. 

America’s initial neutrality in a global conflict continued the norm for the nation and its people. Innovation of technology and food was steady, but slow. America’s entry into World War 1 initiated a chain of events that quite literally changed the way the Nation, and the world, consumed food. 

Companies in America were incentivized to find ways to get calories to the soldiers fighting in the trenches of Belgium, Germany, and France. Innovators and inventors discovered new ways of preparing old foods and methods of keeping them longer. As the war ended – America’s push into a new era of food creation and consumption was only beginning.

In fact, as most of Europe struggled to recover from the wreckage and loss caused by the war – most Americans experienced the greatest decade of their lives.

And this is how America began its ascent into a consumption culture…

Inventions such as the hot dog, hamburger, soft drinks, and candy bars were created by individuals with a passion and an idea. Soon enough American bellies were fed, tastebuds satisfied, and wallets mostly preserved. These pioneers launched brands we now know as Nathan’s, White Castle, Coca Cola, and Hershey’s.

Quickly competitors arose and Americans could choose between Hershey’s and Milky Way, Coca Cola and Pepsi, or Kellogg’s and Post. A sudden influx of abundance, early iterations of technology such as refrigeration and the automobile, and an economic boom now known as the “Roaring 20’s” put the American people in a position of power, bliss, and consumption. 

And thus began the American obsession with having more than enough, experiencing the most rich and vivid flavors, and the demand for more…

Yet quickly, America’s fortunes changed as the Great Depression brought loss of equal, or greater, magnitudes than the gains of the decade prior. The economy collapsed, jobs disappeared as companies closed their doors, and American stomachs were once again unfed. A large percentage of working-class families were suddenly unable to get themselves and their families the calories needed to thrive. 

Companies successful enough to survive the Great Depression were forced to react and adapt to survive. Quality ingredients were replaced with lower-grade nutrients, or chemical curiosities, to lower cost and improve margins. Americans paid no mind and asked no questions because food was suddenly affordable and 5 burgers for 10 cents was a steal.

And thus began the decline of food quality in favor affordability (for customers) and margins (for manufacturers) …

Companies such as Campbells, Heinz, Kraft cheese and Birdseye frozen foods rose to the forefront of American minds and wallets. As the economy returned to a safer place people began expanding the size of their purchases and building reserves. The explosion of non-perishables, refrigeration, and freezing of foods dramatically changed the way Americans, and soon enough the entire developed world, shopped and stored their foods. 

And this is how Americans began to buy more food than they needed…

Powered by post World War 2 inventions such as the microwave and television, companies such as Swanson and Stauffer’s captured a populations tastebuds and wallet with the idea that a perfectly delicious meal could be cooked in under 30 minutes (and eventually 10) without much hassle. With the exception of Stauffer’s (who was a renowned chef in Cleveland), most brands of heat-and-eat dinners were predominantly tasteless and made of low-quality ingredients. 

In fact, early advertisements for “TV-DINNERS” emphasized giving mothers and wives a “day off” and instead enjoying a meal and the evening programming as an entire family. An unrelated note, but incredibly fascinating nonetheless, many of the popular marketing strategies employed by businesses today arose from the efforts of food pioneers and their vision of getting an entire country to choose their calories. 

And thus began the era of valuing convenience over taking the time to prepare a thoughtful, tasty, and mostly nutritious meal…

One could even surmise that this time in American history saw men come home from the battlefields of World War 2 comfortable eating anything, regardless of taste or risk, so long as it had enough calories to keep them going. This sort of attitude quickly spread into the fabric of society itself.

Convenience only grew more popular as fast food chains like McDonalds, Kentucky Fried Chicken, and Burger King began popping up on nearly every corner of the major markets. Originally popularized by White Castle, but made “better” by these brands, take-out dining in America exploded in a way that few other calorie-giving efforts did. Now, people could get a hot and ready meal without even leaving their car. They could take it home for dinner for the family or eat as they navigate the highway – the choice was theirs. 

fast food industry

In a time where freedom was one of America’s biggest exports and automobiles were the norm – it was almost patriotic to eat a burger and fry from McDonalds in your car. 

Fast food originally began with average-quality ingredients. Chemical technology was not advanced enough to simulate flavors, artificially plump meat, or intensify sweetness with less syrup. One could say that these establishments still served “food”. 

As a result, Americans weren’t yet being poisoned by their meals and dramatically impacting their endocrine, cardiovascular, and gastrointestinal systems. Now, McDonald’s French fries have 19 ingredients (11). (Shouldn’t it just be potatoes, oil, salt, and maybe some spices?).

But they were still gaining weight compared to previous generations. It was during this time where the beginning of the overweight and obesity curve takes its first notable vertical jump. 

And so begins the American decline in obesity, disease, and complete ineffectiveness as beings of survival…

Time continued to pass, and more innovation entered the food space. Snack foods, frozen foods, mass-farming, and manipulation of animal-sourced proteins, chemical pesticides on agriculture, and genetically modified seeds, oils and plants are just a few “advancements” in food technology within the last forty years. 

Bottling, canning, and packing materials keep calories fresher, longer. 

You can buy your food at restaurants, fast-food establishments, the grocery store, pharmacies, gas stations, foot trucks, food-carts, vending machines, and many other ways. For a developed nation in 2021, there are calories everywhere. 

And none of this story involves the growth of the liquor, wine, and beer industry…

America’s Not So Healthy Future

It’s easy for a fitness professional, or a health-minded individual, to point fingers and blame laziness, complacency and making “the easy choices” for why America, specifically, is so plagued with obesity and disease. In some sense, it’s not a wrong assertion.

Too many Americans prefer to watch reality TV or arguing on social media with other keyboard warriors while eating processed snacks, drinking bottled sugar, and refusing to go to bed at a reasonable adult hour. Others try to eat healthier, but are mislead with labels and sensationalized headlines, which leads to confusion and less than ideal results.

But that’s not the whole story. By in large, Americans (and western culture as a whole), are set up to fail, get sick, and require the medical industry to extend the length of our lives, quality of life be damned. Inch by inch the approach to food consumption has shifted from survival and necessity to overindulgence and boredom. In a place where at least one-third of American’s are obese, yet waste thirty to forty percent of total food supply (12) – our mindset and approach is absurd. 

American health obesity rates

There are entire generations of people living right this moment who have no idea of a world in which food wasn’t readily available. Whether its down the road, in the vending machine, or ordered through the phone – people have lost nearly all connections with the sources of their foods. 

And so, to some degree, the future relies on a simplification and slow re-education of the population. It began with the success of Whole Foods, Trader Joes, and the “organic” push. Various documentaries, tell-all books, and news reels have revealed the ugly side of industrialized food production. Research has revealed the dangers in certain dyes and additives and the government has had to respond and ban certain things (trans fats, carcinogens).

There is a growing awareness even if it isn’t measurable enough for satisfy the palate of the fitness and medical professional. The population is slowly waking up to the idea that their food, when produced in such bulk, isn’t good for them or the environment. 

As we go forward, and we look at how we coach food with our clients it is imperative the we cut them some slack. They were set up to fail. When coaching diet, fitness professionals must stop coaching clients towards perfection. Any progress towards more vegetables, more whole-foods, more humanely grown proteins, more water, and more connection to the source of the calories is a positive movement.

The coaching and evolution of the American diet must be done inch-by-inch, invention-by-invention, just as the devolution and ruining did. Otherwise, its futile, annoying, and falls upon deaf ears. If we want to see the prevalence of diabetes, hypertension, obesity, and other preventable diseases decrease, and be more resilient for the next virus that shocks society, then we must change our approach and verbiage. 

The Ass Backwards Viewpoint on Exercise

Only in fitness will a complete amateur think that they can replicate the results of a professional. It’s not often you find someone trying to cook a dinner with the disillusion that they are Gordon Ramsey. Similarly, you won’t find many individuals attempting heart surgery on themselves. 

And yet, for some twisted reason, most people think that they can simply walk into their local fitness facility, sign up for a membership, and intuitively know how to get themselves in the shape that they’d like to be in. They think that the little membership card that hangs from their keychain next to the Bacardi bottle opener is their ticket to finally figuring “this fitness shit out”. 

With little knowledge of anatomy or physiology, pain-free programming, or proper exercise technique most people are left throwing spaghetti at the wall and hoping something, anything, sticks. There is a little bit of “this” and a whole lot of “that” as the hopeful fitness enthusiast embarks upon their journey. For most, this journey is frustrating and lacking in results. Far too many in this group see this frustration as proof that “exercise just isn’t for them”. 

Check-ins to their facility slow until they eventually come to a halt. Some will make the drive to formally quit and end their membership with the gym. A large population will keep it though, not because of a fear of the membership separation fee, but for the optimism that “next time” they try, it will work. As such, a standard gym anywhere in America could have as much as 30% of their membership lie dormant.   

By in large, the gym business thrives on this group. Membership sales are the backbone of a healthy fitness enterprise, often offsetting the cost of doing business. When ran optimally, membership at a fitness facility should cover most operating costs (power, water, cable and internet, and the salaries of non-fitness staff). Typically, any gap in revenue to spending is often covered with various fees and penalties as well as point-of-sale items such as pre-workout drinks and protein shakes that carry high margins. 

For the fitness consumer who isn’t “all-in” on the experience a gym membership is a stockpile of potential energy ready to go kinetic once they decide that it’s time to get right. But they never quite find that time. They aren’t motivated to go and do something that is harder than drinking margaritas and arguing with their friends about which Kardashian is the most normal. For the typical American, the gym is a place to go when they hate their body, when they feel guilty about their habits or when they decide its “revenge-body” season.

And since those moments are infrequent, their membership lies dormant and the brand profits while the individual worsens with time. They lose aerobic capacity, muscle and bone density, range of motion within their joints, their sleep cycle is out of whack, their sex drive is flatter than a field in Kansas, and their self-efficacy circles the toilet of anxiety and depression. 

And as such, the fitness industry profits from the broken attitude towards exercise and fitness because the membership base is trackable and easy to understand and predict.

When looking at a gym population, you can break it into 3 distinct groups:

The typical gym goer (2-3 days per week) – understands that exercise makes them feel better, look better, and perform better in a variety of avenues in their life. They need the facility to keep them motivated as they use different pieces of equipment for resistance and cardiovascular purposes. They aren’t one to go to the local facility down the road owned by the well-known coach unless someone they trust goes there.

This person might have hired a trainer to help them, they might take group fitness classes, or they might know just enough to avoid starting a nuclear apocalypse. They train because it’s a good habit, and that’s enough for them. They often snag a Bang or Muscle Milk from the fridge and absolutely love the massage chairs in the foyer. 

This is a break-even member in the eyes of most big box brands. They use enough of the facility frequently enough that their spending matches what they redeem. Some months they invest in more food and beverage, purchase a training package with the new trainer, or get the massage. Others they are in and out like customers of a Motel 6. 

At smaller facilities, these individuals tend to be no frills. They show up. Do the work. Go home. They’ll engage on their terms, but don’t want to be expected to do more than their membership pays for. Sometimes they convert into more hardcore trainees because of the environment, and other times their passion fizzles out as life changes. 

The hardcore gym goer (4-6 per week) – has a home for the obsession, their passion, and their avenue for develop their excellence. They show up with a gym bag packed with belts, wraps, and powders meant to get them from the starting line to the finish line of a challenging training session. Or they show up daily to take their favorite classes, drink the juices, and use the locker room amenities before/after work. 

The gym is a necessary part of their lives. It is a non-negotiable. They know that exercise, stretching, healthy eating, and social interaction is a necessary element to a fulfilled and successful life. 

They have high expectations of their facility, especially if it is a “big box” location. They want warm towels, clean facilities, and the operation to run smoothly. At these bigger brands, these members are break-even at best and “losses” most typically. Their usage of the facility exceeds the price point that they pay, especially if they don’t engage in services like personal training, spa services, or food and beverage. 

At smaller, privatized locations, this population tends to be more community-driven and engaged with the brand. They’ll buy a damn barbell for the owner if money is tight. They’ll donate to the food drives and become unhired coaches to new members during group training. In this setting, they are the backbone of a business and offer more than they’re membership dues could ever cost. 

The Infrequent to Non-Existent Member (0-1 Days per week) – This group of people sees the gym as place where they need to get something out of their system. They go when they “can fit it in” even though they never moved from the couch during their last Squid Game binge. They aren’t motivated to train because they haven’t been scared into action by a bad diagnosis, pushed by a recent experience, or simply don’t enjoy physical stress on the body. 

For everyone, it’s just a box full of weird looking shit that could have been used to torture people during Medieval times. They use it when they “need” it to fix their self esteem and that’s about it. They do things they are comfortable with and leave it at that. A little lifting, a little cardio, and maybe a hamstring stretch or two…

And since most individuals are drawn to the shiny lights, the recognizable brands, the treadmills facing big screen TVs, and the idea that results are instantaneous – the big brands profit off the insecurities and inabilities of the gross population.

It should be stated that most individuals who NEED to exercise, and go to do it, are doing it all wrong. In fact, when looking at the population who has goals of achieving weight loss – the industry is designed to burn them out and keep them coming back in a few months/years…

Ask any seasoned trainer and you’ll hear that the secret to weight loss with inactive (and overweight) individuals is consistency and not intensity. It’s not about how hard John Doe exercises on Monday when he has 55 pounds to lose and a resting heart rate of 79. 

It’s about John Doe getting some workouts in on Monday, and Tuesday, and Wednesday, and beyond. 

Factor the idea of starvation and “Cheat Meals” into the equation and you quickly see why most people are on a roller coaster of 5 pounds. They’ll lose 5 and gain some momentum only to gain it back after a bad week. 

The exercise culture that has been cultivated in America screams that individual should “go hard or go home” or that “sweat is just fat crying”. Gyms desperate for members and attention run weight loss challenges that last 30,60, or 90 days. There is no talk of sustainable lifestyle intervention or embodying the turtle instead of the hare. 

Everything is designed to create short-term motivation and buying windows. Brands care more about your investment dollars instead of your unrealized gains (if we are to relate to financial investments). They want you to commit, provide cash up front, and move on. 

Whereas the little guy, the small business in the industrial parkway that’s a little out of the way sees the client differently. They don’t make money if they don’t deliver results. Results deliver satisfaction, pride, and the “permission to sell”. That client who lost fifteen pounds and got out of shoulder pain with better training protocols would tell everyone they every meet about Doug’s dungeon in Detroit if it got them results. They’ll say things like, “don’t let the front door fool you – it’s the best in the region”. 

But right there is the paradox, the brands that commit to changing the client aren’t always the best marketers. They just show up with a farmer’s mentality and deliver hours of work and craftsmanship until the day is done. People get results. But do the people give referrals? 

The Future of Fitness

In a better world, the bigger box brands are forced to adapt their business models because more and more individuals are committed to going to these “out-of-the-way” locations that are home to dedicated fitness professionals.*

*This isn’t to say that trainers who work for big boxes are bad trainers. I myself have spent 3 years working for Sports Club/LA, 5 for EQUINOX, and currently am employed by Anatomy in Miami, Florida. I love the big box feel and the energy it brings, but by in large, the hiring practices at these places is blanket coverage. You hope to find a diamond knowing you’ll get some coal and something in between.

The business model of gyms entices check-ins – possibly seeing that membership rates GO DOWN with more check-ins per month. The business model adapts to promote results with “cash back” after certain milestones are hit just as a credit card provides cash back on gas pumps or grocery stores. Maybe the industry adapts and puts a higher standard of qualification upon trainers – demanding that they are in this for the client, and not to sell CBD supplements in their underwear. 

But America just needs more gyms to become healthier, right?

Or more people with gym memberships, right?

Or more options for fitness with a bigger, more diverse market space, right?

To reverse the real problem in America, the epidemic of unhealthy people, the fitness industry needs to stop watching top line and bottom-line revenue and instead do a mirror-check. A mirror check is what happens when a slightly intoxicated individual stares at themselves in the mirror and has a sort of “come-to-God” moment that changes their path going forward. The intoxication inhibits their prefrontal cortex from overriding their deeper thoughts, and in that rare moment, they are able to have a conversation with their “REAL SELF”.

Fitness brands must do the same. Trainers must do the same. There must be a commitment to seeing results occur, and trusting the process of referrals, word of mouth marketing, and proof-in-the-pudding campaigns. 

The day and age of selling people on the fitness dream must end if this change is to take place. It’s not about us and it never has been.

The Promise of Results Without Effort

America might be the only place in the world where you’ll find someone with a grocery cart full of Oreo cookies and fat burners. In fact, Americans spend $1.5 billion dollars per year on supplements (13).

Protein powders, muscle-building supplements, weight-loss supplements, vitamins, and so much else fills the shelves of various markets around the country and world. They promise everything in a capsule. 

“Gain 5 pounds of muscle and the resume of Chris Hemsworth in one bottle”

“Burn 20 pounds of fat and discover the paradox between black holes and light in one month”

And the general population eats it up. They love it. They believe it. Even when they know it’s bullshit. 

It’s amazing how quickly a person’s trust is altered when their self-efficacy is on the line. If a person could lose 5 pounds in one month and look better half-naked, then why wouldn’t they at least try? 

It’s the same attitude that leads to gambling addictions if we are being honest…

Gamblers fall in love with the idea of taking their hard-earned money and multiplying in a moment. One hand at a blackjack table could 1.5x your money if you get an ace and a king on the draw. Rinse and repeat and suddenly you can become hooked on the idea that you can create immense wealth (winnings) in an instant. Lady luck is on your side.

For supplement sales, the marketing is meant to make you feel like “THIS” is the time you win. This is the pill or powder that’s been missing. If you would have found (insert supplement here) sooner, then you’d already be the fittest, sexiest model in the world who dominates the television and print ads. All you must do is pay 40, 50, 80, 150 dollars on this pill/powder/program. 

Thus, when looking at the western obsession for pills and powders we find that people are otherwise rational (don’t run the red-light during rush hour) will completely eschew logic in favor of emotional buying behaviors when the possibility of their dream body is at stake. The marketers of supplements deserve awards for their ability to hijack people’s brains and sell them castles in the sky. 

The industry is designed to make money and deliver JUST enough results to earn your purchases next month.

The Future of The Supplement Industry in America

Going forward there will be further regulation on supplements as the FDA cracks down on the ingredient profiles of brands. It’s easier than ever to get a hold of raw ingredients and create your own pre-workout powder. That sort of irregularity in product quality is a dangerous risk that will eventually lead to deaths and injuries. 

At some point, medical interventions such as peptides and even steroids will be legalized under certain constructs and individuals will use more proven, albeit risky, methods to achieve their physical goals. There will be blowback, but eventually, like any massive change in human consciousness, it will be accepted as a normality. Yet, like the next section will discuss – this will simply shift the profit from the supplement industry to the pharmaceutical one. 

supplement industry

Food products, such as protein powders, will remain on the market for many years without concern. The same goes for digestive enzymes, vitamins and minerals, and general health interventions. There are far too many individuals who take 5mg of melatonin and zinc at night to slow that train down. 

There will always be a market for powders that taste like lemonade and make you want to fight King Kong in a bathroom stall. There will always be a market for pills that promise non-so-realistic results. Yet, in time, this market will shrink as the population shifts their money to the more “trusted” pharmaceutical industry. 

In essence, pharmaceuticals are the final graduation step in this system.

The American Health (Sick) Care Model

When looking at the healthcare system specifically, we find an overdependency on “care-after-the-fact” practices that functions to serve you only once you’ve become sick and broken. This is especially true in the North American nations, which comprised 49% of the global pharmaceutical market in 2020; long before the launch of the global COVID-19 vaccines (2). 

In just the last century, the health, wellness and fitness of the average American citizen has declined significantly. Not to be confused with life expectancy, which had gone up roughly ten full years since 1960 prior to recent data emerging from the year 2020. (14). In fact, life expectancy dropped 1.5 years during 2020 (14). 

What is certain, however, is that life quality, has gone down as more and more individuals rely on pills prescribed by their various doctors to keep their conditions in check instead of health and lifestyle modifications meant to (potentially) cure their ailments. For this reason, life expectancy in the U.S. has grown more slowly for both men and women than other parts of the world (14). 

This isn’t a representation of poverty, a lack of healthcare options, or representative of the brainpower and genius that drives medical science. Instead, it represents a capitalistic model designed to keep individuals in a spending cycle until their body eventually gives out. A sad, painful, and nauseating truth. 

The American health care model is built on price markups. Pharmaceutical companies and medical device companies charge significant money for their products to healthcare providers and insurance companies. Those costs are then passed down to the customer in the form of premiums, especially for healthy individuals who wish to have lower deductibles in the event of tragic events. In 2020, the average individual paid $7,500 dollars per year for health insurance, whereas the typical family paid $21,500 (15). 

And this doesn’t even count the various charges and fees that are involved until one hits their deductible or goes out of network…

For example, a hospitals charges thousands for an emergency room visit when someone can’t breathe well while fighting off the COVID-19 virus. Those thousands are sent to the insurance company who covers what their algorithm approves. Typically, they cover the cost of radiology and toxicology-based exams and leave the consumer with a bill that has unpaid expenses for the visit itself, the cost of the bed, and other accoutrements. And this is before factoring in prescriptions and other elements of recovery. 

Therefore, an individual who has gotten sick unexpectedly could still be in debt for two or three thousand dollars after their insurance has paid a share. They were serviced, sent home, and told to rest and be smart until they feel better.

No mention of changing eating habits, increasing physical activity, improving sleep quality and quantity, or avoiding the toxicity of social media arguments.

American Healthcare: Just Pills and Bills

The medical device companies, the hospital, and the pharmaceutical companies will make their profits, upwards of $600 billion dollars in 2021. The insurance companies will have negotiated behind closed doors for better rates than an individual would ever pay, and so their losses are minimal in this scenario as well. Thus, the consumer is forced to foot a major chunk of their emergency bill while also funding their insurance companies Holiday parties. 

And yet, no where in this business model is the assurance that the customer, oops, the patient, is actually better. There is no incentive for the aforementioned business units to truly fix you. 

pharm market

The system is designed to catch you when you fall, which on hand is a Godsend and proof of modern evolution and the ability to defeat illness and disease. Many people, including this writer’s father, is kept alive and well by the miracles of modern medicine in the fight against cancer.

Yet, it’s also a profitable business model with little to no impetus to change as we go forward in time. Preventive care doesn’t print cash at the same rate. 

This model is not designed to help the consumer. It’s designed to protect the profiting interests of those in charge. It’s unfortunate, but it’s the truth. It’s a system designed to catch you once you have diabetes, high blood pressure, or can’t fall asleep…

And it’s a system designed to give you a pill, or six, to solve your problems instead of a health, wellness, nutrition, and training intervention. 

Why would I want you to go pay a gym membership and a trainer when I could just prescribe you a pill to keep your blood sugars down? 

Roughly 88% of diagnosed diabetics are on medication in America. (17)

Why would I entice a young girl to exercise and be physically active during her earliest onset of her menstrual cycle when I can just get on her birth control? 

Roughly 1 in 5 teenage girls (13-18) are on birth control in America (16).

Why would I encourage someone to eat healthier and exercise to improve their mood, anxiety, and potentially depression when there are plenty of drugs that do just that?

Roughly 1 in 6 Americans are on a psychotic drug (18).

This isn’t a complete bash of the healthcare system. In modernized countries around the world miracles take place. Babies are born premature, mother’s survive traumatic bleeding, and accidental deaths are prevented with life-saving treatments, modalities, and interventions. Cancer is caught faster, treated better, and years are added to people’s lives.

By in large, the healthcare industry means well.

But, like all things involving humans, greed and profit still reign. For every great doctor doing the right thing for their patients, there are two or three who are in the pockets of a drug representative. For every great medical device company looking to trim their own profits for the betterment of society, there is some douche bag gouging the market on insulin prices (Martin Shkreli). 

As we go forward, our healthcare industry and the insurance providers must begin rewarding preventative behaviors. They must invest in those who invest in themselves. The answers can not lie behind bad diagnoses. Instead, the answers and solutions must come before the prognosis. 

The Future for Preventative Health Care Modeling

The changes that would improve our healthcare system include:

  1. Professional licensing of trainers and coaches to allow for insurance billing
    1. Comes with the downside of regulation and oversight
  2. Insurance companies building specialized premiums that incentivize healthy living practices
    1. Auto insurance has already done this with safe-driving devices
  3. Demanding updated kinesiology, exercise physiology, and dietetics be added to the curriculum and certification of practicing physicians.
    1. Too many doctors think lifting is bad with age
  4. Greater regulation of the supplement industry with the intent to bridge the gap between naturopathic and pharmaceutical interventions
    1. FDA approved drugs with minimal chemical alteration

Unfortunately, we can’t wave a magic wand and change the healthcare industry for the better. 

But we can change ourselves…

All of these things require the personal trainers and professional coaches to rally with one another. We can’t bicker on social media about squat stances or sell our bodies in exchange for free clothing anymore. We have to represent ourselves as medical professionals capable of making medical changes. 

Our curriculums need to be more challenging. Our work ethics must be scrutinized. Our licensing and certification must be kept up-to-date with proof of research, education, and a commitment to growth.

Then, and only then, can we make the case that we can be considered a medical expense. 

Our Mission Statement to End the Health Paradox

As fitness professionals we are limited. Our scope of practice keeps us in the gym, on the computer, and occasionally in the kitchen guiding our clients to better health. Medical professionals are limited to the care they can provide too.

However, our ability to generate progress and move the human species forward requires us to look honestly at the hand we’ve been dealt and adjust accordingly. We must see the playing field for what it is and draw up better protocols to take on the challenges that lie ahead.

We must acknowledge that the food industry is designed for taste, convenience, and indulgence. We must know that it was a step-by-step degradation of the American mindset and diet that led us here to this moment. If we are to reverse course, we must take the same brick-by-brick approach to our coaching and our recommendations. The ball can be pushed back in the opposite direction.

We must look at our fitness and supplement industries and realize that they prey on insecurities and hope. They profit on the belief that someone can, but the reality that they won’t. We must rise up and demand more of our fitness brands by routinely delivering results and rewarding our people for them. We must make it “cool” to achieve results. We must make it “normal” to do it without pills and powders. We must reject the hypothesis that people are self-sufficient and commit ourselves to a role of paid servitude. 

We must lastly look at our healthcare industry and realize that it is broken at a level that can’t be fixed by internet tirades or blog posts. There are billions, maybe trillions, of dollars made yearly on the industry that manufactures devices, pills, and treatment plans. Doctors aren’t necessarily in on it, but they aren’t necessarily ready to fight back against the hand that feeds them. The industry is rife and ready for disruption, but the disruptor must come prepared to fight legal and financial battles against juggernauts hell bent on not changing the status quo.

The average Westerner is in trouble. They are helpless in an uphill battle against the epidemic of obesity and inactivity. They need a hero. Is that you?

The odds have been set and the chips are on the table. 

I bet we emerge from this pandemic, and this generation, with a better mindset and approach to health, fitness, and wellness in Western culture. The roads to a better world are already built. But we need to stop bickering amongst ourselves, selling our bodies and souls, and reconnect with our real purpose.

We must teach people that light weight can feel heavy in training so that the heavy weight that is life feels lighter. We must educate, we must motivate, and we must dominate the forces that seek profit over all. 

It’s going to be hard, but it’s going to be legendary. 

About The Author

kevin mullins

Kevin Mullins is veteran personal trainer and fitness educator located just outside of Washington, DC. Kevin is the current the Director of Product Development for The St. James after spending nearly a decade as a trainer, group fitness instructor and educator at Equinox. Kevin is also a Lead Instructor for the Pain-Free Performance Certification (PPSC) and best selling author of the book “Day by Day: The Personal Trainer’s Blueprint” that you can learn more about on his website:


  9. America’s History of Food – HISTORY CHANNEL

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