How to Be Skeptical of Health and Fitness Marketing
I was a teenager when I started getting into the health and fitness space. At that time, in the late 90s/early 2000s, most of the information came from fitness and bodybuilding magazines, which, like a wired telephone, probably sounds like an ancient relic to Gen Z’ers and younger. (Our video game controllers were wired too. LOL.) Unless you knew which textbooks to find and maybe which professors to ask (if you could—email was barely a thing then), there was no real way to fact check or verify any of the claims being made.
Often, these magazines would present a multi-page “report” on a specific subject, maybe an ailment, trouble with losing weight, a supplement, and at the end, they would offer a product to resolve the problem—an example of clever content selling/marketing. (“Sales” and “selling” appeal to an individual; “marketing” appeals to a wide audience.)
When I have discussions with my classes about marketing and media literacy, I explain that everyone is trying to sell us an idea, and then, later, they will try to sell us a product. The good ones will try to gain our trust first, build a relationship, and then present us with a solution to the problem they’ve established. Often, the marketers will make themselves relatable in some way, and the solution is actually something requiring low effort and will be something we’d want to do anyway. Thus, the results are easy, desirable, and achievable.
We can apply this scheme to any marketing campaign, any ad, any commercial, and so it is with health and fitness marketing too. In the fitness magazines of yesteryear, those multi-page “reports” were just long, cleverly designed ads that followed this very framework.
What I’d like to do is go through a couple of examples I’ve seen and break them down, first analyzing why they’re effective but also asking the right questions that will deconstruct them because, when you’re new to this area, there’s so much info coming your way that it’s overwhelming, and you don’t know what or who’s right.
If you analyze a few of these sorts of ads or content marketing pieces, you’ll notice that most follow a similar script:
Criterion 1: The testimonial of an individual, with a before and after story.
Criterion 2: Relatability.
Criterion 3: Identifies a problem and offers a simple solution.
Hopefully, as you’ll see, this framework is effective because we have a story with a human face on it, one that we can relate to, and the solution is simple, easy, and it looks like it will solve the very same problem that’s confounded us for so long.
Example 1: GLP-1 Agonists (like liraglutide, semaglutide, Ozempic, Wegovy, Tirzepatide)
First, “In healthy individuals, the incretin hormone glucagon-like peptide 1 (GLP1) potentiates [increases] insulin release and suppresses glucagon secretion in response to the ingestion of nutrients. GLP1 also delays gastric emptying and increases satiety.”1
Due to the short half-life of the natural GLP-1 in our systems, GLP-1 receptor agonists were then developed to help manage blood sugar in diabetes. Moreover, GLP-1 and its receptor agonists also effectively dial down hunger and appetite. Generally, when someone takes a GLP-1 agonist, they don’t get as hungry, lose interest in food, reduce their food intake, and thereby create an energy deficit and, voilà, lose body weight.
I’ll sometimes have YouTube playing podcasts on the TV when I’m cooking or cleaning, and invariably, a health or fitness ad will come up (because my algorithm is trained on fitness content).
One recent GLP-1 agonist ad has a young, thin, attractive woman purportedly giving a testimonial about the efficacy and effectiveness of one such GLP-1 agonist.
It starts with something like this:
“I worked out every day, ate healthy, and couldn’t lose weight, and nothing worked until I took this product, and now I’ve lost 23 lbs.”
Criterion 1: Though no “before” photo is offered, the testimonial begins after the success, and she appears healthy and happy. We’re inclined to take her at her word.
Criterion 2: Relatability. We’ve all struggled with body issues in some way, so she’s relatable.
Criterion 3: Identifies a problem and offers a solution: Apparently, she was doing everything right, and if she’s young, energetic, and doing everything right and had no success, what chance do we have? (Again, this is relatable.) Solution: GLP-1 receptor agonist, simple and easy.
Asking the right questions here:
Qs: She says she worked out every day? For how long?
First, “working out” is not defined. Second, the truth is that no one works out every day. I’ve had phases of being as hard core as a person can get, and daily workouts can only go on for so long, especially if you’re really getting after it, and even if you’re not going hard, it still doesn’t matter how intelligently designed a program is; it’s just not sustainable for daily implementation indefinitely (maybe for a training blow of a few weeks).
So, no one can work out every day for more than a short period, unless they are very short and very sub-maximal (that is, very low effort) workouts, which, then, does that make them workouts? Probably not. Also, then yes, would be ineffective for weight management. Daily training can certainly take place, but training is not the same as working out. For example, athletes will often have skills training or active recovery sessions.
Also, notice that there are no specifics as to what kinds of workouts these were. Were they all cardio? If so, all sprints, moderate-intensity endurance, or low-intensity like walking? Were there workouts with weights? Cross-training? Each of these modalities will have different effects on body composition, fatigue generation, and will have different energy requirements as well as require different timelines for recovery.
Likewise, no specifics are offered regarding what “eating healthy” means. We all have to assume what this entails, and each of us probably has a different interpretation.
What many people have a hard time grappling with—and I was among such people for most of my life—is that eating well and working out and doing those things consistently is not the same as intentional energy manipulation for the goal of dropping body fat.
We can all eat healthily and workout hard every day and maintain a heavy body weight. Furthermore, it’s not exactly easy, but we can even gain weight living like this, which is what bodybuilders do in an intentional “surplus”, a phase where the goal is to increase food and energy intake so that we optimize the muscle-gaining potential of our workouts.
See how all of this begins to unravel with a couple of follow-up questions?
The original statement of this woman just shows that she doesn’t know how to manipulate her energy, that she is unlearned in the ways of controlling calories and food portions—because that’s all it takes to lose weight. You do not even need to work out to lose weight (though you should because it’ll keep you healthier by keeping more of your fat-free mass—your muscle). To lose weight, you just need to decrease your habitual energy intake consistently and for long enough.
None of this is a dig at her or GLP-1 agonists. Some people need the extra help. If someone is standing on the precipice of a major adverse cardiovascular event, then a GLP-1 agonist might be a part of the first line of defense. If you just want to drop a few pounds for aesthetics or general health, it’s better to learn what you’re doing that’s preventing the achievement of your goal. Otherwise, if you stop taking the agonist, you’re going to end right back where you started.
Example 2: MD: Before and After: “Soft and Pudgy” Vegetarian Vs. Jacked Low-Carber
Ted Naiman is a medical doctor. He grew up as a Seventh Day Adventist, who are notably vegan or some iteration of vegetarian.
Dr. Naiman designed a specific diet or dietary pattern centered on high protein, more meat, and consequently lower carbohydrate. His website has before and after photos, before this diet and after. In an interview in his own words, before adopting this diet, he said he was “soft and pudgy”. The before photo is a time when he was on a vegetarian diet (implying that it was low protein).
His after photo, taken after the adoption of higher protein and inclusion of meat, looks like he could be a natural bodybuilder dieting down for the stage. His physique is achievable given the right protocols: proper training, nutrition, recovery, and, again, done so consistently.
Criterion 1: Another personal testimonial. Before photo: “soft and pudgy”, not to mention, despite some obvious sunburn, a fairly pale complexion—making him appear less healthy. After photo: no longer soft and pudgy, bronze skin (appearing healthier), well defined abdominals, along with some vascularity.
Criterion 2: Relatability. Again, for men particularly in this case, most of us have felt soft and pudgy and yearn to have a more muscular and lean physique.
Criterion 3: Identifies a problem and offers a solution: Problem: how to gain muscle and lose fat. Solution: eat more protein (and it’s implied not to eat a vegetarian diet).
Asking the right questions here:
Dr. Naiman’s training is not discussed, so it’s implied that his training was the same in each of the photos. The fact is, the guy in the before photo doesn’t look like he’s ever lifted weights, and the guy in the after photo looks like he’s been at it consistently for several years.
Question 1: So, all training variables were the same? Only your diet changed?
Obviously, that’s not the case. The composition of the diet is huge when trying to change your body, but the adequate stimulus through training needs to be there first and foremost.
Question 2: I want to gain muscle, so I need to eat more meat?
This is often the implication that many low-carbers, as well as ketogenic and carnivore diet proponents make, and there are a couple of problems with this assertion.
One is that without the demands of physical activity, you likely don’t need additional dietary protein apart from some hitting the basement targets. (In the sports literature, more conservative guidelines put these basement targets are on the order of 1.2 grams of protein per kilogram (kg) of body weight (bw); more liberal ones put them at 1.6 grams/kgbw.)
Another problem is that meat is expensive, and it’s not practical for many people to focus on getting their protein from only meat. When I was a teenager and a college student, I couldn’t afford protein powders, chicken breasts, and certainly not beef, so I learned to fill some of my protein requirements with plants that have protein, like beans, as well as some dairy products, like milk, cottage cheese, and yogurt. So, telling someone that they need to or should eat meat, which can be cost-prohibitive, can be disheartening. There were many times when I was presented with such a story, and I felt deflated because I didn’t have the means to purchase the food that I “needed” to build muscle. And this is an issue that I often discuss with young people.
Another problem with this assertion is that it implies that a vegetarian diet is not optimal for health, which, even on the surface and without any dissection seems like a leap in logic. (Any diet can be suboptimal for health.) If Dr. Naiman wasn’t getting adequate protein on a vegetarian diet, that’s simply an issue of menu planning.
Also, the question about whether vegetarians can gain muscle has been thoroughly researched and settled. (Spoiler—they can!2) You’ll hear people say that vegetable proteins are “inferior” compared to meat proteins, though they’ll never define or explain what this means, and therefore, vegetarian diets as a whole are inferior to omnivorous or carnivorous diets for gaining muscle. The “inferiority” usually refers to a lower score on amino acid indexes. The fact is that if you get adequate protein, you have adequate protein for muscle building, no matter what the package it comes in.
Additionally, often, when people hear they need to eat more protein, they first think more meat, so when they see any meat, they think it’s all perfectly fine, including something like a fast-food hamburger or a cheeseburger, which is different from lean ground beef you prepare yourself. If you want something like a restaurant burger, fine, but don’t eat more of it for the protein. You’ll also be getting a ton of calories, a lot of fat, and a lot saturated fat—the molecule most implicated in the increase of LDL cholesterol, which is a causative factor in the development of cardiovascular diseases—and not a lot of nutrients.
So, Dr. Naiman’s body composition may have improved from before to after photos, but if he’s heavily focused on meat, he’s likely to increase his risks of cardiovascular disease by way of increasing saturated fat and consequently LDL cholesterol. Also, if you look at the recommended foods on his website, it’s minimizing ultra-processed foods and emphasizing whole and unprocessed foods. A whole food, plant-predominant diet is the one that is the most health-promoting. The Mediterranean diet, or a similar dietary pattern, for example, is one that includes meat sparingly, and focuses on low-fat dairy, is the one that has been shown to increase health and longevity. It also minimizes ultra-processed foods.
Again, no dig against Dr. Naiman. He advocates a lot of sound advice. Still, like the young woman in the first example, Dr. Naiman’s before photo shows that he was not training with weights, not prioritizing protein, and likely not eating a nutrient-rich diet. These are the changes that he made from the before to the after photo.
It’s frustrating to come across some of the different and often conflicting information regarding health and fitness, but like any other area, someone’s always trying to sell us an idea before they try to sell us a product.
All you have to do is ask a couple of questions that follow up on some the specific details of the story you’re given, and you’ll see that the story doesn’t quite hold up.
A keen reader will ask, okay, Mr. Flexy (a moniker I wouldn’t mind), so what idea(s) are you selling?
I’m trying to sell you on the idea that you have the ability to control and manipulate your health, your body weight, and your physical abilities. I’m trying to sell you on the idea that it’s simpler than you think. It’s the boring basics, and you just have to stick to them for long enough for your efforts to start revealing themselves.
Andersen A, Lund A, Knop FK, Vilsbøll T. Glucagon-like peptide 1 in health and disease. Nat Rev Endocrinol. 2018 Jul;14(7): 390-403. doi: 10.1038/s41574-018-0016-2. PMID: 29728598.
Nichele S, Phillips SM, Boaventura BCB. Plant-based food patterns to stimulate muscle protein synthesis and support muscle mass in humans: a narrative review. Appl Physiol Nutr Metab. 2022 Jul 1;47(7):700-710. doi: 10.1139/apnm-2021-0806. Epub 2022 May 4. PMID: 35508011.