I recently examined a 52-year-old patient who came to me because she was bone tired. She described brain fog and sleeplessness and was convinced something was seriously wrong with her.
And for good reason. Over the past 18 months, she’d seen three different functional medicine providers, paid for two rounds of hormone testing through a direct-to-consumer lab, and dropped $2,000 on a workup that included food sensitivity panels, mycotoxin testing, and what her latest provider called a "comprehensive cortisol curve." She’d been told she had adrenal fatigue and leaky gut. She arrived at my office with a binder of recommendations, a dozen supplements, an elimination diet, and a continuous glucose monitor she’d been wearing for four months. She wanted to know which of these would actually help.
The problem was clear within minutes. She wasn't suffering from adrenal fatigue or leaky gut; neither is a real medical diagnosis. She was in perimenopause, estrogen-depleted, and simmering with anxiety. Her condition had real medical answers, including standard menopause hormone therapy, which her gynecologist didn't have time to discuss — so she turned to Big Wellness.
I see versions of her every week. The 38-year-old convinced she has histamine intolerance. The 27-year-old who arrived in tears about a "low" progesterone level from a DTC lab on the wrong day of her cycle. The 24-year-old whose hair was falling out because she’d been eating 1200 calories a day on an elimination diet she'd built to "heal her gut." The 45-year-old taking a GLP-1 prescribed by an online clinic that has never met her in person.
These women come in with spreadsheets. They’ve read more about their own bodies than most of my colleagues did in medical school. They know what a cortisol curve is. They're buying the supplement stack that's supposed to regulate the nervous system. They've heard of bioidentical pellets, continuous glucose monitors, and the lion diet. Let me be clear: These are not choices born out of ignorance: They’re rational responses from smart and frightened women to a system that's failing them. More and more women are turning to companies, influencers, and virtual clinics that promise to hear them out and provide them with a neat, simple solution. It's a booming industry I like to call Big Wellness.
To understand why so many capable women have found their way to Big Wellness, you have to understand what they aren't getting from traditional medicine. The average primary care appointment is 15 minutes. In that time, you’ll be weighed, asked about smoking, possibly screened for depression with a four-question form, and sent on your way. Your actual concerns — the perimenopause symptoms that started two years ago and got worse, the gut symptoms no one can explain, the sleep that broke at 47 and never came back, the chronic fatigue that began somewhere in your 30s, the sense that your body stopped working the way it used to — get attributed to anxiety, weight, lack of sleep, or "just stress."
The doctors in those rooms aren't your enemy. They want to help, and have trained for years for these exact situations. But they’re working within a system built to move you through it in 15 minutes, not to listen to you for 45. And women — whose pain has been historically dismissed and whose health has been historically under-researched — have correctly perceived this for a long time.
Big Wellness understands this and has built an entire business model on it. Its creators offer what the system structurally can't: time, attention, a coherent story about what is happening inside a woman's body, and the sense that someone is finally paying attention.
A great deal of what’s being sold to women as health is the same thing my generation called dieting, just in prettier packaging.
I know this from the other side of the exam table. In college, my own labs came back normal while my hair fell out, my heart raced, and my body quietly fell apart. Now, in my 50s, I’m experiencing it again — as a woman whose body is screaming and whose doctor cannot hear it.
But Big Wellness is wearing a costume. It’s disguised as a solution for women’s distress, but when its fix fails, it can turn dangerous. In my office, I see disordered eating wearing a wellness costume every week. Cycle syncing that has quietly become a system of food rules. Gut-healing protocols that have removed entire food groups for a year. The mantra “listening to your body" that’s become a way of justifying eating less and less, framed as wisdom rather than restriction. In 25 years of clinical practice, I can tell you this: A great deal of what’s being sold to women as health is the same thing my generation called dieting, just in prettier packaging.
I see anxiety dressed up as nervous-system dysregulation that can be supplemented away. I see women in their 50s spending thousands on hormone pellets when an FDA-approved patch would cost less and work better, because the unhurried internet doctor offered a conversation a 15-minute primary care visit can't.
A long, thorough talk with a medical professional sounds great in theory. But this industry doesn't want women healthy; it wants them hopeful, anxious, and ready to spend. That’s because the moment they actually start feeling OK, they stop being profitable.
Here's what I want you to know. You are not crazy. You are a smart woman with real symptoms in a system that wasn't designed to listen to you. The wellness influencer who finally seemed to — the one who gave you a name for what your body has been doing, who offered you a protocol and a community — she got your attention because no one else had it to give.
Some of what wellness culture offers will genuinely help you — but some of it is selling diagnoses that don't exist for symptoms that very much do. The skill isn't picking a side; you don't have to avoid and swear off less traditional medicine completely. You just can't abandon science either. It's learning what questions to ask, and where to take them.
There is a way through, and it starts with you. It starts with asking better questions, figuring out who to trust, and learning how to ask for the help you actually need.
If you are in your 50s and exhausted, if you are in your 40s and your sleep has broken, if you are in your 30s and your gut and your cycle are off and no one will tell you why, if you are in your 20s and tracking your cortisol with a wearable — please hear me: There is a way through, and it starts with you. It starts with asking better questions, figuring out who to trust, and learning how to ask for the help you actually need. It means moving the locus of control out of someone else's prescriptions and protocols and into yourself by becoming a thoughtful consumer of health news and information.
What does it actually look like to be in charge of your own health without becoming your own doctor? How do you tell self-knowledge from self-surveillance? How do you build a relationship with your body that isn't a project, a punishment, or a performance?
That is the question I try to answer in my new book Beyond the Prescription. It’s also the question I write about every week at Are You Okay?
You can't optimize your way out of a medical problem, but you also can't trust a system that doesn't have time to ask you what is wrong. The third path is the one we have to build.
Lucy McBride, MD, is a primary care physician and author of the popular Substack newsletter Are You Okay? Her first book, Beyond the Prescription: A Doctor's Guide to Taking Charge of Your Health, will be published in August 2026 with Simon & Schuster. Find her at www.lucymcbride.com.
