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Don’t Swallow Your Gum

Rarely does a “wellness” book come along that actually teaches us stuff about personal health we don’t already know, the last one being Tom Emerick’s An Illustrated Guide to Personal Health.   Typically, books that we review undo the misinformation perpetrated by wellness vendors, on the subject of prostate screening, crash-dieting etc.

Another such book that has “come along” (copyright © 2009, but I am just finding out about it now, as my internet connection has been slow lately) is Don’t Swallow Your Gum: Myths, Half-Truths, and Outright Lies about Your Body and Health. The authors are Drs. Aaron E. Carroll and Rachel C. Vreeman.  If the former name rings a bell, it’s because this particular polymath is also part of The Incidental Economist. If that name rings a bell, it’s because TIE has the same impression of wellness as we do, so we often refer TSW readers to them. The only difference being, as far as I can tell, is they have Day Jobs and possibly even Lives, and hence unlike us can’t spend all their time dissing these Goetzel-infused Einsteins.

In any event, these 164 pages will teach you a ton about everyday health and well-being. Like, if your kid swallows his gum, you don’t need to pump his stomach or even turn him upside down and shake him.  He’ll survive. Or whether acupuncture, Airborne, or zinc work. (Sometimes, no, and unlikely.)  Or whether walkers help your baby walk sooner. (Not even close. Incredibly, it’s the opposite.)

Several workplace wellness myths are debunked, like the eight-glasses-of-water thing, a staple of Provant’s program.

More serious topics are covered as well, like fluoridated water, drinking while nursing, and giving cough medicines to children. These are sprinkled in and provide a nice balance.

Quizzify, of course, is full of similar tidbits (to lighten up some much more serious health and healthcare education issues), though in a Q&A format. Indeed, although roughly 30 topics overlap, there is only one disagreement


Yep, you guessed it. Quizzify is totally chill on the chances of getting sick by dipping a chip in a dip that’s been double-dipped. Incredibly and probably uniquely in my lifetime, that puts me on the same side of an argument as George Costanza. Drs. Carroll and Vreeman, by contrast, are firmly in Timmy’s corner. (“Don’t you see? That’s like putting your whole mouth in the dip.”)

We all agree that it is rude and spreads germs. Beyond that, we observe (and we are in good company here) that:

  • If someone is sick enough to spread harmful germs (most germs are harmless), they probably aren’t at the party;
  • If they are at the party, they probably aren’t eating;
  • If they are eating, they probably aren’t double-dipping;
  • If they are double-dipping, the odds of getting those particular germs when you dip are pretty remote anyway;
  • And if they really are that sick, you got way more germs when you greeted the perp via a handshake or kiss.

Further, there is a logical fallacy.  You can’t assume you’ve seen the double-dipper. Someone could have double-dipped while you weren’t looking. Who stares at the refreshment table for the entire party? That’s ruder than double-dipping.

On the flip side, if you go to a party, you want to have fun. If you spend your time fretting over a 20-year-old Seinfeld episode, you might as well stay home. And loneliness — this is a major observation in Tom Emerick’s book — really is a major health risk.

Mind you, the folks at Quizzify aren’t exactly Pollyannas on the subject of party dip. We recommend steering clear of it towards the end of the evening. Not because of the double-dipping risk, but rather because who the hell knows what’s going on in guacamole that’s been sitting out all night in an overheated roomful of half-soused nightclub rabble? (Yes, another Seinfeld line.)

That, though, is the exception that proves the rule. For the large but fortunately diminishing pool of employees unlucky enough not to have access to Quizzify via their employer, this book is a worthy and entertaining substitute, for topics of everyday personal health.



NY Times Economists Diss Corporate Weight-Shaming…but It’s Even Worse than They Say

We never post on Sundays.  We are making an exception today on the theory that a lot of people in the Northeast are at home and would welcome the distraction. Here in Massachusetts it’s so cold that the Governor is urging people to stay indoors.  Heck, we even decided to cancel Ultimate Frisbee.

This is now the seventh time that the New York Times —or its The Incidental Economist bloggers (“TIE” as they call themselves) — has observed that conventional corporate wellness doesn’t work.  Links to the previous six instances follow this posting. Perhaps the seventh time will be the charm. Having covered every other angle except the actual health hazards of wellness, this TIE post specifically eviscerates “biggest loser” programs and their brethren.

HR executives may think they are “supporting” employees by holding weight-loss contests or paying them to lose weight.  Unfortunately, all they are doing is reducing self-esteem, encouraging crash-dieting before weigh-ins, drawing attention to people’s weight, and — in addition to distracting employees from their actual jobs — distracting them from the one thing that benefits people of all sizes: exercise.  It is much better to be “fit and fat” than fight a losing battle to keep weight off with various fad diets.

Further, the Body Mass Index, the 200-year-old metric wellness vendors still use to establish how much to pay or fine employees, turns out to be a very misleading measure of population health. (As “Brad F.’s” comment to a previous blog pointed out, BMIs may be of value if conducted as part of an actual physician-patient relationship. However, actual medicine is of no interest to wellness vendors, other than making people get useless annual checkups. Most physicians practicing actual medicine find wellness programs to be a misguided nuisance.)

Worse than The Incidental Economist says it is

The case against these programs is even stronger than TIE says. TIE supports its case by citing randomized control trials.  But if RCTs are the Gold Standard, the Platinum Standard is wellness vendors’ consistent and total self-immolation in attempting to show their own program impact– despite ample opportunity to manipulate data, select motivated participants, ignore dropouts, and run ridiculously short “weight loss challenges” that end before the weight is regained. We love to cite ShapeUp as an example of that, having exposed them in the Pittsburgh Post-Gazette.  (This was probably overkill on our part, but their CEO had thought a good way to get some attention might be to fallaciously attack our numbers even though his own figures were made up.)

Because great minds apparently aren’t the only ones that think alike, ShapeUp has plenty of company on the Biggest Loser List. Wellness Corporate Solutions has also been “profiled” on this site, largely for comic relief. Pfizer, where actively motivated employees lost a few ounces over a year, actually earned an award from Ron Goetezel for this stellar performance, as well as a spot on our Biggest Loser List.  Our favorite example is McKesson. They also won one of Ron Goetzel’s Koop awards even though their average employee showed an actual increase in — you guessed it — BMI (and cholesterol):

mckesson bmi increase

If award-winning companies can’t get employees to lose weight, who can?

And where would a Biggest Loser List be without Vitality, which pitches its weight-loss program to others but can’t even get its own employees to lose weight?  If wellness companies can’t get their own employees to lose weight, who can?

Where we differ with TIE is on weight control interventions for school-age kids.  They quote one definitive-sounding study, with 4600 kids in it. We don’t have a problem with the actual study. However, because the long-term health and social prognosis for obese children is negative, and because this problem is so pervasive, we ourselves would insist on a much higher level of proof and more experimentation with different program designs before throwing in the towel on these interventions.  (We may very well end up agreeing with TIE when all is said and done. We would just like more to be said and especially done.)

As for employers, our recommendation remains the same: do wellness for your employees, not to them. This means supporting employees who want to pursue health goals, but otherwise just leaving them alone to do their jobs. Don’t even make them play Quizzify if they don’t want to. (But they’ll want to — we guarantee it.)

The Incidental Economist/New York Times on Wellness: A Chronology

September 2014  TIE says wellness “usually” doesn’t work.

October 2014: TIE headlines: “Wellness Programs Don’t Seem to Work as Advertised”

December 2014  TIE says: “We’ve said it before, many times and in many ways, wellness doesn’t save money.”

February 2015  TIE headlines “Another Call to Eliminate Employee Weight Loss Programs”

October 2015   New York Times says: “Provide us with your...weight, or pay up.”

November 2015: TIE headlines “The Feds Are Wrong. Lots of Wellness Programs Violate the ADA.”


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