MAHA: Healthism and the mythology of 'clean eating'

A whole-food, plant-based cancer survivors perspective on it

I began my winding journey toward a whole-food, plant-based about twenty years — not as a trend, not as a brand, and not because some YouTube 'influencer' told me to. I made that choice in the aftermath of a stage 3, triple negative breast cancer diagnosis. When your oncologist at M.D. Anderson Cancer Center looks you in the eye and tells you that big change might needed if you're to survive, the noise around "superfoods" and supplement stacks fades pretty fast. What remains is something quieter and more honest: whole vegetables, whole grains, legumes, fruit. Food that looks like what it actually is.

So when I look at the Make America Healthy Again (MAHA) movement, I feel something complicated. Because some of what it says isn't wrong — yes, diet matters. Yes, ultra-processed junk food is a problem. But the way MAHA says it, combined with the what and who it leaves out, tells a bigger story.

Healthism Dressed Up as a Movement

Dr. Max Jordan Nguemeni, a primary care physician writing in his Substack 'Adverse Reaction', put a name to what I'd been feeling: 'healthism'. The term, coined by sociologist Robert Crawford, describes an ideology that places the full burden of health onto individual behavior — turning food choices into moral 'report cards', while ignoring the structural forces that actually shape how people live and eat.

I watched RFK Jr. post shirtless exercise videos while his department quietly signed off on policies expanding glyphosate use — a likely carcinogen — and while Congress cut SNAP and Medicaid funding. That's not a health movement. That's theater. Designed to distract. And sell.

As Dr. Nguemeni writes, MAHA is essentially a never-ending self-improvement project while the government continues to transfer wealth upward and erode the very infrastructure that keeps people alive.

The Perimeter of the Store vs. the Price of Produce

Here's what the MAHA influencers aren't talking about: food insecurity. Millions of Americans don't have reliable access to food, period. And a meaningful portion of those who do can't afford the produce aisle — let alone the specialty health foods being hawked by the podcast circuit. This is one big reason that I signed on with local Reno Food Systems, as a plant-based 'chef' to help teach the marginalized in our community about truly healthful cooking and eating. Using fresh, locally grown produce. I've stood back and watched as people who had a strong , ahem, 'aversion' to kale gobble it down and ask for more ... when the are given a simple way to prepare it that actually tastes amazing.

When I trained as a plant-based cook, one of the most liberating things I learned was how simple this can be. Shop the perimeter of the store first — that's where the whole foods live. Produce, bulk bins, the bean aisle. Yikes, even the canned and frozen aisle (think those wonderful bags of flash frozen vegetables ... yes, really). You don't need a $60 supplement or an air fryer with fourteen settings. You need an onion, some garlic, dried lentils, broth and a pot.

But that simplicity is precisely what MAHA has no interest in selling you, because simplicity doesn't move product.

The "Processed Food" Problem Is Being Weaponized

Let's clear something up, because I am genuinely tired of this one: not all processed food is the enemy.

The oatmeal in your pantry? Processed. The sourdough bread you baked this weekend? The flour was milled — that's processing. The canned tomatoes that go into your lentil stew? Processed. The Beyond or Impossible burgers? Yes, they're 'processed'. (They also don't contribute to animal cruelty via factory farming and climate change.) These are not the problem.

The problem is a steady diet of what food scientists have engineered to be 'hyper-palatable' — products designed in labs to hit every pleasure receptor in your brain and keep you reaching for more. Bright orange "cheese" dust. Beverages with more ingredients than a chemistry textbook. Snacks calibrated to make it impossible to eat just one. Want to know more about this? Read the 2013 book, Salt Sugar Fat: How the Food Giants Hooked Us by Michael Moss. He exposes how major food companies deliberately engineer processed foods with high levels of salt, sugar, and fat to make them addictive and maximize profits. That was an 'eye operner' for me.

That's ultra-processing. That's the issue. When we flatten all of it into the boogeyman of "processed food," we make it impossible to have a clear-eyed conversation — and we make people feel guilty for eating perfectly good food.

Micronutrient Mania and the Soy Myth

I see this constantly in online health spaces: people tying themselves in knots over individual nutrients, avoiding genuinely healthful foods because of half-understood science.

Soy is a perfect example. I can't count the number of people I've encountered who have banished tofu and edamame from their lives because they heard soy contains estrogen. What they weren't told is that phytoestrogens — protective plant compounds found in soy — are structurally and functionally different from mammalian estrogen. The research on soy and breast cancer, including for survivors like me, is actually reassuring. The American Cancer Society does not tell breast cancer survivors to avoid soy. And yet the fear persists, spread by influencers who are not oncologists.

Meanwhile, people are ignoring the actual dietary patterns associated with cancer prevention: abundant vegetables, whole grains, legumes, and — critically — limiting or eliminating red and processed meat. That evidence is robust and has been for decades.

What the Rest of the World Already Knows

If soy were the hormonal wrecking ball the wellness influencers claim it is, someone should probably tell Okinawa.

The traditional Okinawan diet — one of the most studied eating patterns on the planet, and a cornerstone of the Blue Zones research — is built substantially around soy. Tofu, miso, edamame. These aren't footnotes in the Okinawan diet; they're staples. And Okinawa, at least among older generations who ate that traditional diet, has had some of the longest healthspans ever recorded, along with remarkably low rates of hormonally-driven cancers including breast and prostate cancer.

Okinawa isn't alone. Look at the other Blue Zones — Sardinia, Ikaria in Greece, the Nicoya Peninsula in Costa Rica, the Seventh-day Adventist community in Loma Linda, California. What do these populations share? Diets built around whole plant foods, eaten largely as their grandparents ate them. Strong social connection. A baked in sense of community. Movement woven into daily life rather than performed in a gym.

What they don't share? Supplement stacks. 'Elimination' protocols. A rotating cast of forbidden foods based on last month's podcast. A cabinet full of products with QR codes linking to a discount code.

The Sardinians drink wine. The Ikarians eat sourdough bread and plenty of olive oil. They are not "clean eating." They are just eating — real food, in reasonable amounts, in community with other people — and they have been for generations. Sorta reminds me of Michael Pollan's seven-word dietary philosophy: "Eat food. Not too much. Mostly plants" from his 2008 book In Defense of Food: An eaters manifesto. This was another game-changer for me personally.

There is something almost embarrassing about the contrast: cultures with some of the longest, healthiest lives on earth, eating simply and without anxiety, while American wellness influencers sell $80 "adrenal support" tinctures to people who have been convinced that a serving of tofu might disrupt their hormones.

"The Dose Makes the Poison"

There's an old principle in toxicology: "the dose makes the poison." It applies just as well to nutrition panic.

A spoonful of maple syrup in your chia seed pudding is not poisoning you. A sprinkle of real cane sugar on your morning bowl of whole grain cereal is not the same as drinking a Big Gulp every day. When we treat any sugar — in any quantity — as categorically dangerous, we're not being rigorous. We're being anxious. And anxiety is not the same as health. Having a couple Gardein plant-based 'chicken' tenders on your plate for dinner aren't the ("gasp! It's processed food!!") problem.

I have watched people eat the most "clean" diet imaginable and still be completely miserable, socially isolated, and obsessed with food in a way that looks a lot like disordered eating with a wellness rebrand. That is not health. That is orthorexia nervosa wearing a halo.

What Actual Health Looks Like

Twenty-plus years out from a stage 3 cancer diagnosis, I'll tell you what health looks like from where I stand.

It looks like cooking. Actual cooking — not performing cooking for Instagram, but standing at a stove and making something real. A pot of soup with whatever vegetables need to be used. A grain bowl thrown together, with leftover rice, a can of baked beans or marinated lentils, and a salad, on a Tuesday night.

It looks like eating in a way that is sustainable over a lifetime, not a 30-day reset.

It looks like caring about more than what's on your plate, but also caring about whether your neighbor can afford to eat. It looks like understanding that food systems, environmental policy, labor markets, and healthcare access are not separate from health — they are health.

And it looks like being honest about the fact that a movement led by wealthy people, with thousands of followers, selling books and podcasts and supplement lines, telling you that your personal discipline is all that stands between you and vitality — is not a health movement.

Bottom line: It's a market.

If you'd like to read more about 'healthism':

Healthism and the medicalization of everyday life

R Crawford https://pubmed.ncbi.nlm.nih.gov/7419309/

Revisiting Robert Crawford’s ‘Healthism and the medicalization of everyday life’ by Herrick and Bell https://kclpure.kcl.ac.uk/ws/portalfiles/portal/369243922/Final_healthism_Introduction_to_SI_.pdf

Revisiting Robert Crawford's 'Healthism and the Medicalization of Everyday Life' https://pubmed.ncbi.nlm.nih.gov/41889188/

Healthism: When the Pursuit of Health Becomes Harmful

Health should not be a moral obligation. Sophie S. Whynacht, Ph.D. https://www.psychologytoday.com/us/blog/body-image-and-stigma-bias/202411/healthism-when-the-pursuit-of-health-becomes-harmful

The author is a 20+ year survivor of stage 3, triple negative breast cancer, a trained plant-based cook, and a whole-food, plant-based advocate.