"The fitness industry doesn't want you to get better."

I see this one on social media constantly: “the fitness industry doesn't want you to get better, it wants you to keep coming back.”

Yes, the fitness industry wants you to keep coming back. So does every business on earth. That's not a conspiracy, it's just what a business is. But separate capitalism from the people actually standing in the room with you for a minute.

You can lead a horse to water, but you can’t make him drink.

Personal trainers don’t like training clients who don't improve. That's an actual, repeated complaint you'll hear in a break room — it makes a trainer feel ineffective, and it makes asking for a renewal feel lousy when results aren't showing up. (To any trainers reading: showing up at all is a bigger part of the outcome than people give it credit for, and some movement beats no movement, always.) Therapists feel the same pull — wanting to help a client graduate out of the relationship rather than keep circling the same unproductive rumination indefinitely. Doctors want their patients well. Nobody enters health care hoping people stay sick. What everyone in this industry hopes for is a longitudinal relationship — which is a very different thing than hoping you stay unwell.

Abundance vs. Scarcity

I once heard a trainer say something that stuck with me for the wrong reasons: "I don't like to give too much away in a first assessment, because I want the client to come back wanting more." That felt stingy to me the moment I heard it. I believe in leading from abundance, not scarcity — and people can feel the difference, even if they can't name it. Imagine a doctor withholding a real treatment for chronic kidney disease because they wanted you to keep coming back for more visits. It's absurd on its face. A doctor's job is to prescribe the optimal treatment for the condition in front of them. A trainer's job is to prescribe movement. The fitness industry doesn't want you fat and sick — it wants you vital, because vital, returning clients are the actual business model. Fat and sick isn't the product. Access to an environment that makes you vital is.

"But Dr. Stevens — what about the $6 protein cookies at the front desk that constipate everyone, the energy drinks with 400mg of caffeine, the unregulated supplements pushed at checkout?"

Fair question, and honestly: that's ignorance, not intent. People like novelty. People like their protein and their caffeine. And despite being unregulated, supplement-related deaths aren't something you actually need to lie awake worrying about — file that next to asteroid impacts on your list of real risks. The fitness industry wants you healthy. I can say that with confidence, because this is my industry, and repeat business exists because the thing is working, not because it's failing on purpose.

On Reimbursement

Medicine gets more complicated here, and this is where the nuance actually lives. Surgeons will do surgeries. Hospitals provide high-impact procedures. Why? Because those carry the highest reimbursement from insurance companies — not because anyone involved wants you sick.

One thing worth being precise about, though: doctors do not get paid bonuses to prescribe drugs. That kind of pharmaceutical courtship largely ended a long time ago. What actually happens is more mundane: physicians are typically compensated based on patient volume and visit complexity. If I see you for a twisted ankle, that's a minor billable event. If I see you for medication management across diabetes, kidney disease, and gout, that visit reimburses at a higher rate — and it usually requires more follow-up. Not because I want you sick. Because you are sick, and sicker patients take more time, more coordination, and more visits to manage well. The higher reimbursement follows the complexity of the problem. It doesn't create the problem.

Family medicine doctors, specifically, do not want you sick. There aren't nearly enough of us to take care of everyone as it is. Most of us went into family medicine because we like long-term relationships with patients and a wide variety of problems to solve, not because illness itself appeals to us.

The problem isn't the people. It's the systems some of them are forced to operate inside.

Take glucose strips. If you're diabetic, you need to check your blood sugar daily, often several times a day. The bottleneck isn't the technology — it's the cost. Strips are engineered to match one specific machine. You only need to buy the machine once, but you'll buy dozens of strips every single month, forever, and both are patented just tightly enough that you can't shop around. What actually changed between generations of these devices usually isn't the underlying technology. It's the shape of the strip, redesigned just enough to require the newest machine. That's not a service worker failing you. That's a system engineered for a captive, recurring customer — the exact scarcity logic I distrust.

A good doctor helps you find ways to manage your disease that don't leave you hostage to a pharmaceutical company's patent cycle. A good trainer helps you find ways to manage yourself so the gym becomes an enjoyable addition to your life, not a dependency you can't escape. One of those approaches leads from scarcity. The other leads from abundance.

Try to lead with abundance. And when you're choosing who to trust with your health — a trainer, a doctor, anyone — notice which one you're actually dealing with.

Talk soon,
Dr. Stevens

General health information only — not a diagnosis, not treatment, and not a substitute for care from your own physician. Talk to your doctor before changing your exercise, diet, or medication routine, especially if you have an existing condition.