The Hidden Dangers of Health Coaching: A Closer Look
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The health and wellness coaching sector is a multi-billion dollar industry, yet it operates without regulation, relying on a patchwork of questionable certifications. During my travels as a digital nomad, I encountered several individuals in this field, and I must say, the experience felt quite toxic.
A few years back, while I was living the digital nomad lifestyle in Playa Del Carmen, Mexico, I met countless individuals who traveled from one hotspot to another on the nomadic circuit. This circuit includes popular destinations such as Chiang Mai in Thailand, Bali in Indonesia, Costa Rica, Spain, Portugal, and Croatia.
The nomadic scene is vibrant, filled with a mostly young and ambitious crowd who earn their living online. Their professions vary widely, but there are distinct groups, including online poker players (often the wildest), Amazon sellers, content creators (like myself), tech enthusiasts, and, notably, coaches.
During my time abroad, I formed close connections with both poker players and coaches, the former being an intense and intriguing group. They would often have shared apartments and hire assistants to handle errands, as they could spend up to twelve hours glued to their screens.
However, the coaches intrigued me the most.
The digital nomad coaches I encountered primarily identified as life, dating, or health and wellness coaches. Their approach often resembled a multi-level marketing scheme, with elaborate marketing strategies and a hierarchy of coaches ranging from experienced leaders to newcomers.
While all coaches had their struggles, the health coaches stood out for their particularly toxic dynamics.
They seemed to have fully embraced their own narratives.
What struck me was the level of infighting, with coaches often contradicting one another. When not engaged in disputes, they were busy congratulating themselves, which struck me as odd, especially when it followed complaints about their clients' challenges.
I learned that clients who were not achieving results simply needed to purchase more sessions.
The most concerning aspect was that these coaches frequently worked with individuals who were ill or had disabilities, often seeking help in desperation. As someone who deals with a chronic illness (Ehlers-Danlos syndrome and various immune-related issues), I understand the urgency to regain health. Had my condition been more pronounced during our interactions, I suspect our discussions would have been markedly different.
Although I met only a few health coaches, the industry is vast. Research and Markets estimates there are around 128,000 health coaches, with the market valued at $7.6 billion. However, the American Fitness Professionals and Associates (AFPA) claims it is a $16 billion industry, projected to reach $34 billion by 2031.
Regardless, it represents significant revenue for individual coaches.
The AFPA reports that the average income for a health coach hovers around $69,000, though another source claims it's $40,000. Such discrepancies are common in an unregulated industry, where conflicting information is rampant.
Many coaches I encountered earned considerably more, likely due to the entrepreneurial nature of their work, which allows for greater income potential than traditional roles.
However, these entrepreneurial coaches often lack accountability, leading to chaotic practices.
What Exactly Is a Health Coach?
The terminology in this industry can be quite perplexing. Terms like ‘health coach’ and ‘wellness coach’ are frequently used interchangeably, and sometimes merged into ‘health and wellness coach.’
In theory, health coaches concentrate on physical health, while wellness coaches adopt a holistic mind-body approach.
According to the Health Coach Institute (HCI), wellness coaches address issues such as stress, lifestyle modifications, weight management, time management, fostering a positive mindset, organization, and emotional health. On the other hand, health coaches assist clients with lifestyle habits, weight changes, dietary choices, managing specific health conditions, stress relief, and overcoming addictions to smoking and alcohol.
Despite these distinctions, the two roles often overlap, and their definitions can blur.
So, what areas are off-limits?
“Health and wellness coaching should not be confused with the work performed by specialists like nutritionists or personal trainers. While familiarity with these topics is essential, you aren’t legally permitted to provide your clients with professional nutritional or fitness advice without further certification.” — AFPA
If you're feeling confused, you're not alone. Even the coaches I met struggled to agree on their boundaries. One offered nutrition programs, while another insisted she couldn't, citing her lack of formal nutrition credentials.
In principle, health coaching is meant to encompass supplemental health services, focusing on goal-setting, motivation, encouragement, healthy habits, education, positivity, and accountability.
However, in practice, many coaches exceed these limits, which is unsurprising given the industry’s lack of standardization.
No Certification Necessary
The array of conflicting information regarding health and wellness coaching is overwhelming. Even in regulated fields, discrepancies can arise among professionals, but health and wellness coaching is entirely unregulated.
No national accreditation is required to practice as a health coach, and unsurprisingly, oversight is nonexistent. They also aren’t obligated to comply with HIPAA regulations.
According to the International Association of Health Coaches:
“Health coaches can obtain certification through private credentialing organizations and don’t need a state license to operate, as long as they do not partake in regulated activities, including using regulated titles like ‘Registered Dietitian’ or ‘Licensed Nutritionist.’”
While there are laws governing dietetics in twenty-one states, health coaches can offer a broad range of health and wellness services regardless of local dietetic regulations.
The National Board for Health and Wellness Coaching (NBHWC) is the most recognized certification body, yet certification by the NBHWC is not mandatory for health coaches.
Only about 10,000 of the estimated 128,000 coaches hold NBHWC certification—less than 10%.
All of the health coaches I met claimed to be “certified,” often displaying an impressive-looking badge on their website. However, none were certified by the national board. Many attempted to recruit me into their ranks (echoing the MLM-like nature of the industry), promoting how one could become a health coach for under $2,000 in as little as six weeks.
Their ‘Boss-Babes’ sales pitch, predominantly female, did nothing to entice me into the profession.
Recruitment is a common practice in the health coaching realm, with programs offering commissions for every referral to a certification course. For instance, the Primal Institute provides a 20% commission, amounting to $900 for their health coach course.
Indeed, it is possible to achieve ‘certification’ quickly and affordably.
As for the aforementioned organizations, HCI’s course, promising to ensure you gain clients, costs $5,995 and requires roughly 130 hours of commitment; AFPA’s program is priced at $949 and consists of over 35 hours of video content. AFPA stipulates that enrollees must be at least 18 years old and possess a good grasp of English.
After completing 35 hours of video, graduates receive certification and can start coaching others. To be accredited by the NBHWC, an additional 12-week module costing $1,899 is necessary, followed by a test.
To me, this doesn’t seem like a legitimate credential; it feels more akin to an ‘almond mom’ with a website and a PayPal account. Many of the coaches I met were directed toward platforms for website creation, marketing, and sales funnel development by their training programs. Others sought guidance from social media groups for these skills.
While not all coaches lack qualifications, many do. Given the promotional materials they all utilize, it’s challenging for the average consumer to discern who is competent.
The Supplement Issue
Despite not being qualified as nutritionists, dietitians, or healthcare professionals, many of these coaches promote affiliate products. Some of these products are harmless, while many others are dietary supplements.
The supplement industry can be quite problematic; it often operates under lax standards (if any at all). Most products aren't reliably tested for safety or even to ensure they contain the advertised ingredients in the claimed amounts.
It's a lucrative industry with ample affiliate opportunities for health coaches. One coach I met reported earning $20,000 annually from supplement sales, largely due to her established marketing on Instagram.
I maintain a firm principle: always scrutinize the claims of the salesperson. Personally, I would hesitate to trust a health coach selling me affiliate supplements to have my best interests at heart.
Advice for Seeking a Health Coach
My limited experience adjacent to health coaching grants me no authority, yet I feel confident making this assertion: if you plan to hire a health coach, conduct thorough research. The well-meaning health coaches I encountered were generally pleasant individuals, but I harbor significant doubts regarding their qualifications.
As a person living with a chronic illness who may someday seek a health coach to complement my medical team (often lacking in motivation), I would personally look for the following:
- A coach with a bachelor’s degree-level education, as comprehensive training programs exist beyond quick online courses.
- A coach certified by the NBHWC.
- A coach who refrains from promoting affiliate products.
- A coach who adheres to appropriate scopes, focusing on motivation, routines, habits, positivity, goal-setting, and accountability.
The health coaching industry desperately needs stricter regulations, but until that happens, the above criteria would be my baseline.
Especially since in another life, I too could have pursued a career as a health and wellness coach.