IBS: How Capitalism Cooked Up a Whole New Disease (Part 1 of 2) (2024)

tw: eating disorders

This is the second part of “IBS: How Capitalism Cooked Up a Whole New Disease”. Part II

Introduction

During COVID, I self-diagnosed myself with Irritable Bowel Syndrome (IBS), a catch-all diagnosis for mysterious digestive problems involving the large intestine. Since then, I’ve been introduced to an entire social ecosystem that was previously unknown to me. I knew that traditional eating disorders created extreme subcultures, but I didn’t expect other “nutrition” subcultures to have their own strange dynamics.

While I was writing this essay, I got roped into a conversation with a man who was convinced that his body couldn’t tolerate “FOODMAPS” or anything that wasn’t all-natural. He went on to rail against the entire “establishment” of dietary advice and praised an alternative dietary book as if it were scripture. A nearby woman nodded in assent, adding that she was unable to eat apples due to her body’s personal quirks.

I am worried about modern Americans’ willingness to axe large, non-trivial swaths of their diet. While I wasn’t around in the 1950s, it does feel like something is different about today’s dietary culture. Previous generations at least seemed to draw the line at the natural. But now it seems like nothing is sacred. People are willing to cut apples, legumes, spinach, or even all carbohydrates from their diets altogether.

This trend has come along with a new class of ailments: dietary intolerances and sensitivities. They go by many names: functional dyspepsia, IBS, SIBO. But in contrast to digestive ailments like allergies or Crohn’s disease, these conditions defy causal definition. They seem to come and go without explanation, like a thief in the night.

I want to focus on IBS, which reveals much about the state of our modern dietary culture. Specifically, I’d like to make the case that IBS is the first disease created by capitalism. Sure, you could argue that capitalism has worsened “diseases of affluence” like obesity, cancer, and Type II diabetes. But these conditions would still exist in the absence of capitalism (if in a less prominent form).

On the other hand, IBS requires capitalism for its very existence. If it weren’t for a century of social conditioning, product engineering, and consumption-based thinking, the disease known as IBS would not exist today. This is not to say that suffering caused by IBS is faked or otherwise unreal. Rather, the constellation of symptoms that we call “IBS” could only have formed into a cohesive whole in a capitalist reality.

Step #1: Grease large pan w/ lifestyle marketing

As America became wealthier, companies realized that it wasn’t enough to sell goods that people needed. They also needed to create that need. When it came to food, this was no easy task. After all, people had been eating similar diets for hundreds of years, and this had been working out well for them. The solution to this problem was selling not just a food product but an entire lifestyle.

Will Kellogg was the first to take advantage of this strategy. Kellogg’s brother John, a famous physician who pioneered the science of wellness, was obsessed with the idea of “biologic living”, or the idea that scientific optimization could radically alter the human condition for the better. While many of John Kellogg’s ideas feel eccentric now, the essence of his lifestyle is alive and well. Will’s genius was realizing the potential of selling his brother’s science of nutrition with the science of marketing.

Will’s famous breakfast brand sold cereal not just as food but as an entire wellness package. Kellogg’s cereal promised to actually change your life: it would liberate you from your carnal urges, restore your focus, and discipline your life. With the advent of mass media, this message could be beamed directly into American homes.

This strategy was copied by brands all over the world, becoming the dominant mode of advertising that we see today. Sprite isn’t just a soda— it’s individuality, basketball, hip-hop. Red Bull isn’t just an energy drink—it’s seeking thrills, dance, Formula One. And Subway isn’t just a sandwich— it’s freshness, football, good deals.

This stuff might make you roll your eyes now, but it came at a more optimistic time. Americans were still awed by modernity’s rapid progress and decades away from the daily deluges of ads we know today. They were thus eager to learn how their pedestrian lives could be optimized by almighty rationality. By aligning with Kellogg’s, people hoped that they could transcend the ordinary and become superhuman men of science.

Step #2: Add 1 cup of high modernism and simmer

Kellogg’s lifestyle marketing was inseparable from the idea of high modernism, or “an unfaltering confidence in science and technology as means to reorder the social and natural world”. In high modernism, any problem can be solved so long as the right way to rationally tinker with the system is discovered.1

Kellogg’s aforementioned faith in biologic living was downstream of this idea. With the rapid prosperity that scientific inquiry had brought to America in such a short time, only a cynic would question high modernism’s ability to bring future prosperity.

For a while, it seemed like the optimization of food knew no bounds. Food just kept getting “healthier”, tastier, and shinier. To the optimistic Americans of the 1950s, it must have seemed like every year brought new wonders. Cereal that stays crispy for days on end? Food that glistens with vibrant colors? Impossibly addictive levels of crunch and bounce? What problems couldn’t be solved by modern science?

Of course, we know what came next. Studies began to reveal the costs of unfettered tinkering with food. We learned that plagues like Type II diabetes and colon cancer were the cost of letting high modernism run wild. In 1994, the NLEA went into effect, requiring companies to disclose all the toxins in their food via the Nutrition Facts label. The high modernist honeymoon was over.

Or was it?

The hope was that Nutrition Facts would reel in the web of risky additives that had been sold to American consumers who didn’t know any better. Now the public was armed with knowledge. Finally, science would serve humanity for good!

However, lifestyle marketing allowed high modernism to enter a new phase. Now that Americans were primed to think of products as lifestyles, it wouldn’t take much to extend this to nutrients as well. Protein became a stand-in for strength and discipline, while saturated fat represented “fat Americans” in all their laziness, and gluttony.

Instead of ending it, Nutrition Facts fueled the additives arms race by adding even more metrics to optimize for. Taste-maxxing was out, and health-maxxing was in. Companies found new and exciting ways to drop sugar levels, increase protein, and otherwise engineer food away from being, well, food.

The modern customer was literate, data-driven, and informed. Companies were eager to demonstrate their commitment to health, and labels like “low fat” and “protein packed” began to fill grocery store aisles. If customers wanted to consume a healthy brand, then companies would oblige! The nutrition-as-lifestyle era was here.

Step #3: Add a spoonful of ancient medicine

Despite its scientific foundations, nutrition-as-lifestyle began to look less like atomic science and more like classical elementalism. Nutrients differed not just in structure but in essence: each possessing a moral value. Unsaturated fat became all that is Good: olive oil, fish, and nuts. Saturated fat became all that is Bad: fried chicken, butter, lard. So-called “bad” foods were treated as if they had some sort of evil essence.

Even though bread literally decomposes into sugar in your mouth, the two foods have been assigned different essences. One of them is bad sugar, while the other is good whole grain. In the eyes of the grocery shopper, they seem as different as lead and gold.

Other aspects of nutrition-as-lifestyle came to resemble the ancient Greek science of humorism. Humorism states that sickness is caused by imbalances in the four basic “humors”: blood, phlegm, yellow bile, and black bile. This science spawned the practice of bloodletting, which was standard procedure in the case of “too much blood”.

Nutrition-as-lifestyle takes a similarly reductive approach. It analyzes nutrient intake in a vacuum, apart from complicating environmental factors. Overweight? Eat less fat! Low energy? Eat more vitamins! Nutrition-as-lifestyle scoffs at folk knowledge or tradition, arguing that it has nothing useful to offer to modern science.

Because nutrition-as-lifestyle is so entrenched, we struggle to process cases that don’t seem to match. One such case is the Italian island of Sardinia. Sardinia is a Blue Zone, meaning its residents enjoy unusually long lifespans. Surprisingly, Sardinians have relatively low protein diets. Despite this, as well as other nutrition-as-lifestyle no-nos (eating lots of dairy, daily red wine), the Sardinians do quite well for themselves.

In a high modernist world where proteins are an Absolute Good, places like Sardinia fly in the face of our understanding. Even after learning this information, it’s hard to suppress the conditioning that says, “well, aren’t they probably weak or something?”.

But nutrition isn’t so simple. There are too many unknowns for us to just completely engineer the system from the ground up. Just look at bloodletting: despite reflecting the best science of the time, it still caused untold harm. We must examine cut-and-dry scientific explanations with suspicion and temper them with traditional practice.

Of course, most companies were uninterested in this kind of nuance. Marketing is a lot easier when consumers are thinking in black-and-white elemental terms. And assigning these judgments paved the way for something even more sinister…

Step #4: Skim fat off the top and discard

Profiting off of lifestyle products is one thing, but profiting off of lifestyle disorders is quite another. A 2024 article in The Nation paints a grim portrait of the relationship between capitalism and pathological diets.

Like nutrition-as-lifestyle, eating disorder discourse tries to force complex issues into a reductive framework. Eating disorders are more likely to be portrayed as an ailment that can be “cured” with some biochemical intervention, as opposed to structural issues that are downstream of our culture.

The Good Essence / Bad Essence framework complements this view. If companies can market some foods as Good and some foods as Bad, then they can shift the blame away from their glamorization of consumption and towards the consumer’s personal failings. Why consume less when you can eat “low-calorie high-volume foods”?

So instead of turning on our consumptive culture, people in this trap often develop an obsessive paranoia with self-policing their diets. Even if sufferers of eating disorders can escape their body image issues, escaping the toxic conditioning around self-discipline can prove much harder. And this has downstream effects beyond sufferers.

I can imagine eating disorders in a world without capitalism. They wouldn’t be nearly as prevalent, but people will develop unhealthy dietary pathologies in any society that values being thin. That being said, our eating disorder discourse relies on a particular obsessive mindset around consumption, one that may very well be capitalism-specific.

This mindset would eventually become highly influential on IBS discourse. But while this mindset and the trends that led to it planted many seeds, IBS needed one final ingredient to grow into the mainstream.

Step #5: Stir humans in small pan until stressed

The human body runs on rhythms, and digestion is no exception. We eat, we digest, we excrete, ad nauseam. When our bodies are healthy, each of these steps flow into the next, like movements of a symphony.

But critically, these rhythms also depend on each other. If the brain starts playing an off-beat melody, then the rest of the body will struggle to harmonize in response. So the human body is a delicate balance. When something falls out of place, it is difficult to predict how that will affect the rest of the system.

Human bodies are optimized to play for the conductor that is Mother Nature. But our bodies have gotten used to a new conductor recently: capitalism. Capitalism did not create time, but it did supplant nature as its primary authority.

In the 19th century, most towns lived by their own rhythms. Municipalities scheduled things according to natural signals like sunrise and sunset. There was time, but it wasn’t the definitive Standard Time that we know today.

Capitalism seeks to drive efficiency above all else, and efficiency cannot be measured without Standard Time. Intellectuals were warming up to the concept of Standard Time, and its economic benefits made it all but inevitable. All that was needed was a technological spark— one that could motivate this abstract concept into reality.

That spark ended up being railroads, which provided a clear logistical incentive to shift to formal time. People needed to know when they were going to arrive, after all! Towards this end, enterprising rail tycoons created the first timezones, which were eventually codified in federal law. This idea spread across the world, with the vast British Empire and its famous Greenwich Observatory turning it into a global system. Standard Time became truly all-encompassing.2

The introduction of time did not go off without a hitch. There was fierce resistance to so-called “railroad time” in certain municipalities, and at times it even turned violent. But by 2000, people had quietly accepted “time is money” as the conventional wisdom.

The imposition of time only accelerated thanks to technological progress. Throughout the 20th century, the majority of American buildings gained electric lighting, giving us true independence from the timing of the sun. And in the 21st century, powerful devices gave us access to Standard Time anywhere in the world. But at what cost?

All sorts of strange flattenings occur when a system is imposed from the top down. Some of these flattenings are obvious, but others seep into our way of life so gradually and thoroughly that they escape notice. For example, historian Roger Ekirch proposed that humans used to sleep in two discrete segments before the Industrial Revolution. What else may have been lost? We don’t need a specific causal mechanism to wonder.

We rarely have occasion to consciously grapple with how capitalism has warped our perception of time, but one such time was the COVID-19 pandemic. In the face of overwhelming anecdata, we don’t need a study to know that quarantine threw our rhythms out of wack. After the market came grinding to a halt, people were left to grapple with the steady drumbeat of Standard Time.

It felt so surreal to see the world clinging to almighty Standard Time, even after it stopped reflecting the intuitive rhythm of the world. Time itself felt less real when unmoored from familiar rhythms. But Standard Time was always unreal in some sense. It just took a pandemic to make us realize it.

While it is still early to draw conclusions, a recent Cedars Sinai study suggests that COVID was terrible for our digestive health. But COVID overshadows the far more significant disruption: our collective steps away from the rhythms of nature. Claiming that this chain of disruptions caused IBS would be premature. But when a rhythm of the body breaks down, we should be suspicious of the most serious disruption to bodily rhythms in human history.

And with that, the stage was set. Next time, we’ll talk about how it all came together.

Continued in Part II