Episode Transcript
[00:00:00] Foreign.
[00:00:04] Wealth Divide Part six of six Avoidance of toxic Substances and Behaviors, why ultra high net worth individuals can be surprisingly unhealthy and how wealth secretly undermines the six pillars of health from early childhood, I felt like the black sheep in my family. It made me shy. It made me feel like an outsider. So when I discovered wine in my early teens, I loved what it did for me. It took away the self consciousness. It dulled the ache of not feeling valuable. It made me fun. It was easy to drink. In France, we drank wine at lunch. In Newport, there were five o' clock cocktails and wine at dinner. It was completely normal because it was present at every party and every meal. It never occurred to me to go without until I started to suspect it was getting in the way of my goals. In 2006, I decided to quit. I'd had enough of feeling depressed, overweight and exhausted. Luckily, absence came easy. Raising two children alone in the Swiss Alps meant I was home evenings a lot. I had no social obligations, no temptation. While reading why French Women Don't Get Fat, I learned that the author used a simple trick. She lifted the glass to her lips and only pretended to drink.
[00:01:13] That gave me hope I could still be part of the gang. I was in charge of what I put in my body. What happened next was immediate. My body changed, the weight came off my my motivation to exercise increased, my energy returned and the depression lifted. I had agency. Then a friend took me to the Palace Hotel's Gringo discotheque. One of my first times out sober. I panicked. Not from craving, but from not knowing what I was. Without a glass in my hand, I held onto a Diet Coke most of the night. I danced. I felt sexy in my fitter body and I had a great time. Twenty years later, I'm still sober and with no cravings. When I took the Harvard Lifestyle Medicine coaching course, the six pillar was simple. Avoid toxic substances, alcohol, tobacco, drugs. Clear enough? I already knew that process addictions gambling, binge eating, compulsive sex were real. And I was disappointed they were not represented in the pillar. But recently I looked at the Lifestyle Medicine website again and the description had changed. Now it includes other risky behaviors and exposures.
[00:02:16] Yay. My thinking has been vindicated.
[00:02:20] Access means wealth. Makes everything easier to get, including the things that hurt you. The highest thc, cannabis, the finest wine, private prescriptions, food engineered in labs. Distortion means calling harm by pretty names. It's not getting high, it's microdosing for creativity and connection.
[00:02:38] It's not drinking, it's wine, culture it's not ultra processed food. It's a busy lifestyle. Invisible risk means wealthy people rarely hit bottom. No dui, no job loss, no eviction, no consequences that would force a reckoning for most people simply don't arrive.
[00:02:58] The substances Cannabis I want to say this clearly. Today's cannabis is not what anyone thinks it is. The cannabis available now is not the cannabis of the 1970s or even the 1990s.
[00:03:11] THC content has increased five times over the last 20 years from about 4% to 20% in most legal products today. Some concentrates now reach 60 to 90% THC.
[00:03:23] The science is catching up and it is alarming. A review of nearly 100 studies found strong links between high potency, cannabis and psychosis, schizophrenia and cannabis use disorder. Brain imaging research published in Jamaica Psychiatry found actual physical changes in the brains of frequent users, black spots in the region tied to psychosis caused by excess dopamine buildup. Researchers called it a smoking gun.
[00:03:50] Psychiatrists treating young patients report seeing adolescents who have two or three brief cannabis induced psychotic episodes followed by a much larger one. And yet cannabis is being sold as a wellness product, a conscious alternative to alcohol. Something you do at a retreat after a sound bath with your organic snacks.
[00:04:11] In wealthy circles, you can access the most potent products on the market.
[00:04:15] This is the lie I feel most strongly about right now. It is costing people their minds.
[00:04:21] Stewardship Move. Educate yourself on the difference between THC and cbd. Don't just listen to what appears on Instagram reels.
[00:04:29] Talk to emergency room doctors. They will tell you the truth. And if someone you love is using cannabis and calling it wellness, say something. The science is in. This is not the soft drug. Many people still imagine it to be alcohol. I drank for years without questioning it. I know how normal it feels. I know what it gives you. The ease, the connection, the version of yourself you like. And I know what it takes. My motivation. My rational thought, My agency. My mood. My body.
[00:04:57] Dr. Andrew Huberman has made clear what this science now confirms. Even one glass of wine causes measurable harm to the brain. The story that moderate drinking is harmless or even good for you has been dismantled. Twenty years sober, I know what the other side looks like. Stewardship. Move. Watch Huberman's now famous podcast on alcohol. Don't start drinking. If you do drink, reduce intake to one drink a day. That's the equivalent of five fluid ounces or 148 milliliters of wine for women and two for men. Or better yet, question the habit entirely.
[00:05:33] Ultra processed food. This one isn't yet fully in the lifestyle medicine curriculum, it should be. In December 2025, San Francisco filed the first government lawsuit of its kind against 10 major food manufacturers. Kraft, Heinz, Coca Cola, PepsiCo, Nestle, General Mills and others. The city attorney argued that these companies engineered a public health crisis, deliberately designing foods to be addictive, marketing them deceptively and targeting children and low income communities. Here's the part that stopped me cold. Starting in the 1980s, tobacco giants Philip Morris and R.G. reynolds moved into the food industry.
[00:06:09] Philip Morris acquired Kraft in 1988. A Philip Morris executive once said, you can now have a complete meal of Philip Morris foods. Followed of course by one of our cigarettes.
[00:06:23] The same people, the same playbook, the same science of addiction now applied to what we eat.
[00:06:28] Ultra Processed Food hits dopamine in ways similar to alcohol and cannabis. Chris Van Tuleken in Ultra Processed People argues that these products are a primary driver of diet related disease and that willpower alone is not enough to resist them.
[00:06:43] They are engineered to override normal satiety and restraint. The chemicals that make them irresistible are not accidents. They are the product stewardship move tools like the Yucca app, which scans food labels and flags harmful ingredients. Put that power in your pocket. Better yet, buy food with no ingredient list or at minimum one ingredient only.
[00:07:04] The Exposures I was raised with secondhand smoke before I ever picked up a drink. Before I made a single choice, I was already breathing in something harmful. Secondhand smoke is still a real risk.
[00:07:17] It causes lung cancer, heart disease and stroke in non smokers. Children raised in smoking households carry that exposure in their lungs and often in their long term health outcomes. Prenatal exposure may be the most consequential of all. Alcohol, drugs, nicotine, solvents and other toxins during pregnancy cross the placenta. They shape a developing brain before it has lived a single day outside the womb. What a mother carries, the child carries too. This is generational harm in its most literal form.
[00:07:47] Pesticides are in our food, our soil and our water. Buying organic produce is one of the clearest stewardship moves available to anyone who can afford it.
[00:07:56] Solvent fumes and hazardous household chemicals accumulate in enclosed spaces.
[00:08:02] Cleaning products, paint adhesives, dry cleaned clothes brought straight into the bedroom closet. Poor indoor air quality and combustion byproducts from gas stoves, fireplaces, candles and inadequate ventilation build up silently. The EPA has noted that indoor air is often more polluted than outdoor air. We seal our beautiful homes tight and breathe whatever is inside them. Black mold thrives in old properties such as Newport houses European estates, charming old apartments.
[00:08:30] Chronic mold exposure causes respiratory disease, neurological symptoms and immune dysfunction. Stewardship Move. Filter your water. Buy organic when you can. Choose cleaner, beauty and household products like white vinegar. Test your home for mold. Open your windows. And if you are a philanthropist, fund the gap between what is healthy and what is affordable.
[00:08:52] The behaviors.
[00:08:54] Overwork and achievement. Addiction. This is the one the family applauds, the one that gets called drive, discipline, passion. But the brain doesn't know the difference between a hit of cocaine and and the dopamine rush of a closed deal.
[00:09:07] Overwork numbs at distances. It keeps you from feeling what you have to feel if you stopped.
[00:09:13] Social isolation.
[00:09:14] Wealthy people are often alone in a very particular way. Big houses, private travel, curated social circles. The loneliness is real, but hard to name when your life looks full. Isolation is a health risk as serious as smoking a pack a day. We mostly ignore it. Enabling patterns in families. Covering, minimizing, making excuses, staying quiet to keep the peace.
[00:09:37] These are behaviors too. They feel like love, but they aren't helpful. Compulsive spending and risk taking. When money is plentiful, it's hard to see the pattern. But the brain doesn't care what the substances. Spending, gambling, high stakes, risk. When they become a way to manage feelings, they are doing the same job as any drug. Sex.
[00:09:55] I'm including this because almost no one else does.
[00:09:58] Wealth protects this behavior more than almost any other. Money buys silence. Money funds dalliances. Oxytocin, the bonding hormone, is as powerful as many substances. Attaching it compulsively to the wrong people over and over is a health risk.
[00:10:14] Rage, chronic anger floods the body with cortisol. It damages the heart, the immune system and every relationship it touches. In families where conflict is never addressed directly, rage goes underground and comes out sideways.
[00:10:30] When I quit drinking, control became my dependency. Dr. Anna Lemke has shown that control itself is addictive. The more we manage, the more we need to manage. A big life with a lot to manage can make a lot of this harder to see. Stewardship move. Find a therapist who understands trauma. Find peers who are doing the same work. Fund treatment, access for people who cannot afford it. Bill Wilson, the founder of aa, understood something that took me longer to grasp. In an essay called the Next Emotional Sobriety, he wrote, I think that many oldsters who have put our AA boost cured to severe. But successful tests still find they often lack emotional sobriety.
[00:11:07] Quitting the substance is the first frontier. What comes after learning to live without the dependency, without the demand, without the need to manage everything? Is the next one. If we examine every disturbance we have, great or small, we will find at the root of it some unhealthy dependency and its consequent unhealthy demand.
[00:11:25] Then we can be set free to live and love.
[00:11:28] Twenty years in, it is still the work. There is a deeper layer to all of this. What happens after you put down the substance, how control, achievement and emotional dependency rush in to fill the space is what I'm writing about in my book. Bill Wilson had a name for it. I will have more to say about it soon. This is the final essay in the Health Wealth Divide, a six part series examining the six part pillars of lifestyle medicine through the lens of wealth.
[00:11:57] If this episode landed for you, share it with someone who might need to hear it. And if you haven't already, subscribe so you don't miss what's coming. But here's the real thing. I want you to know if you're carrying something you can't talk about, if you have every resource except someone who actually understands what wealth costs. I work one on one with people like you navigating exactly that. You can reach me@diana oehrli.com thanks for listening.
