My background is in public health, and I love the idea of making healthcare accessible for everyone, but health coaching, exemplified by the Institute for Integrative Nutrition (IIN), in its current state, is not healthcare. It’s the Wild West of healthcare, and we need a sheriff.
Health coaching as a profession is exploding. According to a market research firm, in 2021, the industry was worth about 7 billion dollars and had 128,000 people identifying as health coaches. Health coaching isn’t regulated; there are no educational, training, or background standards. However, you might see health coaching certificates from places like the Institute for Integrative Nutrition (IIN), which bills itself as a more affordable way to receive health and wellness education through its flagship Health Coach Training Program and its Chopra Coaching Certification.
Given the rising popularity of health coaching, the fact that it’s completely unregulated, and that IIN claims it is the biggest nutrition and health coaching school in the world, it’s worth looking into IIN to understand who they are and what they do.
Institute for Integrative Nutrition
The Institute for Integrative Nutrition (IIN) was begun in 1992 by Joshua Rosenthal, who has a master’s degree in education specializing in counseling. He is neither a registered dietitian nor appears to have any formal training in nutrition or dietetics. His biography on IIN’s website states that he has “over 30 years of experience in health and wellness,” though nowhere in this biography does it describe Rosenthal’s training or education in health or wellness.
It does, however, relay a nice story about the origins of IIN:
“Founder Joshua Rosenthal brought together 20 like-minded individuals in a rented kitchen in the heart of New York City to discuss health and wellbeing, sparking the fire that would soon turn into the largest nutrition and health coaching school in the world.”
There is no mention of the training, background, or education that would qualify Rosenthal or any of these “20 like-minded individuals” to start a nutrition or health coaching curriculum. It appears IIN was essentially created by a group of people who liked to cook and had what seems like a passing interest in nutrition but no real training. They wanted to start a business together, and that’s exactly what they did.
“the world’s most respected nutrition and health coaching school with the largest global presence in health coaching” - IIN “About Us”
Accreditation and Complaints
According to the Wellness Council of America, health and wellness coaches should not
- “Advise on diet, exercise, or mental health issues unless licensed to do so in your state and the client is also located in your state.
- Practice outside your license’s scope, education, training, and/or experience.”
With that in mind, let’s turn to accreditation. According to the Department of Homeland Security, accreditation is “the recognition from an accrediting agency that an institution maintains a certain level of educational standards.” If a school is respected and has a significant presence, you would likely assume it is accredited.
IIN is accredited through the National Board for Health and Wellness, which works alongside the National Board of Medical Examiners (NBME). The involvement of NBME adds what I believe to be an unwarranted “halo” to the accreditation. Its role is to help “health professionals across the care continuum enhance and demonstrate their knowledge—both in school and while practicing,” offering “a portfolio of products that include assessment tools.” But what does this really mean in this case?
Accreditation implies oversight of a program and its curriculum that promotes a certain quality of education. NBME provides data to state licensing boards determining licensure, but health coaching does not require a license. Since there are no educational, experience, or training requirements for health coaches, does this accreditation actually provide the implied oversight and assurance of the quality of education that accreditation typically does?
Turning to potential indicators of the quality of education IIN provides, check out the complaints on the Better Business Bureau’s website about IIN. While there can be bias in reviews (i.e., the people who love or hate something are the most likely to review it. The BBB places substantial weight on how customer complaints are handled so it could be argued that it’s just a way of getting IIN’s attention); it is important to note that two themes emerge: complaints about out-of-date material and material that is freely available online. Those themes are quite telling. People are paying thousands of dollars to an organization that operates in a space without educational requirements and are not receiving a quality education. At best, the education they receive is outdated and available on YouTube. By another name, that’s a digital version of a diploma mill.
While IIN’s nutrition and health coaching educational material may be outdated, their understanding of the regulatory laws across the United States is very current, as are their lobbying efforts. The IIN lobbyist has been paid over $400,000 during the last seven years. And what exactly are they spending money lobbying for? According to their lobbying report obtained via Open Secrets, they lobby for
“Issues related to health and wellness coaches. Issues to raise awareness and support for health coaching as part of healthcare. Make health coaching expenses eligible under health savings plans.” [Emphasis Added]
Read that last sentence again: “Make health coaching expenses eligible under health savings plans.” Remember, health coaching is completely unregulated. There is no standard of training, education, or background. IIN is not lobbying for standards of education or training to make the industry safer and more reliable for clients or to improve the quality of the profession and the field. They are lobbying to get paid by insurance. Given the high-impact world of healthcare, this should concern everyone.
As I said, I love the idea of making healthcare accessible for everyone, but health coaching in its current state is not healthcare. Until we can implement regulations, we will continue to see stories like Heather Del Castillo, an unlicensed dietician but health coach dispensing dietary recommendations or concerns that health coaches are interpreting laboratory data.
I think health coaching has potential. I really do. But we need to get out in front of it by establishing guardrails and standards. People want to work in healthcare to help others and have a real impact. That’s a good instinct. However, in this high-impact world of healthcare, we need to ensure that the people and organizations participating in it are highly trained and credentialed. IIN is not the way to do that. IIN, at best, is a well-intentioned but unqualified organization for producing people to work in healthcare and, at worst, is running a grift on students and their potential clients that will get someone hurt or killed. That’s not an if; that’s a when.
The opinions express are those of the author and not her employer