A discounted full-body health check-up may feel like a responsible step towards better health. But in Pill-Free, Dr Chandrakant Lahariya reveals how unnecessary screening can sometimes set off a chain of tests, diagnoses and treatments that a healthy person may never have needed in the first place.
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Like every other morning, Mr Manoj Agarwal stepped onto his balcony to pick up the newspaper, when a glossy flyer slipped out, urging readers to get a ‘full body’ or ‘preventive’ health checkup. The offer seemed irresistible: more than 100 tests at a price far lower than what his family physician had once suggested, sweetened further by a ‘buy one, get one free’ blood test scheme. Mr Agarwal was fifty-two, healthy, active and asymptomatic, but the logic of prevention felt sensible, even responsible. By the same morning, he had booked the package by making a phone call. The blood samples were collected smoothly, and within a day, a thick report arrived. Most values were normal but a few were marked in red.
Before he could process it, he got a call from someone expressing concern over mildly abnormal liver parameters, some of which were slightly above the normal reference value, and suggested Mr Agarwal to consult a doctor and get further tests, such as liver ultrasound and FibroScan, done. Though he felt perfectly well, he went ahead with the investigations, which revealed mild fatty changes in his liver. The physician visit led to further tests—an echocardiogram and a carotid Doppler—to assess cardiovascular risk. The final prescription diagnosed him with dyslipidaemia and ‘high cardiac risk’, and he was started on low-dose statin and an antihypertensive, with advice for monthly followups. In a matter of weeks, a man with no symptoms acquired diagnoses, medicines and anxiety. His drawer now had pills, he was scheduling further check-ups and his self-image subtly shifted from healthy to chronically at risk.
A seemingly harmless newspaper insert had quietly medicalized an ordinary life, turning a healthy man into a patient not because he fell ill, but because he was tested—or let’s say unnecessarily lab tested. Every morning, millions of people across India get such Trojan-horse newspaper inserts, which tempt them to get something done when none might be needed.
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In the last decade, there has been a rapid growth in diagnostic and radiology labs. The growth of these centres and facilities, in turn, required demand generation. Therefore, most diagnostic companies have come up with various attractive packages. The cost of a full body check-up at some aggregator laboratories is one-third to one-fifth of market rates of reputable labs. They do not have any physical infrastructure and use their funds for marketing. As a result, they attract new patients for full body check-ups.
For doing that, aggregator labs have learnt from the playbook of the ‘junk’ food or ultra-processed food (UPF) industry. Until 1991, most Indian business activity was driven by domestic companies. With the liberalization of the economy, however, multinational corporations entered the Indian market in large numbers, and fast-food chains were among the earliest and most aggressive. They faced a significant challenge: eating out was not yet a cultural norm for most Indians, and foods like pizzas and burgers were unfamiliar to many. In effect, they had to create an entirely new market.
For this, they strategically targeted more impressionable groups—children, adolescents and college-going youth. Older adults, accustomed to traditional home-cooked meals, were less likely to shift their preferences. These companies marketed heavily to young consumers, often promoting food not to sate hunger but as a lifestyle choice. Attractive offers such as ‘buy one, get one free’ or unlimited meals at very low prices encouraged overconsumption and helped cultivate a taste for ultra-processed foods.
At the same time, significant research and product development went into designing foods that would appeal strongly to human taste preferences5—high in fat, sugar and salt—making them highly palatable and even habit-forming. These foods were often cheaper and more accessible than healthier options. Over time, many people shifted away from traditional diets toward these processed alternatives. The apparent affordability of such items has come at a high longterm cost to public health.
A similar pattern is now emerging in healthcare. The rise of direct-to-consumer ‘full body check-ups’ without a doctor’s prescription can be seen as one of the most questionable practices of the past decade—closely rivalling the idea of indiscriminate preventive health screening.
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