Disease mongering: ten widely cited examples
Disease mongering is the widening of illness boundaries, or the promotion of new diagnoses, to expand the market for treatment beyond where the evidence clearly justifies it, and the clearest way to understand it is through the cases that scholars and journalists cite most often. Each example below involves a genuine spectrum of human experience whose treatable portion was stretched, sometimes for sound medical reasons and sometimes past what the evidence supports. None is offered as proof that a condition is “fake,” and none is medical advice. This page is an independent reference with no connection to the 2006 Newcastle conference or any prior owner of the domain.
How to read these cases fairly
A useful example of disease mongering is not a condition that is invented from nothing. It is a real experience or a real risk factor whose definition was widened, whose mild end was reframed as needing treatment, or whose promotion was funded by a party that sells the remedy. For most of the cases below, some people are genuinely helped by diagnosis and treatment. The criticism concerns the margins: the large group of mildly affected or merely at-risk people who are told, often through marketing, that they too are patients. Keeping that distinction in view is what separates literacy from cynicism.
Ten widely cited examples
1. Low testosterone (“Low T”)
Ordinary features of male aging, lower energy, reduced libido, and mood changes, were reframed as a treatable hormone deficiency. “Low T” awareness campaigns encouraged men to attribute nonspecific tiredness to their testosterone and to ask for testing and gels, expanding prescribing well beyond the men with a clear clinical deficiency.
2. Female sexual dysfunction
Ray Moynihan documented how a broad, loosely defined category was promoted as a widespread medical disorder, with survey figures presented as if a large share of women were affected. Sexual difficulties are real and can have medical causes, but critics argued the condition was shaped in part to create a market for a future drug.
3. Social anxiety disorder
Common shyness and stage fright sit at one end of a spectrum that, at its severe end, is genuinely disabling. Marketing tied to antidepressants, including the widely discussed “imagine being allergic to people” messaging around paroxetine, risked pulling ordinary social nervousness into a chronic diagnosis requiring long-term medication.
4. Adult attention deficit hyperactivity disorder
Adult ADHD is a real condition that was under-recognized for years, so wider awareness has helped many people. It appears on this list because the same awareness machinery, checklists and pharmaceutical promotion, can also blur the line between a clinical disorder and the ordinary distractibility of a busy life, illustrating how legitimate recognition and over-expansion can travel together.
5. Restless legs syndrome
The uncomfortable urge to move the legs is a real sensation, and for a minority it is severe. Researchers Steven Woloshin and Lisa Schwartz described how media coverage, amplified by the marketing of a dopamine-agonist drug, presented it as a common disorder in need of treatment, drawing in many people with mild, occasional symptoms.
6. Prehypertension
A 2003 US expert panel introduced “prehypertension” for blood-pressure readings above optimal but below the traditional cutoff for high blood pressure. The label captured a real gradient of cardiovascular risk, but by naming a near-disease it reclassified tens of millions of people as needing monitoring and, potentially, intervention.
7. Prediabetes
Successive lowerings of the blood-sugar thresholds for “prediabetes” enlarged the population carrying the label. For some, the warning prompts helpful lifestyle change; critics note that many so labeled will never progress to diabetes, so the diagnosis can generate anxiety and treatment without a matching benefit.
8. Osteopenia
Osteopenia describes bone density that is below the young-adult average but above the cutoff for osteoporosis. It emerged from a technical threshold set for research purposes and was then treated as a condition in its own right, turning normal age-related bone thinning into a target for long-term medication in many women.
9. Premenstrual dysphoric disorder (PMDD)
Severe premenstrual symptoms are real and can be disabling. The case became a mongering example when an existing antidepressant was rebranded under a new name for this indication, prompting debate about whether a distinct disorder was being carved out partly to extend a product’s commercial life.
10. Mild hypercholesterolaemia
Guidelines that lowered the cholesterol levels at which treatment is recommended brought large numbers of lower-risk people into the statin-eligible population. Treating high cardiovascular risk is well supported; the contested zone is the mild, low-risk end, where the absolute benefit of lifelong medication is small and the decision is genuinely finely balanced.
The common pattern
Laid side by side, the cases share a structure. A real condition or a real risk factor exists. A threshold is lowered, or a vague experience is given a crisp name, or a laboratory number is treated as a disease. Awareness activity, often with pharmaceutical funding, teaches the public to notice and to seek treatment. The treated population balloons, and the mildly affected end absorbs most of the growth.
| Example | What is real | Where the boundary widened |
|---|---|---|
| Low testosterone | Genuine clinical deficiency in some men | Normal aging reframed as deficiency |
| Social anxiety disorder | Disabling anxiety at the severe end | Ordinary shyness pulled into diagnosis |
| Prehypertension / prediabetes | Graded future risk | Below-threshold numbers named as near-disease |
| Osteopenia | Real fracture risk in some | Below-average bone density made a treatment target |
| Mild hypercholesterolaemia | Benefit at high cardiovascular risk | Low-risk people made treatment-eligible |
Reading these examples is not a reason to distrust every diagnosis, and it is emphatically not guidance about any reader’s own care. It is a way to recognize the mechanism, which the tactics page sets out in full and the pillar overview ties together with the history of the idea.