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Diana Baroni
Seeking the Latest Health Issues
Warner Books editor Diana Baroni believes that readers are seeking not only books about general health issues but are looking for accurate information on specific diseases and ailments. They're no longer hesitant, she says, about turning to natural remedies or alternative medicine to solve their problems.
While Warner is "definitely open to publishing books on alternative topics -- about natural supplements and herbs that help alleviate major health concerns -- we're very selective, given the number of titles already out there." She cites two books that reflect this philosophy: The SAM-E Solution by Deborah Mitchell (Oct.), which deals with the popular natural antidepressant, and Dr. R. Paul St. Amand and Claudia Craig Marek's What Your Doctor May Not Tell You About Fibromyalgia (Dec.).
Although, after Bob Dole's TV ads for Viagra, it's hard to imagine a medical issue that might still be "forbidden" in polite circles, Baroni believes that it's still difficult to break out a title on some of these formerly taboo subjects. Sometimes, she tells PW, "You find success is not in a book's frontlist life but as a backlist title." When the publisher brought out Dr. John R. Lee's What Your Doctor May Not Tell You About Menopause in 1996, booksellers were very hesitant about the topic; the advance was 8000 copies. Today, it's one of Warner's bestselling trade paperback titles, with more than 670,000 copies in print. Baroni credits the success to Dr. Lee's tireless promotional efforts and "positive word-of-mouth," adding that "the program has helped thousands of women."
Times are certainly changing when it comes to talking about women and breast cancer -- Bosom Buddies (Oct.) by talk-show host Rosie O'Donnell and Dr. Deborah Axelrod had no trouble finding immediate success. Appearances on Today and Larry King Live plus an excerpt in Good Housekeeping sent the book back to press four times earlier this month. In June, Warner made a successful foray into the lucrative boomer market with Dr. Isadore Rosenfeld's Live Now Age Later, about slowing down the aging process. "Boomers," says Baroni with a laugh, "are looking not only to solve their health problems, they're looking to avoid them altogether."
As for the future, Baroni sees the Internet as key to success in this category. "So many people turn to the Net for up-to-date information on health issues. Making them associate your book with that issue will be important. The only drawback is figuring out what the key sites are -- there's so much out there." She also looks for "newer health issues to surface -- ones that affect a large number of people but have not yet been covered. New issues are constantly arising -- it's projecting what they will be that's the key."
-- Lucinda Dyer
Brian Carnahan
Patients Are Becoming More Proactive
The biggest challenge for Rodale these days, says Brian Carnahan, publisher of the company's Healthy Living Books, is staying ahead of the customer. "Consumers are a lot more savvy than they were five or 10 years ago," he explains. "There are so many resources now, what with the Internet, magazines and books -- we want to keep leading them, keep giving them information that's new and fresh."
The Net in particular will affect the way business is done in this category, according to Carnahan. "The days of the generic reference manual are numbered -- 10 years ago, information wasn't available unless I bought a book; now it's at my fingertips. It's incredible."
With this in mind, Rodale is sharpening the focus of forthcoming releases in its Doctors Book series, which began in 1990 with The Doctors Book of Home Remedies, which currently has more than 13 million copies in print. "Traditionally, these have been larger, encyclopedic books," says Carnahan, "but in response to these trends, we're going to launch smaller books on single subjects." The Doctors Book of Home Remedies for Colds and Flu is poised to kick off the newly repositioned series in February and will be followed by others in the spring. Rodale also launched a new imprint this fall: Rodale Reach debuted with The Fitness Instinct (Oct.) by Peg Jordan, founder of American Fitness magazine, and Dr. Duke's Essential Herbs (Nov.) by The Green Pharmacy author Dr. James. A. Duke. According to Carnahan, "We're looking for authors on the cutting edge, who bring a unique point of view to consumers with regard to health and fitness."
He foresees a major sea change ahead, as increasingly well-informed consumers are "taking charge of their relationships with their doctors" and pushing for more integrative health care. "Mainstream medical doctors are starting to embrace alternative techniques," he says. "It's a grassroots movement. It's not coming from medical schools or research or universities, it's coming from patients who are going in and asking, 'What supplements should I be on?' or 'Will acupuncture work for my lower-back pain?' " Pointing to the forthcoming Blended Medicine (Feb. 2000), which combines natural, alternative and mainstream medicine, he notes that when author Michael Castleman began writing the book, "There were maybe a dozen integrative clinics -- now there are close to 100."
On the diet front, "We're waiting for the low-carb backlash," Carnahan tells PW, adding that he's been "blown away" by the recent media coverage, including 20/20, Dateline and Oprah. "We're not the biggest proponents of low-carbohydrate diets," he remarks, "and have taken the stand in the past that they can be unhealthy. They're very hard to stay on, and you gain the weight right back once you go off them."
Rodale is going to continue to "t the line" in this area, Carnahan adds, with a nod to the forthcoming Dr. Shapiro's Picture Perfect Weight Loss (May 2000) by Dr. Howard M. Shapiro. "Our line has always been that diets don't work -- it's really about lifestyle, about the way you eat and how you exercise and the choices you make. That's the path itself."
-- Heather Vogel Frederick
Jen Haller
Diet Books: A Battle of the Personalities
When Jen Haller looks at the health and diet category these days, one of the biggest blips she sees on the radar screen is the Internet. "What's interesting is that it's not necessarily Net bookselling that's impacting us," she explains. "It's the Net itself, and the tremendously broad access to information that it offers."
Haller, who is director of book purchasing for the Cincinnati-based Joseph Beth Group (whose stores include Davis-Kidd Booksellers), says she's seeing sales drop in "1000-page reference volumes," a trend she attributes to the fact that the information in these kinds of books is "all available on the Internet." As another example of how the Net is affecting business in this category, Haller cites "our bestselling title this year -- Michael Roizen's Real Age [HarperCollins/Cliff Street], which ties in to his Web site."
Also doing well are the numerous books targeting the aging boomers, who Haller believes are sure to be a force for years to come. Titles such as Dr. Isadore Rosenfeld's Live Now Age Later (Warner) and books about back pain, arthritis and yoga are selling like hotcakes, she says. Titles that are "hybrids between psychology and health" are a subcategory that Haller notes is picking up. While such a book may still be text-heavy, she notes, "There's a story in it -- it's not just a reference book." In fact, as this element of "story" or "voice" has gained importance, Heller has seen a corollary effect. "It's really the author's personality that moves these books," she explains, "especially as something like Oprah's show has become a venue to sell books and ideas. It kicks it up a notch for authors in this category, who now have to be promoters as well."
Heller is intrigued with this trend, which she notes is currently highlighted by the reigning heavyweight champ in the diet arena -- "the whole idea of protein dieting" -- which she calls "our biggest thing right now" in terms of sales. With books such as Sugar Busters! by H. Leighton Steward et al., Dr. Atkins' New Diet Revolution and Rachael and Richard Heller's The Carbohydrate Addict's Diet flourishing, she adds, "it's becoming a battle of the personalities."
The books "are selling well -- they've gotten glorious press -- but meanwhile you have a number of doctors coming out and saying this approach is completely unhealthy and unsubstantiated. It's become a war of ideas and personalities, but a media-driven war."
As far as what the next flavor-of-the-month on the diet front will be, "It's really hard to tell -- you just never know, this stuff comes out of nowhere."
-- Heather Vogel Frederick
Megan Newman
The Authorial Voice Is Critical
When it comes to emerging trends in the health category, says Megan Newman, editorial director of HarperCollins's newly formed HarperResource division, "I could point to any of a zillion things that have to do with aging baby boomers."
In the area of diet and fitness, "Everyone's trying to find the next Tae-Bo," and low-carbohydrate diets are hot, too, of course, fueled in large part by Oprah's current interest in them and the appearances on her show of authors Rachael and Richard Heller (The Carbohydrate Addict's Diet, Signet). "That unleashed a flood of proposals," Newman reports. "Everyone's trying to capitalize on it."
Subject matter aside, Newman zer s in on what she considers to be one of the most significant changes in the category of late: the element of voice. "As author-driven health books become more and more important, I think we're probably going to be stepping back from the university tome-type omnibus health book," she says. "Consumers are craving more guidance, and the author as prophet or messiah is going to become more important. People want someone to take them by the hand and say, 'This is what you need to try.' "
She points to the success of Dr. Dean Edell, the host of a nationally syndicated daily radio show, whose Eat, Drink & Be Merry: America's Doctor Tells You Why the Health Experts Are Wrong was released last May and has done "extremely well" in hardcover, with close to 100,000 copies in print (a paperback edition is due in the spring). According to Newman, "He's a very funny guy, persuaded by good science, and he presents a point of view on health information, not just 'one survey says this, and another one says that.' He preaches this gospel every day on the radio, which of course has worked very well in our favor."
Newman also considers the information explosion on the Internet to be significant, though not without reservations. "As the Net becomes more of a shopping mall and an advertorial, the question becomes 'How do I trust the information here, how do I know it's not just a show to get me to buy something?' " For promotion and marketing purposes, however, she is a wholehearted fan. "It's a great way to jump-start a book -- we love being able to tie in to an author's Web site and maximize his or her exposure." She cites Burn Rate: The Individualized Cyberdiet (Nov. 2000), which will tie in with author Dr. Stephen Van Schoyck's Web site (www.burn-ratediet.com), "where you can figure out your own metabolic rate and come up with a program that suits your particular metabolic profile." This kind of marketing, Newman notes, is "very personalized. It's not one size fits all. You can really tailor things, using the book as a guidepost."
-- Heather Vogel Frederick
John Duff
Health Titles Are Becoming Less Fringy
The health arena is definitely a good place to be, says John Duff, newly installed publisher at Avery. The long-standing health publishing group was acquired in September by Penguin Putnam, which will continue the line as an imprint. Avery has had great success in the field of health and alternative medicine; its powerhouse title Prescription for Nutritional Healing (1990) hit the five-million-copy mark this year.
According to Duff, "All publishers of whatever size are dabbling in this field because they recognize the trend in the market. Even mainstream traditionalists are introducing books on alternative therapies and complementary medicine because they see they won't otherwise have a market. This is the way consumers are thinking."
Avery has excelled in cultivating sales in health-food stores, drugstores and other nontraditional retailers, drawing on consumers with a displayed interest in health products and new kinds of cures. Under the new ownership, Avery titles will get increased distribution through traditional book markets, while Penguin Putnam titles will gain access to health-food and alternative markets. Duff remarks, "We're going to learn a lot from what Avery did in terms of reaching the consumer via nontraditional retailers."
"Like the consumer market for food and nutrients, the market for books about alternative and complementary medicine has exploded," he adds. "People walk into a health-food store and think, Now what do I do? We'll increasingly publish books to help consumers make choices about trends and products, to help them with the supplement drug or trend of the moment."
Duff points to an increasingly sophisticated and demanding market: "Consumers want more detailed and reliable information to help them make sense of available products." This is true, he notes, at both ends of the spectrum, alternative and traditional approaches. "There's so much to choose from. Neutraceuticals and other alternatives to traditional medicine have long been held suspect by the mainstream, but the gap is closing. As M.D.s accept alternative therapies and integrate them into their practices, books will reflect that. There will be endorsements from all sources, including M.D.s. The books won't seem so fringy."
Duff expects that Avery will go after disease-specific special-interest groups, and he anticipates that the Internet will continue to be influential in the health area. "It provides a safe and easy way for consumers to get information about touchy or embarrassing topics, such as sexual dysfunction, irritable bowel syndrome or any other 'subject X' that people are still reluctant to talk about. There's no interface, no clerks; it will be the 21st-century version of buying books on sex."
-- Suzanne Mantell
Erica Jorgensen
Sees Several Untapped Category Markets
Erica Jorgensen, editor of health, mind and body books at Amazon.com, says the number of health titles has increased feverishly over the past four years, along with health book sales, with the reach and diversity of subjects expanding further and further into alternative medicine.
"A book like [Dr.] Christiane Northrup's Women's Bodies, Women's Wisdom would have been laughed at 10 years ago as too fringy, with too many herbs, too much intuition, too much empowering of the patient," she points out. "Now, it's one of Amazon's top 10 sellers." Similarly, she notes that The American Pharmaceutical Association Practical Guide to Natural Medicines (Morrow), a herbal reference book by Andrea Peirce with an introduction by Dr. Andrew T. Weil, and Alternative Medicine for Dummies (IDG) by Dr. James Dillard and Terra Ziporyn are other titles selling well that wouldn't have five years ago. "The scope of things is changing," she adds. "People are taking health into their own hands." She credits HMO's for forcing this situation, as well as insurance companies that are now covering alternative therapies and the megaselling Weil, who is "really onto something" with his blend of traditional and alternative approaches.
Also, she notes, "People are leery of prescription medicines and giant organizations like the AMA and the FDA -- brand recognition is not important anymore. People are less inclined to trust monstrous organizations; they're perceived as insiders' clubs."
These forces together give a loud message to consumers: health-care advice should be taken with a grain of salt. As Jorgensen puts it, "When someone tells you what you should do, you can explore your options. People are getting smarter about this. They don't get time from doctors -- the average office visit is down to five minutes -- so they're turning to books for help. Also, they realize that online help isn't necessarily to be trusted -- there are too many squirrelly Web sites. People put more credence in books."
Jorgensen expects the health category to explode in the next five to 10 years, with boomers looking to fight the effects of aging, deal with their aging parents, combat marital health, depression and their own changing bodies. "Older people are underserved," she continues. She'd like to see large-print books: "A book on macular degeneration should definitely be printed in large type."
Moreover, hardcovers are hard to hold for people with arthritis, a growing market. "Books could be split into two mini-books that are easier to handle. It's overwhelming to go into a bookstore or search online for a title. Book shopping should be easier. There should be stores that cater to this market." For the increasing number of older consumers, Jorgensen would like to see Amazon.com.aging.
Men are still an untapped market, she adds. "It takes a lot for men to go to the doctor or buy a book on health. They aren't finding the books they want. Books on men's issues like Viagra are cheesy, insulting, dumbed-down. Most books for men seem pitched at 30-year-olds. For those over 40, the only books are on prostate cancer, and by then it's too late. There's a gaping hole in the market, and a growth opportunity [for publishers] with the right approach."
-- Suzanne Mantell
Ehud Sperling
From the Fringe to the Mainstream
For a quarter of a century, Inner Traditions has been at the forefront of publishing titles that often fall into the alternative-health category. As that movement maintains its hold on America's consciousness, so will the titles being produced on the topic, by Inner Traditions and everyone else, says company president Ehud Sperling. He notes, however, that there is a difference between 1999 and the days when the company started. "When we started publishing in this field, we were fringe," Sperling explains. "Now, its a major, major trend."
He believes that in the next few years, Americans will continue to seek more and more alternatives to Western medical practices, and there will be no dearth of titles to help them in that quest. Next year, Inner Traditions will be contributing books on alternatives to Western cancer treatments, antibiotics and addiction: Kenny Ausubel's When Healing Becomes a Crime: The Amazing Story of the Suppression of the Hoxsey Treatment and the Rise of Alternative Cancer Therapies (Apr.), Cindy L.A. Jones's The Antibiotic Alternative: The Natural Guide to Fighting Infection and Maintaining a Healthy Immune System (Aug.) and Brigitte Mars's Addiction Free: Naturally Liberating Yourself from Tobacco, Caffeine, Sugar, Alcohol, Prescription Drugs, Cocaine and Narcotics (Aug.).
"People need to have the ability to take charge of their own health," Sperling tells PW, adding that the days of "worshiping at the church of progress" are over and the alternatives are the solution to health-care problems. He sees books as taking the place of the social networks and close familial ties that once were responsible for passing on vital information from generation to generation. And that will only continue in the future, he predicts. To help fill the gap, Carista Luminare-Rosen has authored Parenting Begins Before Conception: A Guide to Preparing Body, Mind and Spirit for You and Your Future Child (May 2000).
One issue, already hot in Europe, will soon be big in American health publishing, Sperling predicts. He's speaking of the backlash against genetically engineered food, which has been banned by the European Union but its widespread in the United States. "This is a pernicious and very dangerous technology," he reports. "Here in America, no one has any idea. One of the most important things we can do as a society is watch our food supply." According to Sperling, last month's Genetically Engineered Food: Changing the Nature of Nature by Martin Teitel is "the most important book we have ever published."
-- Michael Kress
Linda L wenthal
Category Lines Are Beginning to Blur
"Decreasing differentiation" -- that is the trend to watch in the diet and health category, according to the editorial director of Harmony and Three Rivers, Linda L wenthal. She means that alternative health and Western medical categories are blending together, while diet and nutrition are becoming one concept. This trend, she believes, is already apparent and will escalate in the coming years. Alternative and Western medicine "are two categories now on Barnes & Noble bookshelves," she says, "but within two years, they won't be any longer. It's increasingly difficult to differentiate between the two."
As an example, she cites Robert J. Hedaya's forthcoming The Antidepressant Survival Program (Crown, Feb. 2000). "Alternative remedies are included, even though that's certainly not the book's focus," she explains. L wenthal also sees decreasing differentiation evident in the fields of diet and nutrition. "Increasingly, diet books are going to be interested in total health: low weight equals good health, but don't lose weight at the expense of the diet." L wenthal also points to The Three Season Diet: Solving the Mysteries of Food Cravings, Weight Loss and Exercise (Harmony, Apr. 2000), in which author John Douillard argues that people must eat differently in each of the year's three nutritional seasons. Winter calls for a high-protein diet, spring is the time for low-fat foods and summer, when people are most active, calls for lots of carbohydrates. "If you eat with the season, you will lose weight naturally," L wenthal summarizes Douillard's message.
As the boomer generation ages, health will only pick up steam as a category, L wenthal predicts. Although, as always, aging will be among the bestselling topics, not all titles on the subject will sell well. According to L wenthal, "Books about getting older gracefully will never be popular. Those that say you don't have to get older will be popular." And even as fewer and fewer subjects are off limits these days in mass media, other formerly taboo topics, such as sexual dysfunction and breast cancer, will remain unsuccessful in the publishing world. While considerable discussion centers on these topics, in L wenthal's view, they will never be big book sellers. On the other hand, she adds, technological advances in the field of genetics should lead to many strong-selling titles on that subject.
The Internet, which seems to be changing everything about everything in American society, is making an impact on the health category as well. It's one of the biggest topics on Web sites and in chat rooms, L wenthal comments. "One person can reach hundreds of people with one e-mail or in a chat room" -- a factor, she says, that helps drive book sales in a category that relies heavily on word of mouth. The medium also allows for an increasingly important marketing technique, cross-merchandising books with other health products. With so many titles and so many products available, L wenthal tells PW, these partnerships lend credibility to each and will impact sales.
-- Michael Kress
Terri Thomas
Faces Sensitive Customer Issues in Her Bookstore
Located in downtown Washington, D.C., the Health-Source Bookstore serves an extremely diverse group of customers that range from devotees of aromatherapy and homeopathy to residents from local hospitals in the city. Manager Terri Thomas likes to say that the store represents "a source for medicine and wellness." Its 35,000 titles include a wide-ranging selection of books on alternative medicine as well as textbooks and reference works for M.D.s, R.N.s and other health-care professionals. This specialized reference section, says Thomas, also serves consumers who suffer from serious chronic health problems and are looking for in-depth information; it also serves patients armed with a list of suggested textbooks provided by their physicians.
In business for five years, the store, reports Thomas, now buys "fewer beginner titles. Instead of a basic book about herbs, our customers are looking for something specific on Chinese or Native American herbs. They want good quality, well-researched books on specific disorders and problems. Large manuals on disease don't do you much good if all you're interested in is diabetes."
Current bestselling categories for HealthSource are herbal remedies, body work and Feng Shui. Dr. Michael R. Eades's Protein Power and Dr. Robert C. Atkins's Dr. Atkins' New Diet Revolution are topping the store's bestsellers list this month -- "thanks to Oprah," Thomas adds. She sees very little customer interest, however, in "personal memoirs of a medical problem or illness -- unless it's someone like Christopher Reeve." The store also carries a small section of novels -- medical thrillers and fiction by such authors as Michael Palmer and Patricia Cornwell.
Because HealthSource has always stocked titles on a wide variety of socially sensitive medical issues, a primary concern for the staff is dealing sensitively with customers looking for information on medical problems they may not have shared even with close friends or family members. "The stigmas about certain health-care issues," Thomas tells PW, "have made it difficult for people to get the information they need."
With that in mind, the sales staff avidly welcomes everyone to the store but will approach a customer only if he or she seems to be in need of assistance. "We will never," the store manager emphasizes, "ask, ˜What's your problem?' -- just, ˜May I help you find something?' "
The staff is also careful never to answer specific questions about treatment or diagnosis. When calling a customer to let him or her know that a special order has arrived, the staff will say, "Your book has arrived," rather than mentioning a specific title. "Keeping confidences is important," notes Thomas, who found special prosecutor Kenneth Starr's subp na of a D.C. bookseller's sales records "very frightening for a store like mine."
Thomas sees the future of "medicine and wellness" continuing to expand. "Boomers want to learn how to take care of themselves, keep health-care costs down and learn how to talk effectively to their doctors. Now," she concludes with a laugh, "if I could only find out what the hot new nutritional supplement will be for next year."
-- Lucinda Dyer
Charles Nurnberg
Alternative Healing Titles May Become Overpublished
For Charles Nurnberg, executive v-p of Sterling Publishing, the future is in the mind, not the body. "Over the last year, we've been converting to the mind cure, moving more into the mental area rather than the physical. We're being very careful in what we publish -- more books that show how to live with the stress of life, that concentrate on positive mind issues."
Among the nontraditional health titles that reflect this view are two Sterling titles published last month. Nurnberg calls Timothy Freke's Zen Made Easy a "gentle nudge" toward understanding the benefits of mediation in a healthy lifestyle, and he dubs Pam Spurr (Understanding Your Child's Dreams) "just the right author" to guide parents in using their children's dreams as a positive source of creative, social and intellectual development.
Nurnberg cites the success of "looking-inside-yourself movies like American Beauty" as reflecting a wide-ranging public interest in the mind-body connection -- proof that "it's no longer just people in Northern California or New York City who are interested." But his positive attitude toward the power of the mind d s have its limits: "I still to this day would not publish a book about curing cancer with your mind."
Sterling is also taking a continuing and active interest in some of the more traditional areas of alternative medicine -- including massage therapy, homeopathy, aromatherapy and foods (or lack of) that heal both mind and body. Vicki Edgson and Ian Marber's The Food Doctor (Nov.) features foods that increase memory, enhance the ability to sleep and encourage relaxation. Healthy Fasting by Margot Hellmiss and Dr. Norbert Kriegisch (Feb. 2000) not only explores the philosophical side of fasting but includes recipes that guarantee the fastee gets the the proper amount of nutrition.
On a more cerebral/earthly/profit-based level, Nurnberg is very positive about the future of original trade paperbacks and their lower price points. In August, Nurnberg published The Illustrated Encyclopedia of Well Being by Drs. Julian Jessel-Kenyon and C. Norman Shealey as a hardcover; while it "sold well institutionally and solidly in the trade," Nurnberg anticipates that February's trade paper edition "will be a perennial backlist. The advance is very substantial, exceeding the hardcover sale."
Still, questions remain. Can the boom in alternative healing books continue into the new century? The category, cautions Nurnberg, may be in danger of being overpublished. "There is so much out there -- the big book of alternative healing, the little book of alternative healing -- you had better be publishing a better book and not just relying on 'me too' publishing." Nurnberg sees nontraditional therapies that have been widely used for generations, such as Chinese food cures, continuing to sell steadily in the coming years, while fads such as melatonin will continue to quickly fade.
As for what's next in the ever-changing market for alternative health titles, Nurnberg feels that "if there's a trend left, it will probably be one that's already been around for a thousand years that we are just now 'discovering.' "
-- Lucinda Dyer
