Since ancient times, the allure of transformative experiences has motivated travellers to escape from the routines of daily life and take time to retreat to remote destinations, where they can experience mountain air or sun-drenched beaches, bathe in the sea or geothermal waters, and seek out esoteric knowledge, alternative therapies and spiritual enlightenment.

Health and wellness retreats are now a growing segment of the US$563 billion (€518 billion, £442 billion) wellness tourism market, and range from traditional sanitariums where people go to ‘take the cure’ to Ayurvedic Panchakarma detox retreats, yoga retreats, silent Vipassana meditation retreats, fat farms, fitness bootcamps, detox retreats offering fasting, juicing, colonics and other complementary therapies, and exclusive 5-star resorts that combine ancient healing traditions with modern medical technologies and luxury accommodation in exotic locations.

Health and wellness retreats represent the most immersive and premium end of the spa and wellness market and often include a range of medical treatments and practitioner consultations, yet when my PhD student Dhevaksha Naidoo and I reviewed the evidence for the impact of health retreats, we found only limited scientific research exploring their impact.

While we did find some research suggesting health retreat stays assist with chronic diseases such as obesity, heart disease, high blood pressure, multiple sclerosis, cancer, HIV/AIDS, cognitive decline, stress, anxiety and mental health issues, and positively impact metabolic and neurological pathways, telomerase activity and neural functioning, we found virtually no research exploring the type of people who seek out retreat experiences, their main reasons for doing so, or the range of experiences offered at retreats.

We therefore set out to explore the demographics, motivations and experiences of retreat guests in different locations around the world, and with assistance from the Global Wellness Institute and support from key retreat partners, we conducted a global survey of retreat guests in nine languages (English, Portuguese, Chinese, Japanese, German, Russian, Hungarian, Slovak and Czech). The survey attracted more than 3,000 responses, and the results were published in the International Journal of Spa and Wellness in November 2023.

Why retreat?
The most important factors for attending a retreat were relaxation and holiday (29.5%), to improve general health and learn coping mechanisms (18.1%), and to reduce stress and improve mental health (17.9%). Respondents were either recommended to attend the retreat by a friend, family member or colleague (49.7%) or found the retreat online via Google search (36.6%). The majority of respondents attended a retreat less than five hours away (63.8%) and the longest travel time was 45 hours. Most used a car (61.6%) as their primary mode of transport, with about a third (28.7%) travelling by plane. More than half of respondents attended the retreat with a spouse or partner (53.4%) and 22.3% attended alone.

Retreat experiences varied greatly between respondents. Length of stay ranged from 1-50 days, with 7 days being the most common (17.4%), followed by 5 days (15.2%), 4 days (14.0%) and 3 days (12.4%).

Retreat activities
Retreat activities commonly include recreational activities such as swimming, saunas, steam rooms, hot springs/hot pool, gym and nature walks, along with classes on fitness, nutrition, yoga, cooking, meditation, dance/movement, Nordic walking, pilates, personal development, tai chi and group physiotherapy.

Some retreat guests reported seeing health practitioners during their retreat stay, including doctors (21.3%), nutritionists (11.8%), traditional Chinese medicine practitioners/acupuncturists (5.8%), rehabilitation specialists (5.6%), or naturopaths (4.5%).

A catalyst for positive change
While health retreats may employ conventional practitioners and include mainstream therapies, retreat experiences do not readily fit into the conventional medical model. Modern medicine is driven by the pharmaceutical and healthcare industries that aim to treat specific diseases with evidence-based treatments that have been validated in controlled clinical trials. Controlled trials, however, are difficult to perform in retreat settings due to the unique features of each retreat, the personalised nature of retreat programmes and the difficulty in having a legitimate or blinded control group. Retreats are therefore commonly seen merely as an extravagance or luxurious holiday available to those with sufficient time and money to indulge themselves, rather than a serious medical intervention.

Despite limited scientific research, there is no doubt that retreat stays can be a catalyst for powerful positive change. The few scientific studies that have been done suggest that in addition to the impact of specific therapies and programmes undertaken at retreats, retreat stays can lead to lasting benefits with the adoption of positive lifestyle practices and general health improvements. Retreat stays have also been shown to produce a ‘vacation effect’ by providing a break from routine stresses of work and daily life and to provide an opportunity to contemplate what is truly important. Retreats also induce the placebo effect, whereby people feel better because they are doing something they perceive as positive for their health.

Regardless of the mechanisms of action, it is clear that retreat guests can gain considerable relief from serious conditions such as chronic pain, high blood pressure, heart disease, stress and insomnia. Yet, despite bestowing real medical benefits, the vast majority of retreat stays occur outside the established mainstream healthcare system. Thus, very few people are referred to a retreat by their health practitioner or therapist and few retreats provide follow up programmes that engage with their guests’ regular health practitioners. Furthermore, while retreat guests from some countries – such as Germany, Austria, Hungary, Poland, Spain and Russia – do receive health insurance funding or government subsidies for their stay, most retreats are undertaken at the guests’ expense without support from tax incentives, health insurance schemes or third-party payers. It therefore seems that retreat experiences require people to take responsibility for their own health and navigate their own path through the maze of offerings – guided by recommendations from friends, influencers, or the results of online searches – and are driven by consumer demand without referral from, or interaction with, the conventional healthcare system.

Health and wellness retreats encompass a variety of different philosophies, activities and treatment modalities, yet most have the aim of exposing people to the experience of being well. Such experiences have the potential to reduce the global burden of lifestyle-related disease by providing relief from chronic conditions and promoting lifestyle practices that lead to lasting improvements in health and wellbeing.