PraMa Wellness and Spa at Four Seasons Landaa Giraavaru

I’m sitting under a thatch-roofed pavilion on a private island in the Maldives as a soft-spoken Indian doctor holds my wrist, silently taking my pulse. He’s not timing beats per minute. He’s feeling for something deeper: patterns of energy, elemental imbalances, insights hidden in the rhythm beneath the skin.

This is not what I usually do on vacation.

I’ve come to the Four Seasons Landaa Giraavaru to try PraMa, the resort’s new integrative wellness program. Designed to blend Eastern philosophies with Western diagnostic tools, PraMa offers a full-body workup that includes everything from Ayurvedic pulse readings and posture tests to high-tech biomarker scans and mineral level checks. The idea is to take a snapshot of your health from multiple, and multicultural, angles, and then send you home with a plan to feel better, move better, and maybe even live longer.

As someone who considers himself a New Age skeptic—I roll my eyes aggressively at horoscopes and don’t know or care what a chakra is—I wasn’t exactly the obvious candidate. But at 55, with a widening list of minor but chronic issues and a creeping sense that I could be doing more for my health, I was curious. I also knew that if I was going to spend a week being probed, prodded, and scanned, I’d prefer to do it between snorkeling trips and coconut-oil massages.

I’m in decent shape for my age. I work out regularly, practice hot yoga, eat my vegetables, and do my best to limit red meat and alcohol. (My Dry January evolved into a semi-moist spring and summer). I still have most of my hair. I could stand to lose another five pounds. Okay, seven. My husband and I joke that we’re “straight skinny but gay fat”—pretty fit for general society but definitely not ripped enough to peacock down the beach on Fire Island.

Beneath the surface, though, are lingering issues. Persistent lower back pain, despite two surgeries to relieve a herniated disc a few years ago—blame an unathletic youth and an adulthood spent hunched over a computer. More significantly, persistently high cholesterol and a worryingly elevated coronary calcium score, a measure of plaque in the arteries that puts me at high risk for a cardiac event. Fortunately, my cardiologist is Dr. Arthur Agatston—the guy who invented that score, not to mention the South Beach Diet—and he has me on a strict regimen of cholesterol-fighting drugs and supplements. At every checkup, he assures me I’m going to live a long life.

Still, there’s that inner voice asking, What else can I be doing?

Four Seasons Landaa Giraavaru ticks the boxes of a Maldivian paradise: lavish bungalows lining a powder-white beach or perched over lapis-bright water; cuisine that’s abundant and impeccably prepared; a marine biology center complete with holograms. But this isn’t just a dreamy barefoot escape—it’s also quietly becoming a hub of serious wellness. Under the guidance of regional GM Armando Kraenzlin, who credits PraMa with curing his frozen shoulder and improving his diet, the resort has embraced a more clinical approach to holistic health. Guests can have a yoga therapy session to address their arthritis or diabetes, or have an Ayurvedic doctor prescribe a detoxifying diet. You can still get a warm poultice massage in a tranquil overwater pavilion, but it comes with the option of a full diagnostic breakdown and a long-term care plan.

This mirrors a larger trend in luxury travel. Increasingly, the world’s most elite resorts are offering more than indulgence—they’re offering science-based transformation. And while I’m not one to chase enlightenment, I liked the idea of tempering the typical vacation indulgence and guilt with a touch of introspection and recalibration. A dash of salt in the rum punch, if you will.

The naturopathic assessment started with questions. How do I sleep? What and when do I typically eat? How do I handle stress? (Stressfully.) How much water do I drink? Am I able to disconnect from work at the end of the day? 

Then came the diagnostics.

The tongue scan and iris scan—both purported to identify chronic conditions—raised my skeptic’s hackles. But then things got more concrete. A physical exam evaluated my posture and mobility using a 3D body scanner, followed by a series of squats, lunges, and other exercises to test my flexibility and balance. Later, I sat in a small, sunlit bungalow over the water, electrodes attached to my forehead and feet, while a machine measured 49 biomarkers—everything from serotonin and dopamine to thyroid function, inflammation, and insulin resistance. A device placed on my palm tallied up the amount of minerals coursing through my body; apparently I’m long on mercury. (Admittedly I’ve never met a tuna sandwich I didn’t like, but yikes!)

The most unexpectedly profound part was the Ayurvedic consultation with Dr. Nikhil, who holds a Bachelor of Ayurvedic Medicine and Surgery from Rajiv Gandhi University in Bangalore. Using centuries-old principles rooted in the five elements (space, air, fire, water, earth), he determined that I’m Pitta dominant with a Vata secondary—a fiery, focused, sometimes irritable constitution prone to high cholesterol and acid reflux.

Which, unsettlingly, is correct.

I hadn’t told anyone here about my cholesterol or occasional esophagitis, and they hadn’t done any bloodwork or other invasive tests. And yet, after just a few questions and a pulse reading, Dr. Nikhil is rattling off a list of eerily accurate traits: I get hangry. I sweat easily. I focus intensely. I snore. I often wake up stiff. I stress-eat. I tolerate spicy foods and coffee well. I don’t need to be reminded to hydrate.

It’s uncanny—and strangely moving. I feel seen. Or rather, I feel like someone has taken a particularly revealing X-ray of my body and my personality. It’s the first time in a while I’ve paused to consider both my internal functioning and my emotional health in one coherent narrative.

In between appointments, I swam, snorkeled, and wandered through palm-shaded pathways. At Four Seasons Kuda Huraa—Landaa Giraavaru’s sister property, where I spent the first few nights of the trip—I stepped into an open-air pavilion for a Healing Waters massage, where I reclined on pads filled with warm water, then let the therapist slither her arms and hands beneath my body (relaxing but weird, like being embraced by a friendly squid). I took an anti-gravity yoga class on suspended hammocks (fun) and tried a surfing lesson (challenging). I lay in a “Healing Tent” for a session combining Reiki and sound healing (boring). 

At Landaa Giraavaru, I underwent an “Align With the Earth” ritual, which began with me sitting naked over a bowl filled with smoldering frankincense—yes, smoke literally blowing up my ass—and ended with a fragrant, supremely relaxing massage. But by that point I was fully bought in. 

At both properties, I ate grilled reef fish and drank immunity-boosting tonics… plus my share of cocktails and dessert. But none of the wellness efforts felt performative. In fact, the contrast between indulgence and insight—the back-and-forth between barefoot bliss and high-tech biometric readouts—felt like the whole point.

The experience concluded with a presentation of the PraMa team’s findings, essentially that I’m in quite good health for my age, aside from a handful of cardiovascular red flags and some digestive inflammation—a profile confirmed by both the Western scientific readings and the Ayurvedic assessment they’d performed, as well as by my own doctors at home. They armed me with a packet of recommendations, including a daily routine of yoga, stretching, and breathing; a few supplements to address high cholesterol and other issues; and a list of foods to embrace and avoid (bye bye, tomatoes and shrimp).

Back home a few weeks later, I logged into a virtual follow-up consultation to review my progress. The team reiterated my results and gently encouraged me to stay on track. I also shared their feedback with Dr. Agatston, who found the conclusions perceptive and the integration of Eastern ideas interesting—if not quite FDA-approved.

I still don’t know what my star sign says about me. But I now know that my dosha is Pitta-Vata, and therefore it’s just my nature to sweat a lot, crave French fries, get irritated easily, and snore (sorry, honey). I’ve let some of the PraMa recommendations slide—not quite ready to give up ice cream—but I’ve been taking a multivitamin with selenium to counteract the mercury in my blood. I’m working with my trainer on improving my balance and posture. I’ve started taking spin classes again, for the benefits to my heart and waistline, and just because it feels so damn good. 

And when I do my prescribed yoga routine each morning—the one the PraMa team tailored to my body and habits—I picture myself back on that island: sun-warmed wood beneath my feet, the astonishing blue water just beyond the pavilion, and a quiet feeling that, in a sense, the vacation hasn’t ended.