Research Series · Edition 1
The AI Recommendation Market Structure Report
Edition 1 · Health and Wellness, 2026
Introduces the ARDI Market Structure Framework. Applies the framework across five health and wellness categories, 17,529 AI conversations, 6 leading large language models, and up to 38 U.S. geographic panels.
AI visibility tools tell you if you won. GOSH AI tells you how to win.
Contents
- Executive Summary
- The ARDI Market Structure Framework
- Pilates Studios · Default-Dominant
- Massage and Wellness Studios · Oligopoly
- Med Spas · Local Fragmentation
- Chiropractors · National Recognition with Local Leakage
- Nutritionists and Dietitians · Institutional Authority
- Cross-Category Synthesis
- Executive Implications
- Methodology and What ARDI Measures
- About GOSH AI
01 · Executive Summary
Five categories, five structurally distinct AI recommendation marketplaces.
When buyers ask an AI system for the best Pilates studio near them, a med spa in Tampa, or a chiropractor in Dallas, AI does not return a neutral list of options. It makes a recommendation. Those recommendations are already creating winners, defaults, substitutes, and invisible brands inside local markets, before any buyer visits a website. This report measures how that recommendation layer behaves across five health and wellness categories and 17,529 AI conversations. The finding is that AI recommendation markets have structure: identifiable, measurable, and category-dependent. The same recommendation layer produces five fundamentally different competitive realities depending on which category is being measured. Brands competing in these categories face different strategic realities, and the same competitive playbook does not work across all of them. This report introduces the ARDI Market Structure Framework, a category-level classification model for understanding how AI recommendation markets form, consolidate, fragment, and defer to authority. Each of the five categories measured here illustrates one of the five structures the framework defines.
Five observations stand out as cross-category headlines
One. The AI recommendation default exists on a spectrum, not as a binary state. Pilates Studios sits at one extreme. Club Pilates holds 57.6% recommendation share and wins the AI default position in 94.7% of measured markets. Med Spas sits at the opposite extreme. The leading brand holds 3.4% share and wins the AI default in zero markets, because every measured market has a different local champion. Massage and Wellness Studios and Chiropractors sit between these poles, with national leaders earning approximately 22% share but converting that to per-market dominance in only 25% to 44% of measured markets.
Two. National recommendation share and per-market geographic dominance are related but distinct measurements. A brand can hold strong national share without winning the AI default in most of its markets. The Joint Chiropractic and Massage Envy hold nearly identical national share (around 22%) but differ sharply in geographic conversion (25% versus 44% of markets respectively). National AI brand recognition is one strategic asset. Per-market AI default position is a separate strategic asset. Brands cannot assume the first produces the second.
Three. Local brand survival is inversely correlated with category consolidation. In Pilates Studios only 5% of measured markets are won by a non-Club-Pilates brand. In Massage and Wellness 22% of markets go to local independents or regional chains. In Chiropractors 75% of markets go to local independents. In Med Spas 100% of markets go to local independents. The categories where national chains dominate are the categories where local operators have effectively been excluded from the AI default conversation. The categories where local operators thrive are the categories where no national chain has been able to convert recognition into per-market dominance.
Four. AI always reaches for adjacent and substitute operators when it cannot fill its specialty answer with specialty brands. In Pilates Studios, general fitness chains collectively earn 8.7% of the recommendation surface. In Massage and Wellness, luxury hotel spas earn 5.1%. In Med Spas, dermatology practices and aesthetic surgery offices earn approximately 3%. In Chiropractors, integrated health systems and multispecialty medical groups earn 6.5%. AI's behavior is consistent across categories: when it cannot complete a recommendation list with dedicated specialty brands, it expands the answer to include the nearest adjacent category. Brands in any of these categories that ignore this substitution effect ignore a measurable share of their own competitive surface.
Five. Institutional authority can be a more durable AI default than commercial brand recognition. In Nutritionists and Dietitians, hospital systems and academic medical centers collectively earn more than 25% of the recommendation surface, dominating the dedicated private-practice layer. AI treats institutional medical authority as durably trustworthy across the full model panel. This is a category-specific phenomenon. In categories where AI defaults to institutional authority, commercial brands face a harder competitive surface than in categories where AI defaults to commercial brand recognition.
The AI recommendation layer is not optional and not uniform. It produces measurable, category-specific winners and losers in front of buyers who are making real purchasing decisions before they ever visit a website. Brands that measure their position in this layer can act on it. Brands that do not, cannot.
02 · The ARDI Market Structure Framework
Five structures define how AI recommendations behave by category.
AI recommendation markets have structure. They are not random, and they are not uniform. The ARDI Market Structure Framework defines five competitive shapes that the AI recommendation layer produces across commercial categories. Each of the five health and wellness categories measured in this report illustrates one of these five structures. The framework is the lens. The categories are the evidence.
The five structures
1. Default-Dominant Market
One brand becomes AI's default answer across nearly every model and nearly every geography. National recommendation share is high (50%+ at the top). Per-market dominance approaches universal (90%+ of measured geos). Competitors face a structural disadvantage that does not get closed by national brand-building alone. The AI's "first answer" position is the strategic prize, and one brand owns it.
In this report: Pilates Studios.
2. Oligopoly Market
A small set of brands (typically three) controls the recommendation layer, but no single brand owns it. National share is meaningful at the top (around 20%) but cluster-shaped rather than monopoly-shaped. Per-market dominance is split between the top brands plus regional and local operators. The competitive prize is one of the top oligopoly slots, and local independents have meaningful survival space.
In this report: Massage and Wellness Studios.
3. National Recognition with Local Leakage Market
A national brand wins aggregate recommendation share (around 20%+) but converts that share into per-market #1 in only a minority of measured geographies. Cross-model consensus on the national leader is high. Per-market AI default position is open in 50% to 75% of markets, where local independents win. The strategic gap is between national recognition and local AI default, and closing it requires market-by-market work.
In this report: Chiropractors.
4. Local Fragmentation Market
No national default exists. The leading brand earns a low single-digit share. Every measured market surfaces a different local champion as the AI's #1 recommendation. Cross-model consensus is weak. The AI's "best [category]" answer is built market by market from local citation surface, content authority, and third-party validation. Market-level AI dominance is achievable for any single-location or small-chain operator.
In this report: Med Spas.
5. Institutional Authority Market
AI defers to institutional providers (hospital systems, academic medical centers, insurance pathways, regulated bodies) over commercial brands. Commercial specialty brands earn limited share even when present and credible. Cross-model consensus on institutional providers is high. The competitive surface is structurally harder for commercial brands than in any other structure, because the AI default itself is non-commercial.
In this report: Nutritionists and Dietitians.
The five structures applied to the five categories
| Category | Market Structure | Why this category fits the structure |
|---|---|---|
| Pilates Studios | Default-Dominant Market | One brand at 57.6% share, #1 in 36 of 38 geos |
| Massage and Wellness Studios | Oligopoly Market | Three chains at 11% to 22% share, no single brand owns the category |
| Chiropractors | National Recognition with Local Leakage Market | Top brand at 23% national share but wins only 25% of markets locally |
| Med Spas | Local Fragmentation Market | Top brand at 3.4% share, 0 markets with any brand as #1 more than once |
| Nutritionists and Dietitians | Institutional Authority Market | Hospital systems collectively earn 25%+ of recommendation surface, displacing commercial specialty brands |
Why the framework matters
A brand's strategic posture in the AI recommendation layer depends on which Market Structure governs its category. The work that produces share in a Default-Dominant Market does not work in a Local Fragmentation Market. The work that produces share against commercial competition does not work against institutional authority. National brand-building in a Local Fragmentation Market wastes investment that would compound in a Default-Dominant Market.
Without identifying the structure first, category strategy in the AI recommendation layer is guesswork. With the structure identified, the strategic playbook becomes specific to the competitive shape. The remainder of this report walks through each of the five categories, identifies which structure governs each, and documents the strategic implications that follow.
03 · Pilates Studios · Market Structure: Default-Dominant
One brand owns the AI recommendation layer across nearly every market measured.
Across 8,324 AI conversations about Pilates studios in May 2026, run across all six leading large language models and 38 U.S. geographic panels, Club Pilates is the dominant brand AI recommends. Club Pilates is the top-mentioned Pilates studio in 36 of the 38 geographies measured (94.7%), in every one of the six models tested, and at 57.6% recommendation share overall. More than half of every AI conversation about Pilates studios surfaces Club Pilates by name. No other Pilates brand, dedicated or adjacent, holds a comparable position in any single model or any single market.
What the data measured
- 8,324 distinct AI responses to Pilates studio recommendation prompts (canonical May 2026 panel)
- Six leading large language models: ChatGPT, Claude, Gemini, Grok, Perplexity, Microsoft Copilot
- 38 user-location panels spanning corporate HQ markets, mid-tier metros, suburban submarkets, and franchise-density geographies
- March and April 2026 included as trajectory context only (partial panel: 615 and 1,172 responses respectively); May 2026 is the canonical month for all leadership claims
Top dedicated Pilates brands (May 2026)
| Rank | Brand | Recommendation share | Distinct responses | Models surfacing |
|---|---|---|---|---|
| 1 | Club Pilates | 57.63% | 4,797 | 6 of 6 |
| 2 | National Pilates Challenger | 16.24% | 1,352 | 6 of 6 |
| 3 | Solidcore | 5.05% | 420 | 6 of 6 |
| 4 | Jetset Pilates | 3.52% | 293 | 5 of 6 |
| 5 | The Pilates Room | 3.00% | 250 | 5 of 6 |
| 6 | Pure Pilates | 2.63% | 219 | 6 of 6 |
| 7 | Pilates Platinum | 2.21% | 184 | 6 of 6 |
| 8 | Pilates One | 2.17% | 181 | 5 of 6 |
The competitive structure is barbell-shaped. Club Pilates at 57.6%, National Pilates Challenger at 16.2%, then a 3-point cliff to a tightly clustered second tier between 2% and 5%. There is no middle.
Substitute and adjacent operators
AI does not limit Pilates studio recommendations to dedicated Pilates brands. When AI cannot fill the top-of-list with enough specialty brands for a given market, it reaches for adjacent and substitute operators.
| Brand | Type | May share | Distinct responses |
|---|---|---|---|
| Pure Barre | Barre, adjacent | 5.51% | 459 |
| CorePower (combined with CorePower Yoga) | Yoga and sculpt, adjacent | 4.67% | ~389 |
| YMCA | Community fitness, substitute | 3.98% | 331 |
| La Fitness | Big-box fitness, substitute | 1.84% | 153 |
| Lifetime Fitness | Premium fitness, substitute | 1.48% | 123 |
| Equinox | Premium fitness, substitute | 1.42% | 118 |
Adjacent and substitute brands collectively earn 18.9% of the May 2026 recommendation surface. That is more share than the entire dedicated-Pilates second tier (ranks 3 through 8) combined. The implication for category positioning: when AI cannot identify a third or fourth dedicated Pilates brand for a market, it expands the Pilates answer to include adjacent and substitute fitness operators. This is a competitive risk surface dedicated Pilates brands typically do not address in their own marketing.
Month-over-month movement
| Brand | Mar 2026 share | Apr 2026 share | May 2026 share |
|---|---|---|---|
| Club Pilates | 35.93% | 35.84% | 57.63% |
| National Pilates Challenger | 5.20% | 3.92% | 16.24% |
| Pure Barre | 1.46% | 0.85% | 5.51% |
| Solidcore | 3.09% | absent | 5.05% |
The dramatic share growth between April and May is panel-driven, not market-driven. March and April reflect partial-panel collection (1 to 3 models, 12 to 18 geos). May is the canonical full panel (6 models, 38 geos). What the trajectory shows is consistent rather than improving: as the panel widens to its full scope, Club Pilates moves from approximately 36% share to 57.6% share. The brands that gain share as the panel widens are the brands with the broadest cross-model and cross-geo presence. Club Pilates gains 22 points. National Pilates Challenger at #2 gains 11 points. Pure Barre and Solidcore each gain about 4 to 5 points. Every other brand in the competitive set is flat or undetectable in the partial-panel months. That trajectory is itself a measurement: the structural #2 challenger is the only #2 candidate in dedicated Pilates whose presence holds up as the AI recommendation surface widens.
Geographic concentration
Club Pilates is the #1 brand AI recommends in 36 of the 38 geographies measured. The two exceptions are a single suburban Texas market where National Pilates Challenger wins #1, and one Tier 1 metro (Boston, MA) where Boston Body Pilates, a local independent, holds the top position. No substitute fitness operator wins #1 in any geography measured.
Club Pilates is the #1 brand in every Tier 1 metro measured, every suburban submarket measured, and every franchise-density market measured. Geographic dominance for this brand is effectively universal across the panel.
Model-by-model consistency
| Model | #1 | #2 | #3 |
|---|---|---|---|
| ChatGPT | Club Pilates | National Pilates Challenger | (extraction artifact) |
| Claude | Club Pilates | Pure Barre | CorePower |
| Copilot | Club Pilates | YMCA | National Pilates Challenger |
| Gemini | Club Pilates | National Pilates Challenger | Solidcore |
| Grok | Club Pilates | National Pilates Challenger | The Pilates Room |
| Perplexity | Club Pilates | National Pilates Challenger | Jetset Pilates |
Club Pilates is the #1 brand in every one of the six models tested. There are no model-specific disagreements about the leader. The structural #2 holds the #2 position in 4 of 6 models and the #3 position in Microsoft Copilot. The model that does not place the #2 challenger in its top 3 is Claude, which favors adjacent brands (Pure Barre, CorePower) over dedicated Pilates competitors in the #2 and #3 slots. Microsoft Copilot is the only model where a substitute fitness operator (YMCA) outranks any dedicated Pilates brand other than Club Pilates.
Strategic implication for this category
The dominant brand's market position in the AI recommendation layer is a single, sharp story.
Nationally. The structural #2 challenger is the structural #2 dedicated Pilates brand in 5 of the 6 leading AI models. 16.24% recommendation share in May 2026 versus the next dedicated Pilates brand (Solidcore) at 5.05%. The #2's lead over the rest of the dedicated field is 3.2x. The #2 challenger is the only dedicated #2 candidate whose share expanded as the model panel widened from partial to full. Every other dedicated brand stayed flat or did not surface in partial-panel months.
Locally, the story inverts. Across 12 measured markets where the structural #2 challenger has known physical presence, Club Pilates is the AI's #1 recommendation in 11 of them. The challenger wins #1 in exactly one of its own measured markets. In the challenger's corporate headquarters market, Club Pilates earns 90 mentions and 85 distinct responses as the top Pilates recommendation. The challenger does not place #1 in its own home market. The pattern holds across all of the challenger's measured Florida, Texas, Georgia, Arizona, California, and Utah markets.
The strategic implication is precise: a brand can earn national #2 recognition in the AI recommendation layer while losing the "recommended first" position in 11 of 12 of its own physical markets, including its corporate headquarters. The competitive gap is not a category-level brand-awareness gap. It is a local-AI-presence gap that gets measured every time a prospective customer in any of those markets asks ChatGPT, Claude, Gemini, Grok, Perplexity, or Microsoft Copilot for a Pilates studio near them.
The path to closing that gap runs through identifying the specific citation surfaces and content patterns that put Club Pilates in the AI's top recommendation position for each market, then executing the work to put the challenger in the same position market by market over the next 90 to 180 days.
04 · Massage and Wellness Studios · Market Structure: Oligopoly
A three-chain oligopoly with no single dominant brand and meaningful local survival.
Across 4,422 AI conversations about Massage and Wellness studios in April 2026, run across four of the six leading large language models and 18 U.S. geographic panels, Massage Envy is the dominant brand AI recommends at 22.3% recommendation share. But unlike the highly consolidated Pilates category, Massage and Wellness is a three-chain oligopoly: Massage Envy leads, with Elements Massage and Hand and Stone clustered as co-#2s at 11% each. Massage Envy wins the #1 position in 44% of markets measured. The remaining 56% of markets go to Elements Massage, Hand and Stone, or one of four local independent operators. This is a contested category where national distribution does not translate to per-market dominance.
What the data measured
- 4,422 distinct AI responses to Massage and Wellness studio recommendation prompts (canonical April 2026 panel)
- Four of the six leading large language models: ChatGPT, Claude, Gemini, Perplexity. Grok and Microsoft Copilot were not collected for this category in April 2026 and are excluded from this chapter's measurements
- 18 user-location panels spanning Tier 1 metros, Tier 2 cities, suburban submarkets, and select franchise-density markets
Top dedicated Massage and Wellness brands
| Rank | Brand | Recommendation share | Distinct responses | Models surfacing |
|---|---|---|---|---|
| 1 | Massage Envy | 22.25% | 984 | 4 of 4 |
| 2 | Elements Massage | 10.97% | 485 | 4 of 4 |
| 3 | Hand and Stone | 10.45% | 462 | 4 of 4 |
| 4 | Woodhouse Spa (combined variants) | 5.36% | 237 | 4 of 4 |
| 5 | Great Jones Spa | 2.53% | 112 | 4 of 4 |
| 6 | Renew Massage Studio | 2.42% | 107 | 2 of 4 |
| 7 | Exhale Spa | 2.06% | 91 | 4 of 4 |
The competitive structure is fundamentally different from Pilates. In Pilates, Club Pilates owns 57.6% with a 41-point gap to #2. In Massage and Wellness, Massage Envy at 22.3% leads Elements and Hand and Stone clustered together at 11%, with an 8-point gap from the lead to the co-#2s and a 5-point gap from the co-#2s to the next tier. Three franchised national chains effectively define the category top.
Substitute and adjacent operators
In this category the adjacent layer is luxury hotel spas rather than fitness operators. AI recommends Ritz-Carlton Spa, Four Seasons, Fairmont, Waldorf Astoria, Aman, and Peninsula spas as places to receive massage or wellness services.
| Brand | Type | April share | Distinct responses |
|---|---|---|---|
| Ritz-Carlton Spa | Luxury hotel spa | 1.54% | 68 |
| Fairmont (hotel spas) | Luxury hotel spa | 0.88% | 38 |
| Waldorf Astoria (hotel spas) | Luxury hotel spa | 0.81% | 36 |
| Aman (resort spas) | Luxury hotel spa | 0.68% | 30 |
| Four Seasons (hotel spas) | Luxury hotel spa | 0.66% | 29 |
| Peninsula Spa | Luxury hotel spa | 0.54% | 24 |
Luxury hotel spas collectively earn 5.1% of the April 2026 recommendation surface. About half of Hand and Stone's #3 share. Material, not noise, and concentrated in higher-end consumer queries where AI surfaces destination spa experiences alongside franchised chains.
Geographic concentration
Massage Envy is the #1 brand AI recommends in 8 of the 18 geographies measured (44.4%). The breakdown:
- Massage Envy wins #1 in 8 geos: Tampa FL, Atlanta GA, Miami FL, Dallas TX, Seattle WA, Houston TX, Uptown Dallas TX, North St. Petersburg FL
- Elements Massage wins #1 in 4 geos (Texas and Arizona stronghold): Phoenix AZ, The Woodlands TX, Plano TX, Southlake TX
- Hand and Stone wins #1 in 1 geo: Philadelphia PA
- Local independents win #1 in 4 geos: Great Jones Spa (New York NY), Renew Massage Studio (Denver CO), Burke Williams Day Spa (Los Angeles CA), Jonique Day Spa (Belleair Bluffs FL)
- One market (Chicago, IL) shows a geographic-name extraction artifact and is excluded from per-geo claims
Compare to Pilates where local independents won only 1 of 38 geos. Massage and Wellness supports local brand survival in a way the Pilates category does not.
Model-by-model consistency
| Model | #1 | #2 | #3 |
|---|---|---|---|
| ChatGPT | Massage Envy | Hand and Stone | Exhale Spa |
| Claude | Massage Envy | Hand and Stone | Elements Massage |
| Gemini | Massage Envy | Elements Massage | Hand and Stone |
| Perplexity | Massage Envy | Elements Massage | Hand and Stone |
The Big 3 chains (Massage Envy, Elements Massage, Hand and Stone) hold all three top slots in 3 of the 4 models. ChatGPT is the outlier: it places Exhale Spa (a luxury hotel spa) at #3, displacing Elements Massage from its top 3. Claude, Gemini, and Perplexity agree on the dedicated-chain top 3.
Strategic implication for this category
The category-level story for Massage and Wellness Studios is the inverse of Pilates Studios.
In Pilates, one brand holds a near-monopoly position that translates from national dominance into per-market dominance in 94.7% of markets. In Massage and Wellness, the picture is fundamentally different:
- The national #1 (Massage Envy) holds 22.3% recommendation share. Strong but not dominant.
- The national #2 and #3 (Elements Massage, Hand and Stone) cluster within a single point of each other and within 12 points of #1. The category top is a three-chain race.
- The national #1 loses 56% of markets to other operators. Local independents win 22% of measured markets.
- Regional concentration is a viable distribution strategy. Elements Massage wins all three of its Tampa-adjacent suburban Texas markets and Phoenix without holding a single Tier 1 metro.
- AI's "what's the best massage place" answer expands to include luxury hotel spas at a combined 5.1% share, primarily on consumer queries that lean toward destination experiences.
The strategic implication for brands in this category is the inverse of Pilates: market-level wins are achievable, and a regional or single-market dominance strategy can produce real AI recommendation outcomes. A spa or massage chain does not need to displace a national #1 to become the AI-recommended top choice in its own market. Local independents already do this in 22% of measured markets. Regional chains already do this with concentrated Texas, Arizona, or Northeast distribution.
The path to winning a market in this category runs through earning citation surface and content authority in that specific market's information layer. Unlike Pilates, where the work is competing against a near-universal AI default, in Massage and Wellness the work is becoming the AI default in your own market and holding it.
05 · Med Spas · Market Structure: Local Fragmentation
The most contestable category measured. Local presence is everything.
Across 2,516 AI conversations about Med Spas in April 2026, run across four of the six leading large language models and 18 U.S. geographic panels, no brand holds a dominant recommendation position. The leading brand, SkinSpirit, earns only 3.4% recommendation share. Every one of the 18 markets measured surfaces a different local champion as the #1 recommended med spa. No brand wins the #1 position in more than one market. The Med Spas category is the inverse of Pilates Studios. There is no national AI default. Local presence, local citation surface, and local content authority are everything.
What the data measured
- 2,516 distinct AI responses to Med Spa recommendation prompts (canonical April 2026 panel)
- Four of the six leading large language models: ChatGPT, Claude, Gemini, Perplexity
- 18 user-location panels spanning Tier 1 metros and suburban submarkets
- Methodology notes (more material in this category than the prior two):
- ChatGPT's top 2 raw results are extraction artifacts. Excluded from chapter analysis
- Claude's #2 raw result is a treatment-type extraction artifact, also excluded
- Real dedicated med spa brands have been verified against the per-model and per-geo data; the dedicated competitive set is intact even with artifacts removed
Top dedicated Med Spa brands (April 2026, artifacts excluded)
| Rank | Brand | Recommendation share | Distinct responses | Models surfacing |
|---|---|---|---|---|
| 1 | SkinSpirit | 3.38% | 85 | 4 of 4 |
| 2 | Suddenly Slimmer Med Spa | 2.46% | 62 | 4 of 4 |
| 3 | SkinLogic Med Spa | 2.38% | 60 | 2 of 4 |
| 4 | Vio Med Spa | 2.03% | 51 | 2 of 4 |
| 5 | Glow Medispa | 1.99% | 50 | 3 of 4 |
| 6 | Cienega Med Spa | 1.95% | 49 | 3 of 4 |
| 7 | Ellemes Medical Spa | 1.91% | 48 | 2 of 4 |
| 8 | Mara's Med Spa | 1.87% | 47 | 2 of 4 |
| 9 | Blue Haven Medical Spa | 1.79% | 45 | 2 of 4 |
| 10 | Persona Med Spa | 1.63% | 41 | 2 of 4 |
The combined top 10 dedicated med spa brands hold approximately 21% of the April 2026 recommendation surface. That is less than the share held by Massage Envy alone in the Massage and Wellness category, and less than half of what Club Pilates alone holds in Pilates Studios. The category top is barely consolidated at all.
Substitute and adjacent operators
In this category the adjacent layer is dermatology practices and aesthetic surgery offices. AI recommends Westlake Dermatology, Houston Dermatology Associates, Buckhead Facial Plastic Surgery, La Fontaine Aesthetics, and similar clinical operators as places to receive injectables, lasers, and aesthetic services. Adjacent dermatology and aesthetic surgery practices earn approximately 3% of the April 2026 recommendation surface. Small relative to the categories above, but meaningful given the fragmentation.
Geographic concentration
The most fragmented per-geo distribution in any of the categories measured. Every one of the 18 markets has a different #1 brand. Zero overlap. No brand appears as #1 in more than one geography.
| Geo | #1 Brand |
|---|---|
| Seattle, WA | SkinLogic Med Spa |
| Phoenix, AZ | Suddenly Slimmer Med Spa |
| Los Angeles, CA | Cienega Med Spa |
| Atlanta, GA | Ellemes Medical Spa |
| Denver, CO | Restor Medical Spa |
| Houston, TX | Persona Med Spa |
| Philadelphia, PA | Yofi Med Spa |
| Tampa, FL | Health and MedSpa |
| Dallas, TX | Mara's Med Spa |
| Chicago, IL | Pure Medical Spa |
| Miami, FL | Beyond Health MedSpa |
| New York, NY | Trifecta Med Spa |
| Uptown Dallas, TX | Just Injected Medical Spa |
| North St. Petersburg, FL | Coco Med Spa |
| Plano, TX | Metamorph Med Spa |
| The Woodlands, TX | Seychelles Med and Laser Spa |
| Belleair Bluffs, FL | Radiance MedSpa |
| Southlake, TX | Renew MD Med Spa |
Eighteen markets, eighteen unique local champions. No brand recurs as #1 in any other market. This is a structural finding, not a methodological artifact. The Med Spas category has no national AI default at the recommendation layer.
Strategic implication for this category
The Med Spas category is the most contestable category measured in this report. The strategic implication runs in exactly the opposite direction from Pilates Studios:
- The national #1 holds 3.4% share. There is no dominant brand to displace.
- Every measured market goes to a different local operator. No brand has cracked AI recommendation dominance beyond its home market.
- The top 4 models disagree on who the "true #1" is. SkinSpirit, Skin Laundry, and SkinLogic Med Spa each hold #1 in at least one model, but no brand is consensus.
- Adjacent operators (dermatology practices, aesthetic surgery offices) collectively earn approximately 3% share.
The strategic implication for brands in this category is the most actionable in the report. Market-level AI dominance is achievable for any single-location or small-chain med spa willing to invest in citation surface, content authority, and local third-party validation in its home market. The category does not have a Club Pilates, a Massage Envy, or even an Elements Massage. There is no national AI default to compete against. The work is becoming the AI default in your own market, and the path to that outcome is open in every market measured.
For an emerging med spa brand, the comparative position is favorable: a 50-mention concentration in a single market can win the local AI #1 spot, as Cienega Med Spa demonstrates in Los Angeles, Yofi Med Spa in Philadelphia, and Persona Med Spa in Houston. A 75-mention concentration in two markets would make a brand the only multi-market #1 winner in the category. A national distribution strategy adds expense without competing against an entrenched AI default, because no entrenched AI default exists.
06 · Chiropractors · Market Structure: National Recognition with Local Leakage
One brand owns the national conversation. Local clinics own 3 of every 4 markets.
Across 2,267 AI conversations about Chiropractors in May 2026, run across five of the six leading large language models and 24 U.S. geographic panels, The Joint Chiropractic is the AI's top-recommended brand at 22.98% recommendation share, with a 6.1x lead over the #2 brand. But unlike Club Pilates' near-universal geographic dominance in Pilates Studios, The Joint wins the #1 position in only 6 of 24 markets (25%). Local independent chiropractors win 18 of 24 markets (75%) as the AI's top recommendation. The Joint owns the national AI recommendation conversation. The local AI default conversation is still wide open in 3 of every 4 markets.
What the data measured
- 2,267 distinct AI responses to Chiropractor recommendation prompts (canonical May 2026 panel)
- Five of the six leading large language models: ChatGPT, Claude, Gemini, Grok, Perplexity
- 24 U.S. geographic panels spanning Tier 1 metros, mid-tier cities, suburban submarkets, and select franchise-density markets
- Collected under Search mode (real-time web-grounded), not training-data-only mode
Top dedicated Chiropractor brands (May 2026)
| Rank | Brand | Recommendation share | Distinct responses | Models surfacing |
|---|---|---|---|---|
| 1 | The Joint Chiropractic | 22.98% | 521 | 5 of 5 |
| 2 | Apex Chiropractic | 4.15% | 94 | 4 of 5 |
| 3 | HealthSource | 3.49% | 79 | 5 of 5 |
| 4 | Desert Valley Chiropractic | 3.00% | 68 | 5 of 5 |
| 5 | Core Chiropractic | 2.56% | 58 | 5 of 5 |
| 6 | Reinhardt Chiropractic | 2.43% | 55 | 5 of 5 |
| 7 | Taylor Chiropractic and Wellness | 2.38% | 54 | 4 of 5 |
| 8 | Brewerytown Chiropractic | 2.25% | 51 | 3 of 5 |
| 9 | Unlimited Chiropractic Los Angeles | 1.99% | 45 | 4 of 5 |
| 10 | CoreHealth Wellness | 1.94% | 44 | 3 of 5 |
The competitive structure is single-brand dominant with a long local-clinic tail. The Joint at 22.98% leads the next dedicated chiropractic brand (Apex Chiropractic) by 6.1x. Below #2 the field is a flat cluster between 2% and 4%, populated almost entirely by single-market local chiropractic practices rather than national chains.
Substitute and adjacent operators
In this category the adjacent layer is multispecialty health systems and integrated medical groups offering chiropractic services.
| Brand | Type | May share | Distinct responses |
|---|---|---|---|
| Prestige Health | Integrated health system | 2.07% | 47 |
| Grandview Health Partners | Integrated health system | 1.06% | 24 |
| Vida Integrated Health | Multispecialty practice | 1.01% | 23 |
| Rockefeller Health and Medical | Multispecialty practice | 1.10% | 25 |
| Tangelo Health | Integrated health system | 1.28% | 29 |
| Kaizo Health | Integrated health system (DC top-#1 winner) | ~0.3% | 3 |
Adjacent integrated health systems and multispecialty practices collectively earn approximately 6.5% of the May 2026 recommendation surface. One of these (Kaizo Health) wins the Washington DC market outright as the #1 chiropractic recommendation in that geography. Integrated health systems are not a marginal substitute in this category. They are direct AI-recommended competitors in specific markets.
Geographic concentration
The dominant national chiropractic chain is the #1 brand AI recommends in 6 of the 24 geographies measured (25%). Local independent chiropractors win 18 of 24 markets (75%).
The Joint wins (6 markets): Dallas TX, Los Angeles CA, Miami FL, Tampa FL, The Woodlands TX, North St. Petersburg FL
Local champions win (18 markets):
| Geo | #1 Brand |
|---|---|
| Phoenix, AZ | Desert Valley Chiropractic |
| Houston, TX | Core Chiropractic |
| Denver, CO | Reinhardt Chiropractic |
| Atlanta, GA | Taylor Chiropractic and Wellness |
| Philadelphia, PA | Brewerytown Chiropractic |
| New York, NY | Prestige Health |
| Seattle, WA | Eastlake Chiropractic |
| Chicago, IL | McKinley Family Chiropractic |
| Southlake, TX | Southlake Chiropractic |
| Uptown Dallas, TX | Manning Wellness Clinic |
| Belleair Bluffs, FL | Belleair Bluffs Chiropractic |
| Plano, TX | Willow Bend Chiropractic |
| Boston, MA | Copley Square Chiropractic |
| San Francisco, CA | SF Custom Chiropractic |
| Minneapolis, MN | Lyn Lake Chiropractic |
| Austin, TX | Lifespring Chiropractic |
| Washington, DC | Kaizo Health |
| San Diego, CA | Core Health Spine |
The Chiropractors category slots between Massage and Wellness and Med Spas in market-level concentration. Strong national brand presence at 22.98% (matching Massage Envy at 22.25%), but only converting that presence to per-market #1 in a quarter of measured markets.
Model-by-model consistency
Eleven brands surface in all 5 models in this category: The Joint Chiropractic, HealthSource, Desert Valley Chiropractic, Core Chiropractic, Reinhardt Chiropractic, Rittenhouse Square Chiropractic, Arrowhead Clinic, Capitol Hill Chiropractic, West Los Angeles Chiropractic, Southlake Chiropractic, Woodlands Family Chiropractic. The Joint is the only one of these 11 that holds more than 4% share. Apex Chiropractic surfaces in 4 of 5 models (Claude omits it from the top 100), suggesting Claude weights local independents more heavily than other models in this category.
Strategic implication for this category
The Joint Chiropractic's position in the AI recommendation layer mirrors and inverts the Pilates Studios strategic situation for that category's structural #2 challenger.
National strength is established and durable. 22.98% recommendation share. The Joint is the dominant Chiropractor brand AI recommends, by a 6.1x lead over the next dedicated competitor. Surfaces in all 5 leading models. HealthSource (the only other dedicated chiropractic chain to surface in all 5 models with material share) holds 3.49% share. The Joint is approximately 6.6x larger than the only other cross-model-consensus national chain in this category. There is no structural #2 challenger.
Market-level position is open territory. The Joint wins #1 in only 6 of 24 measured markets (25%). Local independent chiropractic practices win 18 of 24 markets (75%). The Joint loses #1 to local practices in major metros where it has known physical clinic presence: Phoenix, Atlanta, Denver, Houston, Seattle, Chicago, Philadelphia, New York, Washington DC, Boston, San Francisco, Minneapolis, Austin, San Diego, plus suburban Dallas-Fort Worth submarkets.
The strategic implication is precise and inverse to the Pilates Studios category's structural #2 situation. The structural #2 in Pilates has a 4x competitive deficit nationally and an even harsher deficit locally. The Joint has the opposite problem: dominant national AI brand recognition that is not converting into local-market #1 in 3 of every 4 markets. The competitive disadvantage at the market level is not against a single dominant national competitor like Club Pilates. It is against thousands of single-location chiropractic practices that have earned local citation surface, local content authority, and local AI default position in their home market.
The path to closing this gap is to identify the local citation patterns that make a local chiropractic practice the AI default in its market, apply that pattern to The Joint's franchise locations in the 18 measured markets where the chain currently loses, and measure conversion monthly. Each market that converts from local-independent-#1 to The-Joint-#1 in AI recommendation is a unit of franchise-level revenue protection and growth, because consumers asking ChatGPT, Claude, Gemini, Grok, or Perplexity for "best chiropractor near me" are making purchasing decisions before they ever visit a website.
07 · Nutritionists and Dietitians · Market Structure: Institutional Authority
AI defers to institutional medical authority, not commercial brand authority.
Across 2,272 AI conversations about Nutritionists and Dietitians in May 2026, run across five of the six leading large language models and 18 U.S. geographic panels, the AI recommendation layer behaves differently in this category than in any other measured in this report. The leading brand AI recommends is not a commercial nutrition practice. It is a hospital system. Of the top 20 most-recommended brands, 14 are hospital systems, academic medical centers, or insurance companies. Only one dedicated multi-location private nutrition practice (Health Loft at 4.4% recommendation share) breaks into the top 5. In this category, AI defers to institutional medical authority rather than commercial brand authority.
What the data measured
- 2,272 distinct AI responses to Nutritionist and Dietitian recommendation prompts (canonical May 2026 panel)
- Five of the six leading large language models: ChatGPT, Claude, Gemini, Grok, Perplexity
- 18 U.S. geographic panels spanning Tier 1 metros and select strategic submarkets
- Because this category produced a higher rate of institutional and non-commercial entities, additional entity normalization was applied before analysis
Top dedicated nutrition brands
The dedicated private-practice nutrition layer is sparse compared to other categories measured.
| Rank | Brand | Recommendation share | Distinct responses | Models surfacing |
|---|---|---|---|---|
| 1 | Health Loft | 4.40% | 100 | 4 of 5 |
| 2 | Cooper Clinic | 1.14% | 26 | 5 of 5 |
| 3 | Stef and Bri Wellness | 1.06% | 24 | 1 of 5 |
| 4 | Lemond Nutrition | 0.97% | 22 | 3 of 5 |
| 5 | Adelante Healthcare | 0.84% | 19 | 4 of 5 |
| 6 | Culina Health | 0.31% | 7 | 2 of 5 |
| 7 | Noom (telehealth weight loss) | 0.31% | 7 | 2 of 5 |
| 8 | Whole Health Nutrition | 0.35% | 8 | 3 of 5 |
| 9 | The Healthy Kitchen Miami | 0.44% | 10 | 2 of 5 |
Health Loft is the only dedicated multi-location private nutrition practice with material national share. At 4.4% recommendation share across 4 of 5 models, it is approximately 4x larger than the next-largest dedicated nutrition brand. Beyond Health Loft, the dedicated-private-practice layer is a long tail of single-location practices in the 0.3% to 1% share range, surfacing in 1 to 3 models inconsistently.
The dominant layer: hospital systems and academic medical centers
In every other category measured in this report, dedicated specialty brands hold the top positions and substitute or adjacent operators occupy a secondary share. In Nutritionists and Dietitians the structure is inverted. Hospital systems, academic medical centers, and insurance companies are the dominant recommendation layer.
| Brand | Type | May share | Models |
|---|---|---|---|
| Houston Methodist | Hospital system | 2.55% | 5 of 5 |
| Memorial Hermann | Hospital system | 1.89% | 5 of 5 |
| Baylor Scott and White | Hospital system | 1.85% | 5 of 5 |
| UT Southwestern | Academic medical center | 1.72% | 5 of 5 |
| Cedars-Sinai | Academic medical center | 1.63% | 4 of 5 |
| UCHealth | Hospital system | 1.54% | 3 of 5 |
| Northwestern | Academic medical center | 1.28% | 5 of 5 |
| UCLA Health | Academic medical center | ~1.7% | 4 of 5 |
| Baptist Health | Hospital system | 1.23% | 3 of 5 |
| NYU Langone | Academic medical center | 1.14% | 4 of 5 |
| Cooper Clinic | Hybrid medical wellness | 1.14% | 5 of 5 |
| Aetna | Insurance company | 0.79% | 3 of 5 |
| Emory | Academic medical center | 0.84% | 5 of 5 |
| Jefferson Health | Hospital system | 0.75% | 5 of 5 |
| Blue Cross Blue Shield | Insurance company | 0.75% | 2 of 5 |
| Penn Medicine | Academic medical center | 0.70% | 3 of 5 |
The institutional layer collectively earns more than 25% of the recommendation surface, dwarfing the dedicated-private-practice layer. Of the top 20 most-recommended entries in this category, 14 are hospital systems, academic medical centers, or insurance companies. The cross-model consensus is overwhelming: most of these institutional providers surface in 4 of 5 or all 5 models. AI treats institutional medical authority as the trusted recommendation pathway for dietitian and nutritionist searches in a way it does not treat any institutional layer in any other category measured.
Insurance companies appearing in the recommendation set (Aetna, Blue Cross Blue Shield, UnitedHealthcare, Cigna) reflect AI's pattern of recommending consumers contact their insurance for covered dietitian services rather than naming a specific practice. This is a uniquely category-specific behavior not observed in Pilates, Massage and Wellness, Med Spas, or Chiropractors.
Strategic implication for this category
The Nutritionists and Dietitians category presents a strategic situation unlike any other category measured in this report. The competitive landscape at the AI recommendation layer is not defined by commercial brand competition. It is defined by institutional medical authority.
For dedicated private nutrition practices: The path to material AI recommendation share runs through breaking the institutional default. AI's first recommendations for "best nutritionist" and "best dietitian" queries surface hospital systems, academic medical centers, and insurance pathways. A private practice has to displace some portion of that institutional default to win share. Health Loft demonstrates this is possible. At 4.4% recommendation share across 4 of 5 models, it is the only multi-location private nutrition practice to have established meaningful AI presence in this category. For single-location private practices, the per-market opportunity is genuinely open. The fragmentation pattern of single-practice brands at 0.3% to 1% share with 1 to 2 model coverage suggests no local private nutrition practice has yet established cross-model consensus in its home market. The strategic shape of this opportunity mirrors what we observed in Med Spas: market-level AI dominance is achievable for any practice willing to invest in citation surface and content authority in its home market.
For hospital systems and academic medical centers: This category represents an unusually durable AI recommendation moat. Cross-model consensus is high, institutional brand recognition translates directly into AI default position, and the competitive challenge from commercial nutrition brands is minimal. The strategic posture is defensive: monitor for emerging private-practice brands that gain cross-model coverage. Continue investing in the structured-data, citation, and content patterns that produced the current institutional default.
For telehealth nutrition platforms and apps: Current share is small relative to the institutional layer. The strategic path is unclear: AI does not currently treat telehealth nutrition platforms as institutional-grade authority, but the platforms also do not face the local-presence barriers that constrain private practices.
Of the five health and wellness categories measured in this report, Nutritionists and Dietitians is the category where commercial brand-building produces the least direct AI recommendation lift. Hospital systems and academic medical centers benefit from institutional medical authority that AI defers to consistently. Private practices face a structurally harder competitive surface than they would in any other measured category.
08 · Cross-Category Synthesis
Five categories, five Market Structures, one measurement system.
The five categories measured in this report each occupy a distinct position in the ARDI Market Structure Framework. The framework introduced in Section 02 is not theoretical. It is the structural lens that explains why the same AI recommendation layer produces a near-monopoly in one category and pure local fragmentation in another. The synthesis that follows reads each pattern through the framework.
The category dominance spectrum
| Category | Top brand type | National share | Geo dominance | Dominant layer |
|---|---|---|---|---|
| Pilates Studios | Commercial national chain | 57.6% | 94.7% of 38 | Single commercial brand near-monopoly |
| Massage and Wellness Studios | Commercial national chain | 22.3% | 44.4% of 18 | Three-chain commercial oligopoly |
| Chiropractors | Commercial national chain | 23.0% | 25.0% of 24 | National commercial chain + local fragmentation |
| Med Spas | (No dominant brand) | 3.4% | 0% of 18 | Pure local fragmentation |
| Nutritionists and Dietitians | Hospital systems collectively | 25%+ collective | not measured this edition | Institutional medical authority |
The five categories produce five structurally distinct competitive shapes. Brands competing across health and wellness verticals need category-specific AI recommendation strategies, not a single playbook.
The mismatch between national share and per-market dominance
Massage Envy and The Joint Chiropractic hold nearly identical national recommendation share (22.3% vs 23.0%). Their per-market dominance differs sharply. Massage Envy wins #1 in 44.4% of measured markets. The Joint wins #1 in 25.0% of measured markets. Both hypotheses for why this gap exists lead to the same actionable conclusion: converting national AI recognition into per-market AI default requires market-by-market work that does not happen as a side effect of national brand-building.
Local brand survival across the spectrum
| Category | Markets won by local independent or regional chain | % of total |
|---|---|---|
| Pilates Studios | 2 of 38 | 5.3% |
| Massage and Wellness Studios | 4 of 18 | 22.2% |
| Chiropractors | 18 of 24 | 75.0% |
| Med Spas | 18 of 18 | 100% |
The categories where local operators win significant per-market AI default positions are the categories where the national #1 is either absent or insufficiently dominant. This is a structural opportunity for local and regional brands in Chiropractors and Med Spas that does not exist in Pilates.
The substitute operator effect
| Category | Adjacent layer | Combined share |
|---|---|---|
| Pilates Studios | General fitness chains | 8.7% |
| Massage and Wellness Studios | Luxury hotel spas | 5.1% |
| Med Spas | Dermatology practices and aesthetic surgery offices | ~3% |
| Chiropractors | Integrated health systems and multispecialty groups | 6.5% |
| Nutritionists and Dietitians | Hospital systems and academic medical centers | 25%+ |
AI substitutes adjacent operators consistently across every category measured. The mechanism is the same: when AI cannot fill a top-N specialty list with dedicated specialty brands, it expands the answer to include the nearest adjacent category. Substitute share ranges from 3% to 25% depending on category depth. In Nutritionists and Dietitians, the substitute layer is so dominant it functions as the de facto top of the category. In every other category, substitutes are a meaningful secondary share that specialty brands cannot ignore.
Cross-model consensus
Every category measured has a clear AI-consensus leader at the national level, with the exception of Med Spas, which has no consensus leader across any pair of models. Where consensus exists at #1, the #2 and #3 slots show variation by model but converge on a small competitive set. Where consensus does not exist, the entire competitive set varies by model, suggesting AI training data is significantly more fragmented for that category than for the others.
The AI recommendation layer is producing measurable, category-specific competitive shapes that determine which brands win recommendations in front of buyers. The work that produces share in a near-monopoly category does not work in a fragmented category. The work that produces share against commercial competition does not work against institutional authority. Brands in these categories need to know which shape they are competing in before they can develop the strategy that fits.
09 · Executive Implications
What this report changes for the people deciding category strategy.
The Market Structure governing a category determines what kind of strategic posture works in that category. The implications below are organized by audience rather than by market structure, because the people deciding category strategy think in roles, not in frameworks.
For CEOs
- AI recommendations are becoming a category-level competitive surface. The AI's "first answer" for "best [category] near me" queries is increasingly the buyer's first impression, established before any website visit. The categories measured in this report demonstrate that AI defaults already exist, are durable, and produce category-specific winners and losers.
- National brand strength does not automatically convert into per-market AI default. The Joint Chiropractic holds 23% national recommendation share but wins #1 in only 25% of measured markets. The strategic challenge of national-to-local AI conversion is invisible in conventional marketing reports and material at the CEO level.
- Category consolidation patterns measured at the AI layer can foreshadow consolidation patterns at the commercial layer. Default-Dominant Markets (one brand winning 90%+ of markets) signal late-stage consolidation. Local Fragmentation Markets (zero markets with recurring #1) signal early-stage opportunity.
For CMOs
- Search visibility and AI recommendation share are no longer the same measurement. Brands can rank well in organic search and remain Invisible in AI recommendation responses. Brands can hold strong AI presence in some models and be absent in others. ARDI measures the second surface; legacy SEO and AI visibility tools do not.
- Investment that produces share in a Default-Dominant Market does not produce share in a Local Fragmentation Market. National media spend compounds into AI default position in some Market Structures and produces no measurable AI recommendation lift in others. Market Structure should be a determining input into the media mix decision, not an afterthought.
- Cross-model coverage is a separate axis from cross-channel coverage. A brand can be cited consistently in ChatGPT and Perplexity and effectively absent in Claude. Cross-model consensus is one of the strongest predictors of durable AI recommendation position.
For Franchise Operators
- National brand strength at the franchisor level does not produce local AI default at the franchisee level. The Joint Chiropractic loses local AI #1 in 18 of 24 measured markets despite physical clinic presence in many of those markets. The "we are a national franchise" advantage does not transfer to local AI recommendation by default.
- The work to convert a local franchise location from local-independent-#1 to brand-#1 in AI recommendation is local citation surface, local content authority, and local third-party validation. The investment is location-by-location, the measurement is monthly, and the conversion is observable at the per-geography level. This is the work that determines whether a national franchise actually wins local AI recommendation.
- Franchise-level competitive analysis should include per-market AI recommendation share alongside conventional unit-economics metrics. A franchise location losing local AI #1 to a single-location independent is a leading indicator of consumer-acquisition friction that does not appear in same-store sales reports.
For Multi-location Brands
- Multi-location brands operating in Oligopoly Markets (Massage and Wellness) and National Recognition with Local Leakage Markets (Chiropractors) face a structurally different competitive surface than multi-location brands in Default-Dominant Markets (Pilates). Multi-location strategy should be calibrated to the Market Structure that governs the brand's primary category.
- In National Recognition with Local Leakage Markets, the gap between aggregate national share and per-market AI #1 conversion is the most leveraged improvement opportunity available. Closing that gap city by city compounds faster than national share growth and is more defensible.
- Regional concentration is a viable distribution strategy in Oligopoly Markets. Elements Massage demonstrates this in Massage and Wellness, winning all three measured Tampa-adjacent suburban Texas markets and Phoenix without holding a single Tier 1 metro.
For Local Operators
- Local AI default is achievable in Local Fragmentation Markets and in 75% of Chiropractors markets without national distribution. The competitive surface is open in three of every four Chiropractors markets measured and in every Med Spas market measured. National scale is not required for per-market AI dominance in these structures.
- The investment threshold to win local AI default in a fragmented or contested market is materially lower than the threshold to displace a national leader in a Default-Dominant Market. Single-location operators in Med Spas and Chiropractors can earn per-market #1 with focused local citation, content, and third-party validation work.
- Measuring per-market AI recommendation share is the first move. Without measurement, local operators cannot tell whether they are already in a winning position or whether they are losing recommendation share to a competitor that has already done the work.
For Healthcare and Regulated Categories
- Institutional Authority Markets behave differently from commercial brand markets. AI's deference to hospitals, academic medical centers, regulators, and insurance pathways in Nutritionists and Dietitians is structural, not incidental. Commercial specialty brands competing in regulated categories should expect the AI default to favor institutional providers unless the brand has built equivalent institutional-grade citation surface.
- Health Loft demonstrates that commercial brands can break the institutional default in regulated categories. At 4.4% national share across 4 of 5 models, it is the only multi-location private nutrition practice to have established meaningful AI presence. The pattern that produced this exception is worth studying.
- For regulated-category brands considering AI-recommendation strategy investment, the work should be informed by which Market Structure governs the category and what institutional-grade citation surface the institutional incumbents already hold.
10 · Methodology and What ARDI Measures
How this report was built.
GOSH AI's ARDI™ platform is the AI Recommendation and Discovery Intelligence platform that produced the measurements in this report. ARDI™ is designed to measure up to approximately 37 million AI conversations annually at full deployment. This represents platform capacity: 26 canonical anchor prompts, 4 prompt variants each, 36 user-location geographic panels, 6 leading large language models, 2 collection runs per month, applied across 70 categories over 12 months. For deeper methodology questions or category-specific measurement details, contact ardi@mygosh.ai.
For this report
- Models measured: ChatGPT, Claude, Gemini, Grok, Perplexity, and Microsoft Copilot. Each category was measured against the largest available subset of these six models that produced consistent extraction at the time of collection. Pilates Studios was measured against all 6 models. Chiropractors and Nutritionists and Dietitians against 5 each. Massage and Wellness Studios and Med Spas against 4 each.
- Geographies measured: Between 18 and 38 U.S. user-location panels per category, drawn from a canonical set of strategic metropolitan and franchise-density markets.
- Categories measured: Pilates Studios, Massage and Wellness Studios, Med Spas, Chiropractors, and Nutritionists and Dietitians.
- Collection cadence: Continuous monthly. Each category's canonical measurement month for this edition reflects the most recent fully-extracted collection at report-build time.
- Collection mode: Search mode (real-time web-grounded answers), not training-data-only mode, for the May 2026 canonical collections.
- Brand extraction methodology: The Brand Extraction Pipeline applies normalization, canonicalization, and category-specific allow-lists and block-lists to each raw model response. Long-tail extraction artifacts (generic phrases parsed as brand names, geographic-name false positives, malformed multi-word brand strings) are excluded from analysis where present.
- Brand recommendation share: The percentage of distinct AI responses for the category in the canonical month that mention the brand by name. A brand mentioned multiple times in one response counts as one distinct response.
- Cross-model consensus: The number of leading models that surface a brand in the category's top 100 by mention count. A brand surfacing in all measured models is "full cross-model consensus."
- Note on anonymization: One Pilates competitor is presented as "National Pilates Challenger" rather than by name. The finding is being used to illustrate market structure rather than identify a specific commercial target.
The Four Authority States
ARDI™ measures four states of brand presence in the AI recommendation layer:
- Full Authority. AI cites the brand and recommends the brand. Trusted and chosen.
- Borrowed Authority. AI cites the brand or describes the brand without recommending it. Vulnerable to displacement.
- Unconverted Authority. AI is aware of the brand but consistently chooses competitors when asked to recommend. Trust exists, selection does not.
- Invisible. AI neither cites nor recommends the brand. The most urgent of the four states.
Every brand measured in this report sits in one of these four states for each model, each geography, and each month measured. The strategic posture a brand should adopt depends on which Authority State it currently occupies and which state it is trending toward.
How Authority States and Market Structures fit together
The Four Authority States measure individual brand position. The Five Market Structures defined in Section 02 measure category-level competitive shape. Together they form a complete ARDI measurement.
A brand's Authority State only has strategic meaning in the context of the Market Structure that governs its category. A brand in Full Authority state inside a Local Fragmentation Market faces different competitive risks than a brand in Full Authority state inside a Default-Dominant Market. Borrowed Authority in an Oligopoly Market is recoverable through cross-model coverage expansion. Borrowed Authority in a Default-Dominant Market is structurally harder to convert because the AI default position is already held by the leader. Invisible state in an Institutional Authority Market reflects the AI's deference to institutions rather than a remediable brand-building gap.
Reading a brand's position in the AI recommendation layer requires both measurements. Authority State tells the brand where it stands. Market Structure tells the brand what competitive environment it stands inside. ARDI delivers both measurements continuously, by model, by geography, by month.