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The literature has analyzed the effects of lean management on job satisfaction and health in terms of decoupling or essential effects. However, these studies give a partial understanding of the phenomenon, considering these two effects separately, and do not yet explain how and which lean characteristics influence employees’ job satisfaction or health. The purpose of this article is to study these two competing claims. We used a mixed methods strategy to contribute to this stream of research combining both qualitative (a case study) and quantitative (statistical analysis based on the 2016–2017 national French SUMER survey of 26,494 employees) studies. We showed that employees’ job satisfaction and health result from both lean decoupling and essential effects. We contributed to lean literature in clarifying the theoretical definition of lean management considered as a bundle, which involved identifying a distinctive coherent combination of lean characteristics in terms of organizational principles, work organization, and management tools built around ideas of rationalization. The first empirical contribution was to shed light on the way lean decoupling could be associated with employees’ job dissatisfaction and health problems. Our second contribution was to identify a negative essential effect of a lean bundle on employee health through work intensification. Moreover, we found that the core lean just-in-time principle and both core work organization characteristics—work standardization and quality management—are associated with health problems and depression.