When I discuss the concept of health on this blog I include some version of the following:
Health is not an obligation, barometer of worthiness, completely within our control, or guaranteed under any circumstance.
Recently reader Deborah asked me to talk more about this so I thought I would do that today, taking it piece by piece
Health is not an obligation
Health is a complicated concept, it can be a moving target and different people have different definitions. When I say that health is not an obligation, I’m saying that nobody owes anybody else “health” or “healthy” behaviors by any definition. People are allowed to make choices that not only don’t prioritize their “health” based on whatever definition, but that actively put their health, up to and including their lives, in danger.
People are allowed to play sports even though they lead to sports injuries in the short term and can lead to chronic issues. People are allowed to go mountain climbing even though only people who climb mountains fall off of them and get injured or die. People are allowed to spend tons of time outside even though it vastly increases the risk of skin cancer. People are allowed to be sedentary and eat fast food. People are allowed to participate in extreme sports with huge risk. People are allowed to be cast members of Jackass. People are allowed to be rockstars and not get any sleep. People are allowed to be professional football players and put their bodies at tremendous risk. People of all sizes get to make choices about their bodies and health, and there are no obligations as to what those choices have to be. (Those who want to make a “but my tax dollars!” argument can check out this post.)
Otherwise it becomes a slippery slope – if there is evidence that eating a raw foods diet and practicing hot yoga are “healthier” than other choices do we all have to do that? Do we all have to eat cashew cheez between downward dog in 120 degree studios? If there’s evidence that going paleo and long distance running is”healthier” do we all have to eat a ton of meat while ultra marathons? Do we end sports because there are activities people can do that have the same health benefits but are less risky?
People use this idea of “fat people not prioritizing our health” as a justification for their bigotry and poor treatment of us while being completely fine with thin people who behave in the same ways that they believe fat people do. In order to refrain from sizeism and healthism, we need to stop acting like other people’s bodies and choices our business. So unless the people discussing other people’s behaviors and health are excited about being told what they are allowed to do by the newly elected Overlord of Health, it’s time to stop making this argument.
Health is not a barometer of worthiness
It is completely, totally, wildly, inappropriate to use health as a way to judge people. People who have health issues should be given accessible treatment options that have their decisions respected. They should not be judged or asked to prove that their health issue is not somehow “their fault” because that is absolutely horrifying. This is another area where sizeism and healthism intersect
It does not matter what size someone is, or the reason for their health status, or what their habits are, everyone deserves to be treated with basic human respect, and to have care options based on their own values and choices. The only appropriate healthcare treatment is blame free, shame free, and future-oriented. There is no health issue, personal health choice, or health status that should cause someone to lose the rights to basic human respect and life, liberty, and the pursuit of happiness.
Health is not completely within our control
Health is multifaceted and includes genetics, environment, stress level, access to healthcare, behaviors (food, movement, sleep, etc.) Nobody is completely in control of all of these factors, and increasingly experts suggest that we are overestimating the amount of control we have over our health outcomes. The number factors that each of us has control over varies depending on factors like socioeconomic status, ability to access care, social oppression like racism, ageism, transphobia, homophobia, fatphobia etc., effects of things that happened in our past and more. The job of public health should be to remove barriers to health and fight the things that get into the way of health, the current model of public health wherein people try to make the individual’s health the public’s business is ineffectual and just plain lazy.
Health is not guaranteed under any circumstance
An extension of the fact that health is not completely within our control – no behaviors guarantee a specific health outcome, people get all kinds of illnesses regardless of their behaviors or body size. Thin people get all the same diseases that are correlated with being fat, so being thin cannot be a sure preventative or a sure cure.
When it comes to discussions of health and fat people I think it’s very important to make a distinction between the civil rights movement of Size Acceptance, and the healthcare paradigm of Health at Every Size. I also think it’s important to speak out against the bullshit Good Fatty/Bad Fatty dichotomy, and to discuss the ways that healthism and ableism are used as tools to oppress fat people.
And I think it’s important to remember that health is not an obligation, barometer of worthiness, completely within our control, or guaranteed under any circumstance.
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