Fighting Words is a column in which writers rub you the wrong way with their unpopular but well-argued opinions on fitness, health, nutrition, what have you. Got something to get off your chest? Send your pitch to email@example.com. As a college professor I'm often amazed at how seriously my students take their personal health. They worry about getting enough sleep, about eating right and getting to the gym. When I was 19, I drank a whole lot of coffee, smoked weed, stayed up late most nights writing poetry. My friends and I didn't worry about cholesterol or blood pressure. We had other priorities—making art, seeing the world, having mind-blowing sex. The culture that once admired smoking, drinking, and a tendency toward recklessness is now hyper-focused on health. We've become a nation of obsessive scolds, smug and superior when we think we've achieved good health (however fleetingly), self-righteous when we think others are slacking off. The irony is that such "healthism"—prioritizing health above all else—actually gets in the way of our overall well-being. Not only does it make us annoyingly judge-y about ourselves and other people, it ignores the fact that there's more to life than a good cholesterol reading.
Don't get me wrong: a good cholesterol reading is great. So are getting exercise and eating well and getting enough sleep and other life choices that promote wellness. But healthism takes things further. Sometimes too far.
"Healthism is about making self-care a moral responsibility, something to be pursued above all else—to even be the thing worth living for," explains Julie Guthman, a professor of social sciences at the University of California Santa Cruz. It encourages—even requires—us to be obsessed with our own health and sanctimonious about other people's.
You might even say that health—at least physical health—has become our national religion, complete with moral distinctions between good and bad, virtue and sin. We're "good" when we eat skinless chicken and "bad" when we eat chocolate cake. We're "good" when we work out and "bad" when we nap instead. And that's problematic for all sorts of reasons.
For one thing, health is individual. When I had mono as an adult I napped every day, and those naps were healthier for me than trips to the gym would have been. My healthy meal might look pretty different from one for someone with, say, cystic fibrosis or cancer. But the reductionist language of healthism brushes off such nuances, insisting instead on blanket recommendations ("Everyone should work out daily!" "Eating sugar is bad for you!").
For another, the compulsive pursuit of good health suggests that if you do everything right you will live a long and healthy life. You might even live forever. We don't rationally think that, of course. But at its heart, healthism is an obsessive quest to outwit death, a search we know to be impossible and still somehow hope is true.
Because that quest is by definition impossible, it makes us anxious. Sometimes very anxious. "Since health can never be achieved once and for all, it requires constant vigilance in monitoring and constant effort in enhancing," points out Guthman in her book Weighing In: Obesity, Food Justice, and the Limits of Capitalism. Like Sisyphus rolling the boulder uphill, we're doomed to keep pushing ourselves, only to find that age or disease or chance sends the boulder crashing back down.
That anxiety itself isn't benign. Chronic anxiety is bad for both physical and mental health, raising blood pressure, cortisol levels, blood glucose, and other biomarkers, and making us more susceptible to type two diabetes and other diseases. There's psychological fallout, too, from living with an imperative you can never realize.
Then there's the moral overlay, the good/bad dichotomy produced by seeing the world through a healthist lens. Margaret McCartney, a general practitioner in Glasgow, articulates the problem perfectly in an essay about so-called clean eating. "The command to eat cleanly," she writes, "implies that everyone else is filthy, being careless with their bodies and lives." It implies that you're filthy, too, when you don't live up to the impossibly rigid standards of the day.
Healthism is a natural extension of the cult of personal responsibility, the 80s- and '90s-era idea that you have total charge of your health and have only yourself to blame if it's not ideal. And what a tempting fantasy that is, the illusion of control in a chaotic and unpredictable world. But that illusion keeps us from thinking about health in a systemic way, according to medical historian Jan Henderson, who writes that governments love this illusion because it lets them "shift the burden of responsibility for health onto individual citizens." Forget those expensive anti-poverty efforts! Never mind those environmental regulations! Health is just about each person's "lifestyle choices"—no need for a bigger-picture perspective.
Healthism can also lead to stigma and discrimination. I've heard countless stories from people who avoid routine screenings and checkups because they don't want to face the well-documented weight stigma in the medical field. They avoid exercise because they don't want to be yelled at or ridiculed by the svelte CrossFit-heads at the gym or on the street.
Even if everything we think we know about health is accurate (and it's not), do we really want to be a culture of sanctimonious smartasses?