Do you feel pressure to live a “healthy” lifestyle?
Do you feel guilty if you eat “junk” foods?
What is your definition of “health”?
Is it the mere absence of disease?
Does it take into account the psycho-social determinants of health? What about our relationships, our mental health, our access to rest and relaxation, our access to clean water and clean air?
What about the effect of discrimination towards ones skin color or towards ones body size, (racism and weight stigma!)
Our culture which is steeped in dieting and weight obsession, tends to view health within an individualistic framework, often placing the onus on the individual as opposed to the system we live in. We tend to reduce healthy eating into dichotomous and moralistic terms. We are good or bad if we eat or don’t eat “junk” foods, right?!
There exists a national obsession and a preoccupation with the attainment of “health.” An over-focus on the goal of “health” and “well-being.” It has become an almost moral obligation to become “healthy”!
But what exactly does that mean? How can we know if we are healthy?
The term healthism is a relatively new concept that was defined in the 80’s as, “the preoccupation with personal health as a primary…focus for the definition and achievement of well-being; a goal which is to be attained primarily through the modification of lifestyles.” Robert Crawford.
Healthism has evolved over the years and is now defined more specifically by Lucy Aphramor, Ph.D, RDN as follows:
1) is the belief system that sees health as the property and responsibility of the individual and ranks the personal pursuit of health above anything else.
2) ignores the impact of poverty, oppression, war, violence, luck, historical atrocities, abuse, and the environment (which includes traffic pollution, clean water, etc.).
3) it protects the status quo, leads to victim blaming and privilege, increases health inequalities, and fosters internalized oppression.
4) it judges people’s worth according to their health.
According to Aphramor, Healthism involves people NOT taking into account pleasure with eating, satisfaction with eating, how the food actually tastes, and the cost and availability of the food.
Thin privilege and financial privilege also significantly impact this belief system that says people “should” eat a certain way to be “healthy.” If you eat “right”, you are a “good” person. We’ve all heard the “You are what you eat” slogan!? Ah, the pressure of Healthism is upon us is insidious.
Think you are immune to the pressures of Healthism? Let’s take a closer look.
If you see a thin person eating a large salad, what thoughts come to mind?
What if you see a thin person eating a big burger and fries? What thoughts come to mind?
What about a fat person eating that same big burger and fries? Now what thoughts come to mind?
Become aware of your automatic thoughts in each of these scenarios so that you can begin to examine your own internalized biases around healthism as well as fatphobia.
Healthism reinforces the belief system that one must eat a particular way, the “right moral /good way” in the pursuit of the “right body size and shape.” The belief that the attainment of a certain body size will magically result in good health. These belief systems are internalized and then are projected onto others. They become judgements about how one “should” or “should not eat.” Or how one “should” or “should not” move their bodies (exercise).
Nutritionism: what is it?
Nutritionism is also a relatively new phenomena in our culture. Michael Pollan referenced “nutritionism” in his book: “Food Rules.” While he criticizes our culture as being too obsessed with nutrition and health in general, he also endorses behaviors with foods that paradoxically reinforce these fear based beliefs systems. There are several messages in his book worth pointing out.
First, he endorses avoiding products that contain more than five ingredients. He encourages the avoidance of most processed foods such as crackers, chips, cookies and candy.
Is it healthy to avoid these foods?
Can we eat these foods and still be “healthy?”
He also suggests not buying cereals that “change the color of the milk.” Say good-bye to your Lucky Charms and Coco Puffs! Haha! He generally recommends to not to buy any foods you see advertised on commercials. His biggest takeaway is: “Eat food, not too much, and mostly plants.”
I know he means well and it can be helpful to study the fundamentals of human nutrition and how this can relate to diseases prevention and what the body generally needs to consume to function optimally as well as to feel good and thrive, however, he also unintentionally reinforces fear and guilt in our already fear and guilt ridden diet obsessed culture. Fear and guilt and stigma and judgments do not actually serve as effective motivators for people to take good or better care of themselves.
Nutritionism is the usage of food rules, focus on diets, calories, and labeling foods such as “good” or “bad,” focus on portion sizes and willpower to control how much one consumes. Control and restrictive eating models often result in feelings of guilt and shame. They undermine trust with our bodies because fear and control dominate. Chaotic eating styles and disordered eating are not exactly recipes for good “health.”
Healthism often overlooks critical factors that affect one’s health status. Factors like food insecurity. Many Americans struggle with where to find their next meal and may be blamed unfairly if they consume certain products deemed “unhealthy.” We often judge people who “eat too many processed or fast foods. They should know better.” The pressure to consume “approved/healthy” foods in order to be a “approved/good” citizen is what healthism is all about.
Not everyone has equal access to these “healthy” foods. Not everyone has access to go their local Farmer’s market and buy an eight dollar heimloom tomato.
Furthermore, our current medical system blames weight first for most ailments and often promotes weight loss as the solution without having any evidence to support that intentional weight loss diets work in the long term to fix whatever ailment brought them to the appointment in the first place. These folks face weight stigma which negatively impacts health outcomes in long term studies. Read more about weight stigma here: https://www.mindful-nutrition.com/what-is-weight-stigma/
Think about how you were raised. What were the messages you received about health and healthy eating? Did your parents allow you access to fun sugary “junk” foods, or did you have to go to your neighbors (like I had to!) to sneak hostess ding dongs and lil Debbie cakes?
Our early messages about health as well as the impact of diet culture have shaped our views of “healthy eating.”
We live in a culture where eating disorders are continuing to increase and this reflects a deep confusion about our identities and definitions of health, nutrition, and wellness. Clearly, something is not in balance as eating disorders continue to increase. If fear, control and avoidance dominate our plates instead of pleasure, permission, and awareness then we need to radically re-define what healthy eating is and how to reach a level of health that goes beyond the superficial and captures the totality of our relationship with food and our bodies.
Share with me below what your definition of “health” is!
Inspiration for this article comes from my colleague Robyn L Goldberg, RDN at askaboutfood.com
Thanks Karen, this is an excellent piece and much of what you talk about has been on my mind every day lately.
After several years filled with multiple types of extreme chronic stress and illness I’ve realized that trying to lose weight right now (for an upcoming and dreaded annual doctor’s visit) is adding yet more anxiety and pressure. This leaves me in a constant state of guilt, because I’m not doing what I “should”. Also, I know weight gets blamed for a lot of things and at age 61, I’ve been trained to worry about diabetes, dementia, cancer, heart disease and stroke. Yet, my own mom lived to be 91 and though considered obese/overweight she did not worry about it at all and lived by her own personal code.
I know many slim people that suffer from all the health issues and diseases I mentioned, yet by comparison, I feel judged, inferior and a failure in the “healthism” environment.
Everyone has their own unique challenges and this piece makes it clear the real struggle is in how to let go of all this outside pressure and just accept ourselves and our personalities, anxieties, health issues, heredity, relationship with food and coping methods.
Your article really clarifies where all this pressure is coming from and it’s a lot to tune out! But ha, so far, trying to become a different person at my age isn’t working for me, at all! It just leads to more guilt.
I remember as a kid, in my family we just accepted people as they were built or made, without judgement. There weren’t all these “one size fits all” health messages being shoved at us from every direction all the time.
Thanks for the support you’ve provided in the goal of enjoying life and food again.
Thank you for reading and sharing!