Healthism

It’s not every day that I read something forwarded to me by another provider in a related field that just stops me cold. This announcement by Dana Sturdevant, MS, RD was one such. In it Dana was advertising a webinar (How Healthism Overshadows Healing: Ethical Considerations in Treatment Planning) that she and her colleague Hilary Kinavey MS, LPC put together on the subject of “Healthism.” I had never heard the term, but the moment I read it I knew exactly what it must mean.

If, like me, you have not heard this term before, here is a definition by Lucy Aphramor RD, PhD:

“Healthism is a belief system that sees health as the property and responsibility of an individual and ranks the personal pursuit of health above everything else, like world peace or being kind. It ignores the impact of poverty, oppression, war, violence, luck, historical atrocities, abuse and the environment from traffic, pollution to clean water and nuclear contamination and so on. It protects the status quo, leads to victim blaming and privilege, increases health inequities and fosters internalized oppression. Health-ism judges people’s human worth according to their health.”

I was struck by the synchronicity of this concept with what I have struggled to convey to parents and providers over the years. Dr. Aphramor’s definition of healthism rang a clear bell of recognition.

How many times, when forced to take a young person out of their sport in order to heal the ravages of their eating disorder, have I heard the lament that soccer or Lacrosse or basketball or tennis was this child’s whole identity and their greatest source of self esteem, their social life.  “What can we do together as a family, doctor, if we can’t do sports?” I am asked. “We are all very active and into good lifestyle choices. Isn’t that good for you?”

In all good conscience parents are trying to “make the lifestyle choices” which they have been told by their doctors, their friends, and the New York Times lead to the best possible (and longest) life.

That’s all very well and good, but what if their child were hit by a car and lost both legs? What if they were born without control over their limbs, as in some forms of cerebral palsy? Would they be any less their beloved child? Less worthy as a person? To what extent does our relentless, much publicized focus on health detract from the teaching we owe our children about what it means to be a person, a good person?

Is being healthy and fit more important than be caring and kind? How many discussions around the family table (where it still exists) focus on sports, exercise and diets as opposed to humanism, public service or spiritual concerns? Is it as important to cultivate the intellect and critical thinking as it is to cultivate a fit body?

You can have both, you say? Well, maybe– if you are a middle class American who lives in a safe part of town, has access to clean water (no longer a certainty), and plenty of fresh food. If you have those things you are lucky. Not necessarily good, but lucky.

In the same way that many people mistake beauty for virtue, they also mistake good health and fitness for virtue, ignoring the role of fortune– in both senses of the word– in the affairs of man. What if your family lives in a war zone? Working out is the least of your concerns. What if you have six little brothers and sisters and “outside” is gang infested? What if there is lead or arsenic in the water you drink? What if you were born with a significant disability? What if a bomb takes away your feet? To mistake a perfect and long-lived physical body for a virtuous human being is a big mistake, and certainly one we should avoid passing on to our children.

Choice? Healthy choices? If it boils down to that for you, you are fortunate. But rather than gloat, look around and know that there but for the grace of God go any one of us.

Take a look at Dana and Hilary’s webinar, you (and I) might learn something.