The Myth of Prioritizing Our Health

One of the justifications for the bullying, stigmatizing, shaming, and paternalism that fat people have to deal with is that it’s because we aren’t prioritizing our health and that’s bad for society.

Of course that’s based on the idea that by looking at someone’s body you can tell their priorities, behaviors and health.  Of course there are people of all sizes who prioritize their health in many different ways for many different reasons.  Of course those are none of our business.  Of course people are under no obligation to prioritize their health in any specific way.  And of course this whole argument is based on stereotypes.  But let’s pretend it’s true – that by looking at fat people you can tell that we don’t prioritize our health.  Then is the poor treatment of fat people justified?

At this moment I am watching late night coverage of the Olympics.  They are showing luge and a man is on a very small sled traveling over 86 miles an hour across a steep path of ice (a speed which I’m not legally allowed to reach surrounded by metal in my car on an abandoned highway.).  Earlier today I watched a snowboarder compete after he broke a rib on a training run, heard from another snowboarder who had pulled out of an event because he was trying to avoid injuries before his next event, and I heard about a female mogul skier who had torn the ACL in both of her knees requiring four surgeries, and we haven’t even begun to discuss the sport of skeleton which is like luge except people go head first.  Head first.  Head effing first.

None of these people are prioritizing their health. In fact, very few athletes do – they tend to prioritize winning, or playing.  People justify their poor treatment of fat people based on the argument that we are putting ourselves in a position to have above “normal” healthcare costs by our behaviors, and based on that logic (with which I don’t agree) athletes are doing the same thing since they are putting themselves in a position to have above “normal” healthcare costs with their behaviors. Does someone want to calculate the healthcare costs of people who participate in sports – not just sports injuries but the effect on the human body for life?  With all the research on the health benefits (and low risks) of walking (for those for whom it’s not precluded by disability), why not have a war on sports?

Lots of research shows that sleep is very important to health.  How many people aren’t getting the recommended amount?  Should we make some guesses about the health problems that causes, do some quick back of the envelope calculations and have a war on people who under sleep?

There are thin people who engage in the behaviors which are used to justify the mistreatment and paternalistic attitude toward fat people – being sedentary, eating a lot of fast food etc. and yet there is no war on thin people who don’t prioritize their health.  So I have to wonder if people believe that if these behaviors don’t make someone fat then they should be defined as healthy?

Health is complicated, it’s multi-dimensional, and it’s not entirely within our control and there are many, many competing theories about how to achieve health.  The idea that if we can successfully stereotype a group of people who look a certain way, then we can justify poor treatment of them is, I would hope obviously, highly problematic.  Each of us gets to decide how highly to prioritize our health and what path we should take to get there and anything other than that is a fast and slippery slope to a very bad place.  Do people who believe that raw foods are the healthiest thing get to have a war on everyone else?  Do people who believe that paleo is the best place get to have a war on everyone else?   Those who want to talk about fat people and their tax dollars can head right over here.

The truth is that this whole “it’s about their health” thing is a sham that has been built up to justify and protect prejudice and create profit.  The suggestion that society is stereotyping and bullying fat people because we aren’t prioritizing our health is ignoring the truth, not just about fat people, but about everyone else as well.

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Published in: on February 9, 2014 at 9:59 am  Comments (24)  

24 CommentsLeave a comment

  1. You are so damn good! Damn! Damn! Damn good! 10.0 from the head judge of Sparkle ;)

  2. Some excellent points. And not to mention the fact that very often, health problems are outside our control anyway. I got my joint condition because of a faulty gene – nothing I could do about that. The husband of a friend is dying of lung cancer, despite having never smoked in his life. My daughter has a gut disorder she was born with.
    Maybe the truth – that your health is largely a matter of luck – is so scary to people they’d rather convince themselves that its something they’re doing and distract themselves from this lie by persecuting fat people? (or skinny people, or poor people, or gay people or whatever prejudice they prefer). It’s all scapegoating and nothing whatsoever to do with helping people.

    • Yes. People are definitely scared of things they can’t control. They like to believe that health and weight are within their control and some refuse to see that the truth is often the opposite. I avoid the dentist and only brush once a day. I floss occasionally, if I feel like it. I just got my first cavity at 41 and it had more to do with an angled wisdom tooth than anything else. I was just blessed with strong teeth. I don’t pretend otherwise.

  3. Thank you, Ragen!!! I am going to remember (and use) “With all the research about the health benefits of walking, why not have a war on sports?”

    • Me 2

  4. If they’re going to bring up sports and health, they should mention how much football costs our society as more and more players are discovering they irreparably damaged their brains by playing. Or the long-term damage caused by steroid use. Or the knees and hips that have to be replaced. Dementia, domestic violence, depression, substance abuse, suicide attempts … all because they valued winning and success more than their health.

  5. Thanks for mentioning walking having health benefits & being generally safer than most other exercises (I did fall & smash a kneecap while walking, but that is mostly about me having cerebral palsy & the sidewalks in my city not being maintained well enough for anyone to be safe on them, which is also one reason why I now use a rollator walker.) I have tried quite a few other forms of exercise in my life, have not been very successful at most of them, but always I have walked. Yet, I am supposedly endangering my health more than some guy traveling nearly 90 mph on sheer ice! Yep, we live in a real sensible, enlightened society! And I am fed up to here with all the yapping/lecturing about ‘personal responsibility’ & ‘prioritizing health.’ We are all mortal beings, we will all die sometime, anyone can get any illness/disability, & the great majority of it is beyond our control. Plenty of people who do all the ‘right’ things have serious health issue &/or die young, while plenty more do everything we are told is wrong & live to be very old. And some of the ‘magic bullets’ which we are told guarantee health & longevity may work fine for some, but not at all for someone else, or may even hasten health problems & early death. Not only do we not know how to make naturally fat people permanently thin or naturally thin people permanently (or sometimes temporarily) fat, we also do not know why some people live much longer than others, aside from the very obvious causes of murder or suicide. Besides, WHY is it anyone else’s business if that soda or those potato chips make me die a little sooner? I am not forcibly taking them with me? The art of minding one’s own business is lost in modern culture.

  6. I think one of the most ugly things about the “prioritizing your health” myth is the fact that many of the people who push this idea are simply more privileged than others who don’t have the money to engage in a lot of healthier habits–for example, buying fresh, healthy produce or exercise in places where there isn’t the risk of being shot.

    I saw this a lot going to a graduate school that was mostly upper-middle-class and white. “Oh, I can’t eat *that* because that’s unhealthy…” Many people do not have a choice. Many people do not live within easy access of grocery stores. Looking back, I should have called this attitude out more.

    • Yes, this! Anybody remember that little handy-dandy diet book that was the big thing a few years ago, that started “Eat food, not too much, mostly plants?” You can boil down the pages of rules for good eating to these:

      1. Have the leisure, kitchen, and ingredients you need to make almost everything from scratch.

      2. Live close enough to a farmer’s market, and have enough disposable income, that shopping there isn’t more hassle than it’s worth.

      3. Have time to sit at a table and eat slowly after you make your scratch meals from things you bought fresh at the farmer’s market. All three meals. Don’t have two jobs or be sole caregiver to any dependents. Also have time to do the dishes.

      4. Don’t be poor.

      • Yep. Which is why although I decided to go mostly vegan because diabetes runs in my family, I don’t moralize about it. I *know* that part of the reason why I can do so is because all four of the reasons you listed apply to me.

        I want to do more to work on eliminating the food disparities in this country. I know there’s a nonprofit in Oakland that works on this, but I am also wondering what else I can do.

      • Jenny, this is beautifully said. Absolutely. The emphasis on “healthy eating” assumes deep, deep privilege and it really bothers me that so few people who push the “eat real food — mostly plants” agenda seem to see this.

        I am under cardiologist’s orders to follow a strict low-sodium diet. I am lucky enough to have a well-paying job. I’m also lucky enough to live in a town (of about 30,000) that has 3 decent grocery stores where I can get good produce, including organic if I want it, and free-range chicken. We have a farmers’ market in the summer. My partner and I have no dependents living with us, and we’ve worked out a balance where he does the grocery shopping and the dishes and I cook the made-from-scratch, low-sodium meals. And EVEN SO the time it takes is too much for us sometimes after a full day’s work, and a couple of times a month we yield to the temptation to get take-out Thai food even though I know the sodium levels are very bad for me.

        If I were poor, or a single parent, or working two jobs, or didn’t have a car and had to take the bus miles to a decent store and then carry whatever I bought back on the bus with me, or had an elderly or disabled relative to care for, or didn’t have a workable kitchen space, or any combination of those — there is no way I could cope with trying to cook for myself every day, no matter what my cardiologist (assuming I could afford one) said.

        My ability to prioritize my health this way reflects my very high level of privilege (as well as my personal choice, as Ragen rightly points out), and it is just maddening how many equally privileged people feel smug and self-righteous about scolding and badgering the less privileged for not “eating healthy.”

  7. So I’ve been buying Woman’s World every week because, in the typical cognitive-dissonant way of these magazines, they have some really good recipes a few pages over from the diet talk. They have a new diet literally every week, and each one promises to make you thin and full of pep. If I followed every diet, so far (I get them late, so this is just January) I would have:

    *Gone on a one-day crash diet of Metamucil and foods rich in potassium, in order to clean myself out from a presumed period of indulging in salty, starchy foods over the Holidays.
    *Immediately spent a week eating a ketosis diet even stricter than Atkins: unlimited portions, all meat.
    *Switched back to an old-fashioned “square meal” sort of diet, with protein, carbs, and fruit or vegetables at every meal (and also portion restriction).
    *Then gone vegan for a week in order to “prevent obesity.” Anything I wanted, as much as I wanted, as long as it was plants.

    And this is supposed to make me healthy, how?

    (But seriously, if I had the money and was responsible only for myself, I might do a diet a week from Woman’s World so I could write a book about it.)

    • I thought about doing that myself – going on some idiotic crash diet every week and blogging about it, just to show how ridiculous the idea is.

      • The new one is all “starch is bad, starch is bad, don’t eat anything starchy and also no sugars, also limit your portion size of everything but vegetables, and drink these magic fruit smoothies twice a day.” In typical WW fashion it puts the cover teaser for this awesome diet right next to a picture of a sweet cookie dip that is basically several varieties of starch and sugar layered in a bowl, and so rich a single serving would blow more than half of the diet’s calorie allowance for an entire day! (No, seriously, it would. The nutritional info is there next to the recipe.)

        Is the subtext that once you are socially acceptably thin you can go ahead and eat the forbidden thing that is basically the antimatter version of your diet? Or is it that if people aren’t struggling with the tension of cognitive dissonance, they won’t either buy the magazine for the diet that will make them socially acceptably thin or buy it for the sugar-high recipe?

        I also note that the magic fruit smoothies are made of fruits that are hard to find in many areas and on the extremely expensive end of the price range for fruit.

        • If it worked they wouldn’t get repeat business. And if they said “You can never eat cookies again”, no one would sign up for it as it would obviously be unsustainable. Clever marketing.

  8. Ragen: “Each of us gets to decide how highly to prioritize our health and what path we should take to get there…”

    Tying into some of the stuff Mari wrote: Often these decisions aren’t in the hands of the individual. Think of the 40-plus workweek and how employers would react if they suddenly had to let everyone cut out a couple of hours earlier every week –with pay– in the name of more time for sleep/exercise/cooking a healthy meal at home.

    To me the most pernicious element in all this moralizing is the pretense that each of us, fat or thin, has absolute power over our health. The same people who put up roadblock after roadblock to healthy living for the individual then turn around and scold the individual for not being able to get around the roadblocks effectively. [scowl]

    • Thanks for your comment! I agree, as I also said in the piece “Health is complicated, it’s multi-dimensional, and it’s not entirely within our control.” Part of not being entirely within our control is that we don’t have all of the options available to us, my point was that the decision about what to do within our own circumstances does belong to us and not to people who think they know better. I write more about access issues here http://danceswithfat.wordpress.com/2011/01/20/fat-chance-for-healthcare-access/ and here http://danceswithfat.wordpress.com/2012/09/17/the-thing-about-access/

      ~Ragen

      • Ah, thank you for those. (As an Eternal Temp– six years now with no “permanent” job, I hear you on the health insurance thing.) The irony is, most of my docs have tiptoed very carefully around the issue of my weight in the last several years– except the one who said point blank that “turning into a beanpole” probably wouldn’t help my bad ankle and I’d be better off concentrating on nutrition and not weight loss. I guess I’m the exception that proves the rule… so far. :/

  9. Health is so complicated. I’m the thinnest I’ve ever been as an adult and I’m also the unhealthiest I’ve ever been as an adult. Though, I a, somewhat healthier than I was after finally having my gallbladder removed on the 31st of January. This idea that thin=healthy is dangerous to everyone. We’re so concerned with body size that we have no actual idea what health is and what it can entail for people.

  10. I’ve also noticed that sports and exercise injuries aren’t counted in the prioritizing health model.

    And that it was fortunate for me that I could afford rather a lot of body work (Alexander Technique, Rubenfeld Synergy, etc.) to get the rather surprising side effect of being able to enjoy walking. I still mistrust anything that people have to force themselves to do.I realize that our instincts aren’t perfect guides, but our choices (especially when strongly socially influenced) aren’t perfect guides either.

    I’m putting in a partial recommendation for Chris Kresser’s blog (chriskresser.com)– it does assume that not being fat is a good idea (but doesn’t have that as a central concern) and that people have resources to pursue their health, but it’s very good on human variation and scientific evidence. In particular, there are people who can’t digest anything with much fiber in it, so the usual advice to eat more plants is bad for them. They may be able to solve their digestive problems, but they should take their gut problems seriously until and unless the gut problems get resolved.

    • That’s true. My daughter has just such a gut disorder and has to eat quite a low fibre diet or she is very ill. Pretty much the only vegetables she can eat are over cooked carrots.
      I am so sick of people telling me that if she were vegan, she’d be healthier. I’d like to ask them where they got their degree in gastroenterology! As it is, we’ll follow the advice of her specialist. Incidentally, my daughter is really slim but that’s because she can’t absorb food :(

  11. Still collecting Woman’s World. This week’s diet (the Feb. 10 issue; magazine deliveries to local stores are running late) promises Paleo on a budget. I want to dig a bit more deeply into the tons of assumptions that underlie the Latest Greatest Diets Ever of the Week, using this one as an example. Paleo, says the article, is based on plain meat, fish, fruits, vegetables except potatoes, nuts, and seeds except beans, because that’s what people ate “before farms dotted the landscape.” So if you buy the cheapest plain meat, fish, fruits, vegetables except potatoes, nuts, and seeds except beans, you’ll be healthy (and thinprettyyoungpeppyfashionable).

    Except, no. I happen to have neighbors who eat “paleo” because they never stopped eating “paleo.” I put it in quotes because nobody eats the way they did in the Paleolithic, because cultures and traditions have never stopped changing since humanity began. Breakaway harpoons with floats and kayaks with watertight paddling suits were invented after the Paleolithic, opening new food sources to my neighbors’ ancestors. But anyway. Even nowadays, with grocery stores and microwaves, here’s a short list of local traditional foods that are not in this “Paleo on a budget” diet and some that are not in the “Paleo” diet, period, because you can’t get them in any store:

    *Fish heads freshly boiled–craved by pregnant and nursing women
    *Fish heads subjected to a process that turns them into something like Limburger cheese–craved by some, loathed by others
    *Air-dried fish
    *Fish smoked until it resembles chips of wood
    *Fish roe and milt, fresh from the animal
    *Fish eyes, mammal eyes, eyeballs in general
    *Blood soup with horsetail sprouts, a regional tradition in early spring
    *Wild starchy roots, wild berries, wild greens: even those that are closely related to domestic species have much less sugar and higher proportions of other nutrients because of domestication, and fewer than half a dozen are ever seen in stores, and those only in Japanese markets
    *Sea mammal muscle meat, blubber, and chitlins
    *Limpets eaten raw and live or pit-cooked right on the rock they cling to
    *Gumboots, AKA chitons, an invertebrate that looks like Cthulhu’s beard lice but tastes pretty good
    *Deer guts
    *Seaweeds of all kinds, sometimes with snails or fish roe on them–and again, most not available in stores
    *Octopus
    *Whelks
    *Wild ducks, geese, cranes, and shorebirds, with all of their fat and blood and most of their innards

    I’m sure I left some out. These are not matters of personal taste. A real “stone age” diet isn’t “just like us, except leaving out some things.” It’s a completely different culture with different rules for eating. It’s strongly seasonal, very local, and much, much less picky. And the nutritional profile for a pre-agricultural diet is not, repeat not, the same as what you can get from eating cheap cuts of domesticated muscle meat and whatever vegetables are on sale this week!

    The one good thing about these Latest Greatest Diets Ever of the Week is that they only have two pages in which to get their point across instead of entire books full of bumf. When you cut down the premise of a diet to a single paragraph, the logic holes stand out starkly.

    • *Wild greens kept over the winter in a container made from a sea mammal’s stomach so that the acids in the stomach lining will create a kind of sauerkraut, incidentally changing the nutritional profile; very few people use this method anymore, but the point is that lactic acid fermentation is very old
      *Berries preserved under a layer of melted seal fat: still done, and again, it changes the nutritional profile of the fruit
      *Wild birds’ eggs
      *Seasoning herbs not grown commercially anywhere

      I know there’s more.

      Also, if “paleo on a budget” doesn’t allow beans or potatoes because they are products of agriculture, why does olive oil get a pass?

      • I’m guessing that olive oil will get its turn as mainstream Demon Of The Week any day now. I’ve already seen this in certain Vegan circles: Olives + all refined oils are OMFG!POISON!!11 for everyone!!11

        Anything to keep us all chasing trend after trend and laying out big bucks in the name of “health.” :/


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