Health?

I have recently re-read an important book, Against Health: How Health Became the New Morality. In their book, the authors, Jonathan Metzl and Anna Kirkland argue that what is considered healthy is becoming more and more narrowly defined and carries a moral tone.

How often have you heard things from your doctor like, "We'd like to see you at a healthy weight." and only if you think about it do you see that the term actually has very little bearing on health, especially if at the time it is said you are not ill. Or "healthy foods" -- does that mean it is not poisonous? Or what if I am allergic to a so-called "healthy food"? Is it healthy for me? 

Think about it, what does "healthy" mean?

In an essay entitled "To Overhaul the System, ‘Health’ Needs Redefining", H. Gilbert Welch says


"In the past, people sought health care because they were sick. Now the medical-industrial complex seeks patients. It encourages those with minor symptoms to be evaluated and urges those who feel well to get “checked” — just to make sure nothing is wrong.

So, if health is the absence of abnormality, the only way to know you are healthy is to become a customer.

But healthy people aren’t great customers; they’re like the people who pay off their entire credit card balance each month. The money is in those in whom an abnormality can be found.

The medical-industrial complex has made that relatively easy to do.

It develops diagnostic technologies able to find smaller and smaller abnormalities. So more and more of us are found to have damaged cartilage in our knees, bulging discs in our backs, and narrowed blood vessels throughout our bodies. And far too many are also found to have “spots” or “shadows” that are seldom significant but are said to be “worrisome.” So more and more of us have knee surgery, back surgery, angioplasty and more diagnostic investigation."


If we imagine that health means the absence of illness, that is not much help either, because illness is a slipperier concept than most of us think.

 appealing to health allows for a set of moral assumptions that are allowed to fly stealthily under the radar. And the definition of our own health depends in part on our value judgments about others. We see them—the smokers, the overeaters, the activists, and the bottle-feeders—and realize our own health in the process.


Metzl, Jonathan (2010-11-23). Against Health (p. 2). NYU Press reference. Kindle Edition.


Anyone indulging in behaviors that are not socially sanctioned come to be viewed as ill. Look at the number of things now called "addictions", so much so that addiction in the original sense becomes almost trivialized.

A few weeks ago when I met with that new therapist for us to become acquainted with one another, she saw my assertion that being fat does not equate to being unhealthy as indicative of my pathology. When she said, "But Cheryl, you don't see the whole picture", she was saying to me that I was denying my own "illness".

Medicalizing or pathologizing a condition can help to remove blame from the individual, but I believe that it actually extends the reach of moralizing discourse. The strategy is also reminiscent of Stockholm syndrome: what tempts people to make use, as part of emancipatory political projects, of the very same medical discourse that has been used to justify their oppression? Over ten years ago, Wendy Chapkis decried this return to biological determinism as a guarantor of civil rights protection, reminding us that “difference may be arguably described as a ‘fact of nature,’ but its expression remains a social and political act... The fat person who argues moral validity by saying that he can’t help being fat and has good eating habits and takes plenty of regular exercise seeks deliverance. It is an understandable goal, but one based on truly fraught reasoning that allows healthism to flourish unchecked. As sociologists Abigail Saguy and Kevin Riley point out, “although a focus on behavior rather than body size potentially removes the stigma associated with larger bodies, it may reinforce the moral imperative to engage in healthy lifestyles.”14


Metzl, Jonathan (2010-11-23). Against Health (pp. 76-77). NYU Press reference. Kindle Edition.


 In responding to her that I am healthy and "can’t help being fat and [have] good eating habits", I was actually supporting  the vey thing I decry. I was engaging in a variation of the Good Fatty, one deserving of "deliverance" because I am not one of *those people* who eat nothing but junk food, neglect their health and generally match all the stereotypes. 

Separating health from morality is no easy matter. Why must I be healthy to be worthy or good or moral?

© CHERYL FULLER, 2010. ALL  RIGHTS RESERVED.