Healthism: The Cultural Complex That’s Making Us Sicker

One of the core tenets of Buddhism is that suffering is inevitable, but that our beliefs can cause us unnecessary suffering. Nowhere is that more true, IMO, than in our cultural approach to wellness— “healthism.”

What is healthism, you say? You may not know the term, but you are already an expert in its ways.

Healthism is a pervasive belief system that says health should be valued above all else, and that each of us is responsible for our own health. Any failure to be healthy is both a personal and a moral failure.

Healthism is so commonly accepted that we rarely question its values; it’s like asking a goldfish to explain what water is. Yet if we take a closer look, we can see that there is no inherent truth to healthism’s claims; and that by simply loosening its hold on our minds, hearts, and bodies, we can breathe a little easier. Let’s take a look at each of the core beliefs of healthism.

“Each of us is responsible for our own health.”

The implication within this statement is that you, and only you, should be taking care of yourself. But why is this a truth? We are born as fundamentally interdependent creatures. We require not just physical but emotional care from our families and communities as we grow.

We are not all born with a genetic blueprint for health. While some of us will naturally be healthy, others will have a less-effective immune system; poor eyesight, or some other natural genetic variation that falls short of our cultural ideal of “healthy.”

Further, we are not all born into ideal circumstances that will foster health-- balanced nutrition, low pollution, economic stability, healthy and responsive caregivers are a privilege we don’t all have. As adults, many of us do not have access to healthcare, or our insurance limits what care we are able to receive.

Most of these circumstances are simply beyond our control, and yet we have an unwritten expectation that we should all be able to “manage” our health.

The harm here is that achieving health is simply not possible in the same way for all of us. According to healthism’s logic, if you aren’t healthy, you must be doing something wrong. You’re not exercising enough; you’re not eating “right;” you should see your doctor; you should give up on Western medicine and see a natural practitioner.

Healthism is the voice that says, “No excuses!” while ignoring the role of oppression, poverty, racism, sexism, trauma, violence, environmental factors, and naturally occurring disease or variations in the human genome.

There is no acknowledgement of the social, cultural or environmental challenges that individuals face within a system. Don’t have enough money? You can eat healthy on $5 a day! Meal prep! Sheet pan dinners! No time to exercise? You have the same 24 hours Beyonce does, you just need to use them better! Park further away from the store! Get your steps in! No insurance? Well, why don’t you have a job that offers it?

With healthism, it’s always the individual’s fault.

External stressors count, too

One of the most common ways I see healthism affecting my clients is its ability to deny a lived experience and to disregard external factors. So many of us expect that, regardless of what we’re experiencing in our lives, we should still be able to eat healthy, kill it in the gym, get our 10,000 steps in.

Living through a time of political upheaval is inherently stressful and will take some of your energy reserves just to survive. To a large degree, our bodies don’t know the difference between mental stress (what’s going to happen to my retirement fund?) and physical stress (I just ran a 5k). We will have less energy available as a result of either stressor. This is normal. You are normal.

Healthism suggests that we should be able to manage our sleep, our stress, our anxiety, in the same way it suggests that we can manage our physical health. Sure, there are things we can do to get better at living with stressors, or to improve sleep patterns— but the reality is that, no matter how good your morning routine is, you cannot eradicate external stressors. And let’s not forget that not all of us have the privilege of time and money to engage in the behaviors that would ameliorate that stress— no matter what healthism says.

Healthism denies the systemic and environmental causes of mental health symptoms and places the burden for dealing with them back on the individual. Anxiety and depression are normal and healthy responses to an unstable political situation, for example—a failure to thrive in these circumstances is not a reflection on the individual.

Healthism says, “Healthy people are the best people.”

Because it places such a high value on health, healthism says that healthy individuals are morally superior to unhealthy individuals. After all, they’re the ones who have managed to take their health into their own hands, showing us all that it’s possible! This is what we’re all striving for, right?

This is the principle that allows insurance companies to deny coverage for pre-existing conditions. It says they are not healthy enough to deserve healthcare.

This is why we consider thin, “fit,” able-bodied people to be the “norm,” and others to be deviations. A quick look across the tabloids or a flip through social media will tell you which bodies are most valued in our culture. Celebrities are shamed for “letting themselves go.” People using mobility aids are missing or invisible. It’s no coincidence that the featured bodies are the ones that hold privilege.

Because if you recall, in reality, health is not something that everyone has equal access to. This means that privilege determines who is healthy, and who is considered morally superior. Those with financial privilege, educational privilege, white privilege, thin privilege, cisgender privilege, able-bodied privilege are at the top of the pyramid.

When we buy into healthism, we reinforce the structures of racism, ableism, sexism, and white supremacy (among others).

“Healthism shows up when we joke about getting diabetes from a single dessert, or refer to a rich meal as a “heart attack on a plate”—implying that those health conditions are caused by failures of a perceived personal responsibility to be healthy, not by structural forces that disproportionately harm the health of people living on the down side of power. Healthism shows up when we suggest that trans people should be more worried about the side effects of long-term hormone therapy than their own lived experience of their gender.” -Aubrey Gordon, @yrfatfriend

How does healthism show up in your life?

• Healthism says, you shouldn’t be so tired, you haven’t done that much today— even when you’ve spent the day feeling anxious about the future.

• Healthism says, you’re not doing enough to take care of yourself.

• Healthism makes us feel guilty when we are sick, as though we’ve done something wrong.

• Healthism says, “I don’t want my hard-earned money to pay for someone else’s healthcare,” or, “Why should I pay for people who don’t take care of themselves?”

• Healthism doesn’t take into consideration the amount of work that each of us may have to do. It positions self-care as mandatory and shames us for not “finding the time.”

• Healthism judges others, saying “She just hasn’t been taking care of herself.”

• Healthism ignores those that are missing from our wellness spaces (brown bodies, black bodies, disabled bodies, fat bodies, trans bodies). Rather than asking why these spaces are so white, it says, “Yoga is for everyone!” and, “If everyone would meditate daily, they’d be healthier.”

• Healthism assumes that the fat person at the gym is there to lose weight.

• Healthism shames us when we are tired, under-resourced, or unmotivated to exercise.

Healthism is selling you:

• Products to control your weight

• Products to manage your time

• The idea that you would be better if only you could control your health.

Healthism is a powerful cultural complex. It reinforces existing oppressive systems externally, and as a personal complex, it can keep us locked in harmful cycles of self-blame. My experience is that by simply recognizing where and how healthism acts in our lives, we can start to loosen its grip on us; take the pressure off of ourselves, and reduce the suffering we experience as a result of feeling like “we should be doing something more” for our health.