The obligation to be healthy at every size.

It is sad that this even needs to be said, but given the fact that we essentially live in a health meritocracy, let me be the first to announce:

You are under no obligation to be healthy.

And, as an addendum: even if you were, eating “well” and exercising wouldn’t guarantee your success. There. I’ve said it. And as much as this might chap the ass of every health promoter out there, I feel that personal agency and a basic sense of privacy are sorely missing from most conversations of health promotion, and from conversations of Health at Every Size.

Health at Every Size exists in order to address the health concerns of people who, well, have health concerns. It is not, nor should be, a vaunted ideal that everyone must strive to live up to. It is an alternative. To what? To weight-loss dieting, to punishing “health regimes,” to doctors whose anti-fat bias drives them to diagnose you as fat and send you limping off on a sprained ankle with a prescription for steatorrhea.

An alternative, not an obligation.

It’s sad that we’ve come to the point where this needs to be pointed out. But it seems to be the reality that health habits, and health status, are no longer private matters. When people believe that you are receiving health care services off their backs and their premiums, they believe it becomes their business to police your personal habits. When health becomes not just an indicator of damn good luck, but of social status — because only responsible, smart people know how to avoid getting sick, and have the money for all those special foods/supplements/alternative therapies you’re supposed to buy in order to be a worthy citizen of the health meritocracy! — people forget about respect for their own and other people’s privacy.

This, despite the fact that the definition of health itself has not even been definitively pinned down, that it has evolved through numerous variations through the years, and will likely continue to evolve. Despite that nutrient requirements are different for each person. As are genetic profiles, family histories, and every single one of the social determinants of health.

The factors that determine health are different for everyone — which means it is up to you to decide what to do. No one can do it for you.

But we live in an era, a really strange era, where our life expectancy is better than ever before, and where we have (arguably) adequate access to health care. But, in some kind of terror, we strive continually for a zero-risk situation — and we strive for it not by addressing systemic disparities in access, but through laughably insignificant personal attempts, and individual finger-pointing.

But there are no zero-risk situations. Even people who do everything “right” sometimes get sick and die. In fact, everyone eventually gets sick and dies. Despite attempts to the contrary, our mortality rate as humans remains stubbornly at 100%.

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