Against health moralism

Concept of discrimination with an obese man pointed the finger for his overweight.

Here’s a recent comment from The Skeptical OB Facebook page:

I love how this page tries so desperately to falsely reassure obese people that it’s ok to be obese and there will be no long term complications to your health. It’s mental snake oil and people are eating this page up.

It’s similar to many comments over the last few day. The morally conceited apparently can’t tell the difference between health and moralizing about health.

The comments were precipitated by a series of posts and memes that called attention to the harms of health moralism.

Their devotion to the “health” of others allows the morally conceited to feel morally superior.

I noted that thin people feel superior to those who are overweight; that appeals to health involve moral assumptions, as well as power and privilege; and that we are hypocrites: demeaning those who risk their health by being overweight while venerating those who risk their health (and brain function) by playing pro football.

I didn’t think the argument was particularly sophisticated but clearly I was wrong. Many people confused my opposition to health moralism with opposition to health. Nothing could be further from the truth.

What’s the difference between health and health moralism? Health is a state of being; health moralism is a method of controlling others. I’m entirely in favor of people being healthy but I strongly oppose efforts to control personal behavior under the guise of promoting health.

Why? Because health moralism is astoundingly arrogant and often harmful TO health.

Consider this excoriation of preventive care by David Sackett, MD a pioneer of evidence based medicine. It’s really an excoriation of health moralism.

First, it is aggressively assertive, pursuing symptomless individuals and telling them what they must do to remain healthy. Occasionally invoking the force of law …, it prescribes and proscribes for both individual patients and the general citizenry of every age and stage.

Second, preventive medicine is presumptuous, confident that the interventions it espouses will, on average, do more good than harm to those who accept and adhere to them.

Finally, preventive medicine is overbearing, attacking those who question the value of its recommendations.

The moral panic over the “obesity epidemic” is a classic example.

Of course morbid obesity is a serious health problem with potentially deadly consequences. However, simply being overweight is not only safe, but actually appears to be protective compared to “ideal” weight. That’s what the scientific evidence shows.

Despite that:

– Health moralism pursues healthy individuals and tells them they are ill or will soon be ill.

But the truth is that you can be overweight and healthy.

You’d never know that from the disgust toward the overweight.

– Health moralism assumes that any problem experienced by an overweight person is due to weight.

But you can be overweight and ill and your illness is not caused or even affected by overweight.

You’d never know that from the harms that overweight people experience when trying to get care for health problems. They are often told that their problems are due to weight when they are completely unrelated.

– And, as the comments on my Facebook page demonstrate, health moralism is incredibly defensive, attacking anyone who questions their effort to judge and control the behavior of others.

You can recognize that overweight is a risk factor for — NOT an inevitable prelude to — illness without condemning those who are overweight.

But you’d never know that from morally conceited fatphobes who feel entitled to rage against any effort to treat overweight people honestly and with respect.