What is “Healthism”? (August 2018)
This is a term that you may or may not have heard before. Today, whether it be on social media or advertisements, we are swimming in statements pertaining to “Healthism.”
Robert Crawford defined healthism in 1980’s as “the preoccupation with personal health as a primary…focus for the definition and achievement of well-being; a goal which is to be attained primarily through the modification of lifestyles”.
We often hear messages pertaining to what we “should” or “should not” eat, how our weight is correlated to our health status, or how going on a specific diet will improve a medical condition.
I had the pleasure of hearing two colleagues, Hilary Kinavey, MS. LPC and Dana Sturtevant, MS, RD from Be Nourished in Portland, Oregon, speak on this topic at the Binge Eating Disorder Association (BEDA) and National Eating Disorder (NEDA) Conference in Brooklyn, NY. They used a wonderful quote by Lucy Aphramor, Ph.D., R.D. from Well Now Program that nicely sums up healthism:
1) (Healthism is) the belief system that sees health as the property and responsibility of the individual and ranks the personal pursuit of health above anything else.
2) It (healthism) ignores the impact of poverty, oppression, war, violence, luck, historical atrocities, abuse, and the environment (which includes traffic pollution, clean water, etc.).
3) It protects the status quo, leads to victim blaming and privilege, increases health inequalities, and fosters internalized oppression.
4) It judges people’s worth according to their health.
To summarize, healthism involves individuals not thinking about satisfaction, taste, cost and availability when considering their health. Thin privilege and financial privilege have a significant impact on the belief system that people have regarding what they should and should not eat.
Furthermore, healthism breeds individuals that don’t consider how their obsession to eat and appear a certain way molds their belief systems as well as how they view and interact with themselves and others.
Hilary Kinavey and Dana Sturtevant gave a great example of healthism in relation to the Mediterranean Diet, stating that it “reduces the risk of cardiovascular disease but only if you are rich or highly educated (International Journal of Epidemiology, 2017).” Too often, we hear about the results of studies without being informed that these results are solely based on a specific population instead of capturing all ages, socioeconomic status, and psychiatric history.
Be aware that healthism is not related to what one is eating. The usage of food rules, focus on diets, calories, and labeling foods (such as “good” vs. “bad”), references to portion size, or using the term willpower (which can result in feelings of guilt and shame) are all examples of restrictive eating are representative of what is known as “nutritionism.”
The term “nutritionism” became known after Michael Pollan referenced it in his work upon seeing the phenomenon of people becoming afraid of various foods or food groups due to diet culture messages such as:
- “Don’t buy cereals that change the color of the milk.”
- “Avoid products that contain more than five ingredients.”
- “Don’t buy foods you see advertised.”
Sure, it can be helpful to understand the basics of what we are putting into our body. However, nutritionism requires focusing on this to an obsessive degree.
Pollan recommends looking at food, and how it works in our body, from a lens of nutritional benefit.
It would be wonderful if we lived in a world where everyone could feel comfortable going to a healthcare appointment with the knowledge that they would be properly treated for the reason they made the appointment.
Sadly, our current medical system blames weight for most ailments instead of looking at the presenting problem objectively and treating the patient as such.
Healthism certainly has an impact on individual’s belief systems and can particularly effect how others are discriminated against based on their diet. For example, healthism emphasizes the purchasing of “approved,” “healthy” products that may not be accessible to all based on their socioeconomic status. Further, many American citizens struggle with food insecurity and are unsure where their next meal is coming from or when they will be able to eat again. Yet, these individuals are often judged for what they are lucky enough to be able to eat.
Our upbringings and the messages we have seen and received from a young age may also contribute to our views of health.
These social determinants shape our view on health and can contribute to “healthism” or “nutritionism.”
It is important to explore how we can be open to changing the dialogue surrounding health, nutrition, and wellness.
- Crawford, R. (1980), Healthism and the medicalization of everyday life. International Journal of Health Services ,10:3, 365-88
- Pollan, M. (2007). Unhappy meals. New York Times Magazine. Retrieved from http://www.nytimes.com/2007/01/28/magazine/28nutritionism.t.html.