The word “healthy” is used to describe foods, lifestyles, relationships, and body sizes, yet the definition of the term is not universal.
As a Registered Dietitian, when I first start working with my clients, they often start talking about their eating habits with phrases like, “I eat healthy foods, so I don’t know why I feel this way,” or “We eat healthy in our house, we never have ‘junk,’ so I’m not sure why I was diagnosed with *fill in the blank with every syndrome and chronic disease here*,” or “I’m really healthy, I exercise everyday no matter what and don’t eat carbs, but I have these stomach pains.”
This is why I say – “It’s important to note that striving for health will not necessarily yield health.”
Although we are under the assumption that we have 99% control over what happens to our bodies if we eat “healthy” and participate in “healthy” activities, this is not actually the case. In fact, according to the Centers for Disease Control, we have about a 25% ability to influence our health via “healthy” behaviors, but there are other determinants of health, including genetics, access to medical care, income, and gender that together, have a greater influence on our health than diet and exercise. As a Registered Dietitian, it’s my job to help people strive for health, but the work I do may not influence someone’s overall health if these other factors play a larger impact on the outcome.
With that in mind, I would like to redefine health by sharing what health is not.
Health and Body Size
Because our society is so strongly influenced by a culture of wellness, and health and striving for health is seen as a matter of morality, people will often feel shame when they receive a diagnosis of heart disease or Diabetes, for example, as if these diagnoses are based solely on what they eat or how often they exercise.
As a reminder, there is not one disease that only impacts people of size; you can be thin and unhealthy or fat and healthy and vice versa. There is also a strong notion that all bodies have the potential to be thin – and therefore healthy – if people engage in “healthy” eating and exercise behaviors.
What is true is that people have the ability to improve their health through nutrition and movement regardless of their body size.
Let me say it again for the folks in the back: Although the diet industry would have us believe otherwise (because their profits are fueled by our buy-in to the Seduction of the Thin Promise), we can improve our health status (based on metabolic health factors) without a change in our weight. And even if a smaller body suffered fewer health issues, we don’t currently have a way that is safe and effective to get people smaller and stay there.
Health and Thoughts and Behaviors
In order to avoid shame, compete with the other determinants of health, and try to shrink their bodies because of the false belief that body size is equivalent to health, some people will engage in disordered eating behaviors.
These behaviors can include yo-yo or chronic dieting, eliminating specific foods or food groups, skipping meals (ie intermittent fasting, restriction, ignoring hunger cues), participating in detoxes or cleanses, and experimenting with supplements and alternative therapies for weight loss.
When these behaviors don’t lead to the goal (and they won’t; the data shows that 88-95% of people who lose weight on diets gain it back within 3-5 years), body dissatisfaction, lower self-esteem, increased disordered eating behaviors, risk of a diagnosable eating disorder, and hopelessness ensues.
Health includes physical health, yes, but also encompasses social, emotional, occupational, environmental, and financial health. Health cannot be achieved if one of these categories is out of balance with the rest.
By this definition of health then, participating in weight loss behaviors which can result in a reduction of our mental health status, is, therefore, not healthy.
Health and Food
Food plays an integral part in our health. We need to eat for survival, and for some, the inclusion or exclusion of a food or food group is a matter of life or death. However, for the large majority of us, eating a varied diet of all foods – both work and fun foods – will not harm our health.
Foods that are deemed “healthy” may not be so for everyone, although it won’t impact their survival, it may leave them uncomfortable or sick.
For instance, cauliflower everything and celery juice are the latest darlings of the food fad world. Eating these foods may make someone feel good about their efforts to strive for health and they will tout the benefits to everyone and anyone who will listen. But cauliflower and celery juice are not healthy for everyone.
For someone with Irritable Bowel Syndrome, they may not be able to tolerate either food because they are known to trigger uncomfortable gastrointestinal symptoms if they are sensitive to fermentable carbohydrates called FODMAPs.
If they are striving for health, people with IBS would need to avoid these foods in order to feel healthy.
The Bottom Line
Food can play a role in our health but what we choose to eat is not the end-all, be-all of what makes us healthy.
Many factors, including how we view body sizes, food choices, and our thoughts and beliefs about food and body size in relation to health can lead to the demise of our health.
When we begin to remove morality around these topics and allow people to have body autonomy – to choose whether or not to strive for health – and live in peace without experiencing bias, more of us will experience what it truly means to be healthy.