Obligatory Health: My body’s not your problem.

By | May 12, 2009

I am not especially talented at talking about The Health Issue, that is, the whole “but what if being fat is unhealthy?” question. There are a few reasons for this. For one, statistics bore me, and I lack the patience and interest to dutifully seek out medical studies to use to disprove other medical studies. I’d rather just settle to remove myself from that conversation altogether, since there’s lots of folks who do it better. Statistics don’t really speak to individuals anyway, and just because statistical data is making the case that, say, being fat means you’ll die X years sooner than a less fat person, that doesn’t actually translate to you, individually, dying X years sooner than your thinner friend as a sure thing. So I tend to shrug my shoulders unless something related to fat and health really grabs my attention, or, better yet, captures my imagination.

As of late, one thing I’ve read repeatedly in scattered and diverse places is the idea that it is impossible for a person to weigh 300 pounds and not have health issues as a result of their size.

Here’s the thing: much of the time, when it comes to human bodies, nothing is impossible.

The human body is more remarkable than the most remarkable thing you can imagine. It’s a miraculous self-contained machine. If you’ve spent even the tiniest bit of effort seeking out information on how the human body works, its efficiency and complexity has probably blown your mind. We’ve all heard crazy tales in which the body surprises us with what it can do, like the apocryphal story of a kid lifting a car off her trapped parents in a burst of adrenaline, or a hiker who managed to survive in the freezing wilderness for a week when even search and rescue efforts were losing steam (and hope).

The human body is not a simple machine. It’s an incredibly complicated one, and each individual unique body has its own quirks and subtleties and nuances. Some bodies are sickened by certain foods; some are not. Some bodies heal quickly from injury; some don’t. Some bodies have disabilities; some don’t. It’s hardly a stretch to argue that some bodies are fitter at certain weights and some bodies are fitter at other weights and both can be normal and “healthy” for the individual body in question. Sticking your elbow in your ear is a difficult bodily challenge. Weighing 300 pounds and being healthy is not so much an inconceiveable situation.

Because here’s the other thing: health, itself, is both private and subjective.

My health is none of your business. Your health is none of mine. The health of the barista who hands me my coffee in the morning? None of our business. The health of your postal carrier? None of our business. The health of a particular film star or professional athlete? None of our business. The health of a fat stranger walking down the street in front of you? None of our business.

A popular argument when discussing fat and health is “but obesity [sic] accounts for X% of healthcare costs and I don’t want to pay for fat people’s health!” Setting aside the fact that having this as a “problem” is a huge privilege, considering the numbers of people in the US with no health coverage at all right now, it’s also an academic point. In an insurance model, healthy folks will always wind up subsidizing the healthcare of those who are less healthy. Your premiums contribute funds to a company that then pays for other people’s chemotherapy, or their hip replacement surgery, or their smoking cessation plan, or their gallbladder surgery or their skin grafts or their physical therapy or their psychotherapy, and so on. And if you ever need any of these things, you can rest assured that your health insurance will be there to pay for your treatment too, and that it will consist of the dollars of fat people and smokers and the elderly and the disabled and promiscuous sex-havers and rugby-players and and anybody else you might resent for squandering your health insurance dollars by behaving or just existing in a way that may compromise their health and put them at risk for injuries (in other words, living a life). And if you never get sick or injured, and thus never get your hands on those precious insurance funds to which you’ve contributed so many dollars over your working life? Congratulations! You have managed to live a life never being sick or injured, which aside from being extraordinarily rare, ought to make you thoughtful and thankful enough to cheerily help those who’ve not had your experience.

Virtually no one can survive a reasonable lifespan and remain completely free of the need for medical attention. Even when your money is helping to pay the healthcare costs of others, their health is still none of your business.

Standards of health are always arbitrary and always mutable. If they are based on anecdata or individual experience, they may be too specific to apply to a larger group of people. If they are based on statistical analysis, they may have little to say to an individual person with a unique set of circumstances surrounding their body, their level of ability, and their particular experience. What if, for example, rates of elevated blood pressure amongst fat people are being influenced by the fact that many fat people are having their blood pressure checked with an incorrectly-sized cuff? What if medical research is occasionally biased in favor of supporting the result that the researcher (or whomever is funding the research) expects or desires, such as in the recent revelation from a former Harvard researcher that he falsified data on a sleep apnea study to make it look as though obesity was a contributing factor, because the real data was not supporting this hypothesis? What if there’s legitimate research that contradicts the stuff that everybody just knows but it simply isn’t gaining media attention because, well, it’s contradicting the stuff that everybody just knows about health and fitness and body size.

The reality is that different bodies have different parameters of what it means to be healthy. People (of all sizes) with chronic ailments are going to have a wholly different concept of health for their bodies than I do for mine. And that ought to be okay. Because we should not feel obligated or responsible to each other – total strangers in particular! -to meet someone else’s standard of health if it doesn’t work for us.

This is why I am disturbed by movements such as Congress’ plan to incentivize health care by rewarding people for eating “healthy”, for exercising, and, of course, for losing weight. For one thing – eating well and exercising (or, at least, being active inasmuch as you are able) are their own rewards, as human bodies typically respond well to being used in the ways for which they were originally intended. Also, these programs essentially favor those with the financial wherewithal to engage in “healthy eating” AND people without long-term disabilities or chronic ailments that make exercise difficult or impossible (arguably, the latter group should merely give up, lie down and wait to die, when chronic health problems prevent their aspiring to the heights of health piety applied to those without these mitigating circumstances). Finally, good health is subjective. A person with chronic and uncurable back pain is going to define feeling healthy differently than a cross-country runner, just like a cancer survivor in her late 80s is going to define feeling healthy differently than a 20-year-old who’s never been hospitalized, and it makes total sense that this should be the case.

In a broader sense, there is something very troubling about the way we as a culture are moving toward a place where people’s bodies and their health are (sometimes literally) public property. I not opposed to people being healthy; I am rather opposed to a homogenized definition of health. Individual people should be both enabled and encouraged to be as healthy as is possible within the parameters their body has placed upon them – it is unfair to penalize someone and condemn them from “health” for the rest of their lives because they do not meet an inevitably arbitrary standard. I am also opposed to a world in which meeting said standard – which would change frequently anyway – is obligatory, and in which bodies of all sorts are colonized by a movement that claims to know what’s best for us, that our opinions no longer apply. Do we really, really want Health Police patrolling the supermarket aisles looking for health-criminals and health-deviants? Isn’t this a personal freedom issue? Oughtn’t we to be trusted with our own bodies?

In the end, some people weigh 300 pounds and are healthy. Some people weigh 300 pounds and are not. (Some people weigh 150 pounds, and ibid.) Both states are possible. Both states are legitimate. Both states are normal. And it’s still none of our business if they are or if they aren’t. The only bodies you really need to know are the bodies of anyone for whom you provide the bulk of their physical care – your kid, or your parent, for example – and your own. The body of that 300-pound stranger walking down the street in front of you? That could be me, and I am capable of managing my own damn self.

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