The Cult of Health

A few days ago, someone in my Facebook feed shared an article about how psychiatrists want to classify an obsession with health as a mental illness. The impropriety! How could it possibly be that wanting to be healthy be a disorder?!

I don't know if the article was correct, and I certainly don't know the details of psychiatric diagnoses, or what should be a disorder or not. I'm not a psychiatrist. But the article did get me thinking about a more general concern I have - that the fixation on health isn't so much about actually being healthy.

Before I go into this, I need to take a few steps back.

A number of years back, I was browsing the health section in a book store. There were plenty of books to choose from, but almost all of them were complete crap. I left the the book store with two thoughts: people want to be healthy, and there's plenty of misinformation out there for anyone wanting to make that choice. For a society that demonises being fat, glorifies being fit and thin, what we've got is an industry dedicated to making money from it.

Fast forward a little. A couple of years ago, I joined a gym in a somewhat futile effort to get in shape. One day, as I was trying to work my triceps, I looked up at the TV. There was an ad for some equipment that promised all the results without any of the effort. Here I am in agony making barely any inroads, yet there was a machine promising me everything I wanted without needing to engage in this masochistic endeavour. Naturally I'm dubious, so I kept my gym membership and did not get suckered in by the infomercial, but again there was that parasitism on the desire for being fit. (Ignoring, for a moment, the false promise that is a gym membership.)

About 18 months into the gym membership, and it was going reasonably well. I was losing weight, though not as much as I liked, and I was getting fitter. Then two things happened: I injured myself, meaning I had to cut back, and I took on some extra responsibility at work, which meant I was working longer hours and eating a lot of pizza (provided by the company). In a month, I had regained over half of the 11kg I had lost over the previous 18 months. There had to be a better way.

First, I read The Healthy Programmer - a book I had bought during a sale, but it sat on my virtual shelf for months. I read it in 4 days, and was eager to take my new-found knowledge and put it into action. Second, my mother told me about a website called MyFitnessPal, which I could use for tracking my food and exercise - something I took to quite obsessively. And between the diet and exercise, I've had really good results. I'm now normal weight for the first time in my adult life, and I recently beat the 10km mark in a run.

So hopefully I've established that I do have an interest in health, in being healthy, and in leading a healthy lifestyle. I'm not at all opposed to the idea of people wanting to be healthy, and I don't care in the slightest if that interest in health for others is something related to wanting to look sexually desirable or simply wanting to avoid the prejudices our society has against the overweight. People spend far too much effort impugning and maligning the motives of others. (Again, the impropriety!)

1. Health foods - There's an aisle in my local supermarket dedicated to what it calls "health" foods. It's good that there's an aisle for foods that don't contain foods with allergens, it's hard to grasp how the foods in that section are any healthier than the equivalents in different aisles. Are the organic almonds really better for me nutritionally than the regular almonds sitting with the other nuts? Are bars made of sesame seeds, condensed milk and honey? They taste good, don't get me wrong, but it's hard to know where the "health" comes into it. And of course, the "health" food is opposite the wall of vitamin pills and meal replacement powders. So we have an entire section of the supermarket dedicated to foods pretending to be better for us next to pills and powder that try to mimic food. Whatever happened to a balanced diet?
2. Health food claims - Two aisles over from the wall of pills is the wall of sugar, which incidentally is my favourite wall because it has dark chocolate. But it's also the aisle that shows how health claims permeate all our subconscious desires. Because labels like "all natural" and "99% fat free" sit proudly on packets harbouring highly process sugar melded into fun shapes. No marketer is really trying to convince us that Starburst is actually healthy, but highlights the absurdity of the practice taken to an extreme. It's comical on that packet of Starburst, but pernicious on TV dinners with the brand "Healthy Choice".
3. Superfoods - There's no such thing. There are basic micro and macronutrients we need to survive, and the best way to do that seems to be to eat a balanced diet. But beyond that, the idea that there are particular foods that are nutritionally-overcharged and really ought to be on our plates is nothing more than marketing hype. Our species survived and thrived long before the vitamin pill aisle, and we similarly did without kale salad dusted with quinoa and chia seeds and a side of acai berries.
4. Calories - On the flip-side to superfoods is the dreaded notion of energy. So while most of us need ~2000 of these a day to survive, foods that are high calories are demonised despite having a good nutritional profile. One article talking about the nutritional content of almonds, for example, talked about all the nutrients it had in it, then warned people off them because they are very high in calories. Again, it seems to be the superfood thinking - that there's this one magic ingredient that we should consume copious quantities of, and it would be almonds if not for its caloric content.
5. Ethical eaters - I can appreciate vegans being so for ethical reasons, or people not wanting to eat certain foods because of industrial practices. But it amazes me how these ethical considerations just happen to line up with what they think is healthy. Just a vegan's luck that not only is eating animals cruel to the animal, it's unhealthy for us. Just as organic has extra nutritional benefits, genetically modified food is a health crisis in waiting, and those "unnatural" artificial sweeteners are already a health crisis. It's great that there's a direct correlation between ethical eating and healthy eating...
6. Diets - Inevitably I'm asked what kind of diet I'm on. I answer "none". After being looked at sceptically, I elaborate "I'm on the not overeating diet". After growing up in a world where fat was the enemy, now it's carbohydrates that are the enemy. We now should quit sugar, live like our paleo ancestors (with our modern foods), take two days a week for radical reduction in calories, or even kick-start our metabolism with coffee filled with butter and coconut oil! And when those techniques don't do anything to help with the obesity crisis, you can be sure there's going to be some new techniques complete with success testimonials just around the corner. Again, whatever happened to a balanced diet?
7. Willpower and choice - Everywhere in the West seems to be in an obesity crisis right now. So while more adults all around the world are becoming overweight, the issue keeps coming down to choice. That is, if you are fat, then you chose to be fat. If you try to lose weight and fail, it's because you didn't have the willpower for it. In other words, you are the disgusting blob you are because you make bad choices and don't apply willpower properly. It strikes me as a post hoc justification for victim-blaming, and that's highlighted by how much this argument is used by junk food companies to oppose regulation, but it's prevalent nonetheless.
8. Motivation-in-a-box - The internalisation of the willpower argument is the idea that a particular product is going to be the thing that finally motivates you into becoming healthy. Right now, it's activity trackers. A few years ago, it was Wii Fit and Dance Dance Revolution. For as long as I can remember, there's always been some product that plays to our recognition of our inactivity. Even at the gym, I see infomercials on the TV for products that will tone our body without the slightest strain.
9. The shortcut - Since the dawn of our species, we've taken the effort to make us look better than we actually are. We want to give the impression of health, youth, and vitality. The beauty industry is the logical, albeit absurd, consequence of this fundamental drive. And, thankfully, for those who recognise that there's no such thing as a product that will get them the look they desire, there's a product that will give the illusion. Body-shaping clothes sitting atop of skin full of fake tan and anti-wrinkle cream, you can appear healthy to the ouside world.
10. Purity - Perhaps the worst aspect of health as a commodity is the expectation that health should be the aspect of our being our actions revolve around. Why should it be that drinking a glass of red wine for its supposed health benefits is acceptable, while drinking a glass of red wine for the sheer pleasure not? This idea that we have to be obsessed with our health (and by extension, everyone else's) is something that's just assumed by the "my body is my temple" crowd. The flip-side of this language is the impurity of failing to live up to the same aspirations, thereby condemning the failure as having morally failed.

What's questionable to me is whether any of this is doing us any good. Do any of the products in the store that have health claims make for part of being healthy? Does the consumption of superfoods and avoidance of calories? Do any diets, ethical or otherwise, work? Does making it a matter of willpower? Or is the focus on the appearance of health creating the market for products that mimic the look? And are we just becoming self-righteous in the condemnation of others for the crime of not living to our ideals?

We can frame obesity in economic terms, as everything is these days, and deduce that it's a moral imperative from the sheer weight exerted on our medical systems - similar to how we've deduced the moral imperative to rid tobacco from the world. But while smoking has declined, decades of focus on the "obesity epidemic" has seen obesity soar, as if somehow obese people haven't gotten the message that it's really really really really bad to be obese.

It seems to me that the focus on health as this sole marker of societal (and therefore, human) worth needs to be vastly toned down, or at the very least addressed in the way other health crises have been addressed - by trying to root out the underlying factors. Because what we have right now is a self-aware society getting more obese doomed to failure by the memetic equivalent of snake oil. The focus on health, at least in the current environment should be considered a complete failure, because it has not led to healthy outcomes. It hasn't even led to a blueprint for health that people can at least try to follow, beyond eat less skittles and exercise more - with the purchasing of skittles thereby being a moral failing. Clearly something has gone horribly wrong!

The Driving Analogy

Consider the following three scenarios:

1. A driver refuses to wear a seatbelt
2. A parent fails to secure their young child's seatbelt
3. Someone drives drunk

In each of these scenarios, it reflects the choice of an individual. Yet these three scenarios aren't equivalent. In the first, the person is taking a personal safety risk. If they end up in a car accident, the chances of injuring themselves are much greater. In the second, their own choice puts at risk someone who couldn't make that choice for themselves. In the third, their choice is putting at risk other people since roads are a shared resource.

When I think of health claims, I don't care so much if a person chooses to treat themselves with whatever they think were work. If they have cancer and want to cure it by homoeopathy, it's their funeral. Think that magnets or shark cartlidge will cure a bad knee? A fool and their money are soon parted. This is the equivalent of someone not wearing their seatbelt. While there might be other factors to consider (such as individuals organising together to claim that seatbelts are a propaganda device of Big Auto that cost countless lives), it's their freedom to make that choice.

The child case is a bit more tricky. After all, parents do have responsibility for their children, but it's also recognised that a child has rights beyond the parent's dominion. A parent using prayer to cure a sick child while there's actual medical intervention that could help the child a gross violation of that child's liberty. Not strapping a child in securely may be harmless in most trips, but seatbelts aren't there for most cases - they are there for when things go horribly wrong.

Many diseases are communicable. Someone infected with the flu deciding to come to work because they're "taking echinacea" is shirking their social responsibility and putting others at risk. Like the drunk driving scenario, there are potential consequences for people who didn't make that choice. Vaccines are a good example of this, as not only is it putting the individual at risk, but it also puts others at risk (as recent epidemics have sadly shown).

The idea that it's one's personal freedom to choose what "treatments" they wish to undergo only works when that ailment/treatment is only putting themselves at risk. For the latter two cases, it should be uncontroversial that it's not just their own freedom at play. It is uncontroversial in the seatbelt case because people agree that seatbelts save lives. Yet if someone believed that seatbelts not only have no effect, but actually caused harm, how do you separate out that they should be forced to use a seatbelt with their child? Or if they believed that they were a good driver no matter how much they drank, would it be seen as anything other than intrusion that they would not be allowed on the road in that condition?

The difference between driving and alt-med is that people don't dispute the facts in driving. Alt-med is filled with science-denial and paranoid conspiracies in order to justify the harm that they cause. The personal freedom many argue for harms the personal freedom of others, so they just deny the facts instead.

Birth Control vs Religious Liberty

http://www.abc.net.au/news/2012-02-17/religious-leaders-unite-against-pill-plan/3836440

Religious leaders from multiple faiths have united in an unprecedented show of strength against US president Barack Obama's healthcare plan to ensure all women have access to birth control.

Roman Catholic Bishop William Lori likened the situation, of the government forcing church-affiliated groups to provide insurance cover for birth control, to forcing a kosher deli to serve ham sandwiches.

"It is absurd for someone to come into a kosher deli and demand a ham sandwich, but it is beyond absurd for that private demand to be backed up with a coercive power of the state, and downright surreal to apply that coercive power when the government can get that same sandwich cheaply or even free just a few doors down," he said.

A number of years ago I heard a report about a small town in Australia that had the highest birthrate in Australia. The only pharmacist in the town had refused to stock and supply birth control on religious grounds.

His place in the community was not just a matter of religious freedom, however. By deciding that he couldn't sell contraception on his religious grounds, he made that choice on behalf of everyone. After all, why should people need contraception? The pharmacist was Catholic!

And this is the problem with this analogy of religious freedom. Healthcare is not a religious service. Any individual is free to avoid using and buying birth control if they choose to on religious grounds, but being a healthcare provider while refusing to stock health supplies is pushing those religious grounds onto others that they may or may not want.

In short, if you want to be a health provider, then it's not a matter of religious choice. If religion cannot provide a public service in a manner that best serves the public, then they shouldn't be in that business. They as individuals are free to ignore any contraceptives that may be on offer, what they are losing here is the ability to deny that service to others.

Baptist leader Professor Ben Mitchell said his church members would be prepared to defend their religious freedom.

"Tens of thousands of us, maybe hundreds of thousands of us, would be very willing to spend nights in jail for the sake of the preservation of religious liberty," he said.

"It's not just our coffers that are at risk, it is our very freedom."

What's at risk is the ability to easily push one's religious belief onto others. That's a very Orwellian take on religious freedom.

Morning Scepticism: Organic

Let's say there's something about organic farming that makes for better food. Why can't these processes be isolated and incorporated into other farming processes? Likewise, if there's something harmful about a particular farming process, why can't that be removed or replaced instead of wishing the whole system to go away? This is one of the problems I have with advocates for organic food, it's so often put forward as a false dichotomy between the worst in industrial farming or organic. It's the same with those who seek herbal remedies instead of conventional medicine, if there's actually something in a herb that works then why can't that active ingredient be isolated and incorporated into medicine? It seems its not a clash of efficacy but one of principle, you either accept organic farming practices or you want to poison earth and the people on it with *shudder* chemicals.