March 18, 2015

Is health promotion really healthy?

Although this disordered type of eating
has yet to be added to the diagnostic
manuals, a strict focus on eating healthy
can be harmful to your health
 Call it boredom, call it one-track thinking, call it a need to make friends, I have been reading and researching a lot about the birth and movement of health promotion.  Health promotion is defined as the behaviours we engage in that helps to prevent illness, injury, and chronic disease.  The idea grew from the 1960's and 70's as the medical system made a shift from taking responsibility for patients health and placing it on the individual.  Now, you may think that's great, people need to take responsibility for their health...and so do a point.  Unfortunately, what grew from this was something more sinister (and definitely more judgey).

At the same time, surveillance medicine was growing in practice.  You know, those charts and scales that tell us if we are "good" moral citizens of health (or if we are lazy, gluttonous, and sloth-like)? The Body Mass Index (BMI) comes to mind as well as percentiles that label our kids too short, fat, or stupid for their age group.  These measurements would help apply the "motivation" necessary to get the fat eating less and exercising more or eat more veggies and less saturated fat.  Although there were many positives to this population health approach, it would also serve as a great way to blame the individual for their health (instead of the environment, the government, or the medical system).

You may be familair with the woman on the left.  When she made this poster it went viral and is a great example of how our culture influences our beliefs.  The woman on the right, based upon her question, believes you are a better person based upon percentage of body fat.  Interestingly, research has shown that the more subcutaneous fat (fat under the skin) you have the healthier you are.  Based upon her low body fat, one could assume that she spends hours in the gym..hours taken away from caring for her kids. I commend the woman on the right for her rebuttal.  Being a good mother or person does not include how much body fat you have or how you look in a two peice.  It is sad that the woman on the left doesn't understand this.  It is sad that her children will be raised by a woman who clearly defines success and happiness on a superficial level.

The health promotion movement, in my educated and experienced point of view, has caused more harm than good.  I have noticed a great divide between the "moral, upstanding, intelligent, do-gooders" that cling to their regimen of hard-core exercise and caloric restriction and the "immoral, lazy, unintelligent, energy-sucks" that "choose" to let themselves go, get fat, eat crap, and cost tax payers money.  The health promotion movement has created a population of judgers while there is no real science backing up their healthy behaviours.  I could write a book on the unhealthy and unsafe practices that make up the fitness industry and you can't throw a bunch of organic kale without hitting a new book on the confusion that makes up nutritional science.  What we know about the promotion of health has been built on nothing but personal interest, the drive for perfection, and our society's definition of beauty. 
It makes me sick and very sad that advertisements like this one have become more prevelent in health promotion. This "blaming the individual" approach is a simpleminded and ignorant approach to obesity "management".  Based upon the belief that if you overeat or overdrink you will get fat...(and getting fat is your choice) removes any focus on what really causes obesity (politics, environment, stress, low income, high stress, lack of sleep, government deals, processed food, high levels of sugar in foods labeled "healthy"...I could go on).  By saying "it's your fault you're fat" not only places shame on people (leading to depression) but it takes away from actually making a difference.  Nice job. Brilliant!

The results of the movement for health promotion includes a rise in eating and exercise disorders in children and adults, shame and depression leading to an increase in suicide and suicide attempt / ideation in obese kids and adults, and the growth of an industry that doesn't make any sense.  I loved being a health promoter, but now I feel ashamed I was a part of this.  At one point I did judge those who ate "crap" and chose not to exercise.  I believed it was the individuals responsibility and if they strayed from the path of righteousness, they should pay for their own health care.  I was the definitive health promoter.  But now I am more aware. I'm aware of the illness health promotion has caused and it does make me cry when I think about it enough (so I won't think about that now, I'll think about that tomorrow - Scarlett O'Hara).

I am doing what I can to get out of the health promotion business.  Although I still want to implement physical activity as therapy and I still want to add nutritional counselling as a way to deal with mental health, I will not be catering to an industry that has more to do about judgement and looking good than it does with authentic health. 

That's all.

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