The Hazard of One Size Fits All

HeadIt’s hard to miss the zeal that people bring to matters of health, wellness, and fitness. We’re part of it. Believing that health systems should, can, and will do better in helping folks with obesity, we devote silly amounts of time to writing about it daily. The motivation is simply to share information that might help people connect the dots to better approaches. But spending so much time on this subject leads us to an inescapable conclusion. The hazard of veering toward one-size-fits-all is great and always close at hand.

When people find something that works for them, the impulse to tell the world is strong. Also strong is the desire to affirm the rightness of a chosen path by seeing others take it. So messianic zeal for ideas about health, wellness, and fitness is a hazard, and one that is all too common.

Body Shaming Fitness

In the New York Times, Jane Coaston writes that body shaming dressed up as a fitness goal is still body shaming. Sure, she says, explicit body shaming does not escape notice these days. So it’s gone underground. She describes how fitness and aesthetics become fused into one by popular culture:

“I am constantly under a barrage of Instagram posts and magazine covers that urge me toward strength and performance goals while simultaneously implying that maybe if I meet those goals I’ll also meet an aesthetic goal, too. And maybe that aesthetic goal is more important.”

Awareness of social pressure does not necessarily relieve it. This week, Coaston is writing about how she can’t quit from extreme workouts. “In fitness, I want to hurt as much as humanly possible,” she says.

Somehow this does not sound like the pursuit of good health. But it does sound like a zealous pursuit.

Seeking The Answer to Obesity

Likewise, people looking for answers to obesity often get caught in believing they’ve found The Answer. For people who are seeking a medical approach, right now the most effective option for many people is bariatric surgery. Not for everyone, though. Most people have good or even excellent results. However, some will have poor results and some will have complications that lead them to regret the surgery.

In part, this comes from the normal diversity of human experience. But it also comes from the heterogeneity of obesity. The clinical condition is far from being a uniform experience. To the extent that we even know the causes, they can vary wildly from person to person. So it is unreasonable to expect that one single approach will work for every person. Thus the hazard of thinking one size fits all in obesity care is especially great.

At the other extreme, some people find great comfort in claiming “fat” as their identity. The notion of obesity as a medical condition is offensive. Fat acceptance makes it easier to shut out all the apocalyptic warnings about an obesity “crisis” that no one knows how to solve. It makes sense for these people.

But for others, being called fat is offensive and the medical complications of obesity are unmistakable. So fat acceptance is not really a good option for all.

In any event, one thing is clear. Thinking that one size fits all for health, wellness, and fitness is a serious hazard. It’s also an exercise in self delusion.

Click here for Coaston on body shaming in the name of fitness and here for her most recent essay on extreme workouts. For more on the issues with thinking that one size fits all, click here.

Head, painting by Guilherme de Santa-Rita / WikiArt

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November 14, 2021