Being Healthy Is Not the Same as Being Virtuous

‘Illness and disability are not ways to measure the value of a human life’

Photo: Aitor Diago/Getty Images

There is a common, problematic way that many of us conceive of “health.” Too often we equate the absence of illness with morality. This leads down many troublesome paths both on a personal and a policy level. It seems we need to be reminded periodically that health is not a moral virtue.

Diet and lifestyle are probably the most commonly moralized aspects of health. How many times have you heard disparaging comments about “lazy” people who “pop pills”? Or the notion that medication is an easy substitute for the hard work of eating “clean” and exercising?

As a family physician, I see patients frequently who internalize these ideas and feel like medication is a personal failing, a sign that they are somehow morally weak. This sets up a dichotomy: Either you are virtuous and take no medication, or you are sick with vice and medication is the punishment you deserve.

This is — of course — ridiculous.

Many medical conditions have nothing to do with lifestyle or even if they are improved by lifestyle change, medication is still necessary. Do I celebrate with patients when we are able to de-prescribe one of their medications? Absolutely! But not because they have found some new moral strength. I’m simply happy when patients feel better. Full stop.

There’s a huge difference between lifestyle counseling and selling a cure-all based on lifestyle change. The former makes you a health care provider, the latter makes you a grifter.

Moralizing ideas are nothing new — they are some of the historical roots of medical grifting and snake oil selling. Over 100 years ago, a guy you might have heard of by the name of John Kellogg led a pseudoscientific health movement that was utterly fixated on virtuous eating. He quite literally believed that flavorful food would lead to a whole host of sins, chief among them masturbation. Really.

The modern wellness industry inherited Kellogg’s moralizing attitude toward diet, but now the aesthetic of the…