The Obligation to be Healthy

I’ve been thinking about this since the lively discussion yesterday about whether or not it’s OK to be fat.  Opinions differed but many people said they thought it was OK to be fat IF the fat person was healthy.  That made me ask if people are obligated to be healthy, and one person specifically said, we are obligated to be healthy.  Others seemed to agree with that statement, although they might not have said so in those exact words.  Several people said things along the lines of people need to be able to work and pay their bills and take care of their families so that they are not a burden on society.

I’m troubled by this because I’m not perfectly healthy.  I have some pretty serious health problems, including severe recurrent treatment resistant major depression (how’s that for a diagnosis?) and PTSD.  Most likely, I will have these things forever.  Sometimes I manage them better than others but they aren’t going to go away, no matter what I do, no matter how hard I try to be healthy.  And I resent the implication that this means I am not OK.

Now, some people posted things like it’s OK if someone is not healthy as long as they are trying to get healthy.  But who gets to decide if I am trying hard enough to get better or not?  What if there are treatments I’ve decided not to try because they are too expensive and I can’t afford them (don’t want to be a burden on society by making all those healthy people pay my expensive medical bills, you know) or I feel the risk outweighs the possible benefits?  And is it really necessary for me to keep trying to “get better" even though I know the chances of recovery are so small?  Maybe I would prefer to accept myself as I am and learn to live with my conditions.  But some people might think that’s not OK.

Sometimes I am not able to work and pay all my bills.  That’s why I get Social Security and Medicare and sometimes I even get food from the food pantry.  Does that make me a burden on society?  Does society really judge our worth based on the amount of money we can earn and spend?  Unfortunately, I think many people do.  And before someone says oh no Kelly, we didn’t mean you, you aren’t a burden, consider why you might say that.  Maybe you think I am not a burden because you know me.   Maybe I’ve helped you in some way, maybe I’ve given you some helpful advice, maybe I stayed up talking to you on the phone the night before your surgery when you were scared.  Maybe you know I took care of my neighbors’ cat after the man next door was shot in the head and his wife spent weeks at his side in the hospital.  Maybe you know I took in my mentally ill nephew when he got kicked out of yet another foster home and needed a loving home.  Maybe you just think I’m a nice person.  And maybe you think those things mean I’m not a burden after all, even though other unhealthy people are.

But what makes you think all those other nameless unhealthy people you see as burdens aren’t nice people, too?  What makes you think they don’t do helpful things, even if they can’t work, even if they have a lot of medical bills that your tax dollars help to pay?

I know some people will continue to believe people are obligated to be healthy and that it is not OK to be less than healthy, no matter what I say.  I can’t change that.  But I can say that such an attitude is offensive and hurtful to me.

Well said Kelly! I have to agree! It is not for anyone to judge another's health or size.

 Let me clarify my thoughts from yesterday.  I said it was not OK to be overweight IF it effected other people.  There is a total difference in my mind between being obligated and it being OK.  No one has the right to say we must be healthy.  No one has the right  to say what we can and can not eat or how much we exercise.  I don't think of people that are overweight as a burden on society.  Nor do I look at people that are unhealthy and think that.  I have never regretted money that goes to help with medical expenses for people that are unable to work.    

Why then did I say it was not OK?  This goes back to my own life experiences.  My mom died at 56 from lung cancer.  I blame smoking.  It took me years to get over the anger I had towards my mom.  I felt if she had chosen not to smoke then she wouldn't have died.  It has been over 20 years and I still miss her.  I love her dearly and I need her in my life.  Morally I have a problem with ME being morbidly obese.  It was not OK for me to eat myself to death when there was something that could be done about it.  It is not OK for me to leave 3 young children without a mother because I died from a heart attack, cancer, or other weight related disease.  I do not have the right to judge if it is OK for another person to be healthy enough or insist that they be healthy.  

I hope I didn't offend you yesterday.  It was not my intention.

I’m of two minds on this one.

On the one hand I think that statement, “it’s ok to be fat as long as you are healthy" is presumptive. We don’t know if a person is unhealthy BECAUSE they are overweight or because of something completely different. I know folks who were perfectly healthy before WLS who, through no fault of their own, are very UN-healthy now. But I digress.

On the other hand…and I pointed this out on Facebook…unfortunately the way the US healthcare system is set up, one person’s ill health is everyone’s financial responsibility. Especially now with the Affordable Care Act (and please…I am not debating the Act with you so please don’t go there).

So I think that in addition to owing it yourself to do what you can to be healthy, you do have a slight obligation to the rest of humanity. I know that I personally understand that sometimes people are not healthy despite their best efforts. Those are the people to whom I want any help, taxes, insurance rate hikes to go. However, I do NOT want to have to pay for other people’s bad lifestyle choices. I’m sorry. I just don’t. So that’s my basic thought on that.

But lastly I’ll just say that I don’t think anyone was saying you aren’t a nice person if you’re not healthy or can’t be healthy for whatever reason. I haven’t gone back and re-read the thread but I don’t recall many character judgments (short of a few deflections). Just that many people feel as if being fat was not acceptable for them in their own lives and some doubt that anyone COULD be happy as a bigger person.

The problem there, to me, is you never know. Like remember curvaceousdiva? She posts on Facebook all the time. She often posts pictures of herself before surgery because she genuinely liked herself, how she looked, etc. Her health was bad so she took corrective action but she did not hate her plus-sized body. Like I said, until I got to a certain point I didn’t hate my body. So I am here to tell everyone that – no – not every fat person is going around with a sense of self-loathing. It MAY be fair to say most are. But not all.

I’ll close with this distinction, Kelly. I see you. You are doing what you can to address your health problems and live the best quality life you can. My mother (God rest her soul) did not. She blatantly ignored medical advice, was defiant by exhibiting precisely the behaviors she was told to change and generally just did not give a rat’s ass after a while. I took (and take) exception with that.

She’s dead now. She won’t be around to see her grandchildren grow up. She won’t be at my wedding (y’know…the one where pigs fly and we all watch the newscast about a snowstorm in hell?). She won’t be at my brother’s wedding. And for what? So yes, that makes me sorta angry and I don’t think it’s ok. I guess she had the right to give up on herself, but I personally think that was selfish. Don’t get me wrong. I love and miss my mother but I posted about this when she was alive. My feelings haven’t changed all that much. I just wish I could have prompted her to change.

BUT ANYWAY. I say this all to say there is a clear difference between people who approach life the way you do and people who approach life the way she did.

According to my personal standards, you are beyond ok. You are fabulous. According to those same standards my mom’s behavior was not.

Very well said, Nik! You showed the struggle between indivdual  choice and selfishness in  your post. This is such a complicated issue. My boyfriend Brian's father is going through a ton of medical problems right now due to a series of lifestyle choices in which he didn't take as good care of himself as he could have. I don't judge Brian's dad for his choices but as a result of never exercising and years of smoking he has lung problems and bone problems and stuff like that. I don't consider the man a burden on society in any way but it is sad to see people affected by the choices of others. Our choices don''t make us bad or good as people (we all have some bad and some good, and we all give and take from society so no one is a burden) but I do recognize that my choices affect others and vice versa and may even hurt my loved ones.

I agree that Kelly is fabulous too!

Some heath issues we have control over - some not.  The one we can control and choose not  to - can make the bystander really angry and resentful.

i.e a smoker get a lung cancer  - most likely due to smoking - but there are a lot of people who get that even if they did not smoke.
Drinking and driving - one example where one person action can affect many people.

And so on. 

" I know some people will continue to believe people are obligated to be healthy and that it is not OK to be less than healthy, no matter what I say. I can’t change that. But I can say that such an attitude is offensive and hurtful to me."

If you are doing everything to get - be healthy - why would you feel hurt or offended by someone ignorance?   Unless you feel guilty and less than... - why would their opinion matter?  


I was relatively healthy before RNY. No so much right now. I though getting RNY would prevent me getting sick. I was wrong. I had more docs visits, doc bills, more pills to take - and so on. 
But I have no control over that.  

I try to follow the best diet for me - proteins, vitamins - minerals.   That is what I can control.  That is my responsibility.  My responsibility is to be as healthy as I can be in my current situation. 

Beautifully said, Kelly. My opinions (see my Health at Every Size mention on the other thread) would probably be pretty unpopular here and I'm not down with fighting on the Internet so I'm not going to go into it, but basically, it isn't anyone else's job to judge *anyone's* usefulness/burden, health status, or anything else, for that matter.

I wasn't part of the orignal converation, but..

I think it's bull. *I* don't get to decide for anyone else if it's "ok" for them to be fat. It's NOT my business. Blah, blah, blah society this and society that. We're really going to legislate health (and morality, to an extent) to 400 million people. REALLY? I don't think so. When I was fat, albeit, not yet over 300lbs, I could hike and do some stuff like that. I was young too and that helped. But I had people say "What? You hike?" and the underlying message was "You look too fat to hike." And I have friend that is vegan and a professional bellydancer and she's a size 18. Thats just her body. But she always gets crap for being a plus sized bellydancer. The same attitude I got, like how can you do that and be fat? And my mother, most of her life she was never more than 98lbs. Ate like crap and was always in poor health. But looked fantastic in a size XS bikini! To this day that woman has a total aversion to green foods. That's most vegetables. She won't eat them. She lives on meat and carbs and junk food.

You cannot sum up the quality of a person, what they have offer as a whole package or the quality of their life by what their clothing size or scale says. If you can, well, maybe it's not the fat person that's the ugly one in this equation.

I saw a few comments about being healthy and I even posted that is why I had WLS. I even agreed with one post about drug addicts (who btw USUALLY cause their bad health or are drug addicts because of their bad health. in which case they really are not to blame). I didnt see where anyone attacked you on a personal level though, just spoke about it in a general way. I take care of people who have PTSD and various other diseases and I know how hard it is. It cant be cured as far as I know only managed with meds. It makes it very hard to keep a job, at times even a relationship. I also have neighbors who abuse the Medicare system by feigning disability so they can have drug money and lay around doped all day. Those people are who I object to and I think we have every right to. Someone with an honest disability should not be ashamed at all. Dont let people upset you Kelly, you are an honest person. Honesty is worth all the money in the world.

I didn't say I was attacked personally.  But when someone says it's not OK if people are unhealthy, and I am unhealthy, that is sort of an attack on me.  It's an attack on all unhealthy people who think they are OK even though they aren't healthy.  It is insulting to tell someone they are not OK.  It is insulting to tell someone with a chronic health problem that it is not OK to have a health problem.

How do your neighbors get drug money from Medicare?  Medicare doesn't give me any money.  It pays for some of my medical expenses (usually 80%, and I have to pay the other 20%, along with an annual deductible and monthly premiums) but it doesn't give me actual money that I can use for dope or anything else.  Unless Medicare covers medical marijuana in states where that is legal, but I don't believe I saw that listed as a covered expense in my Medicare handbook.

You also have to be disabled for two years before you qualify for Medicare, which is a long time to feign disability, although some people may do so.  Actually, that's not even correct - you have to qualify for SSDI for two years in order to qualify for Medicare, but I think you have to be disabled for five months before you qualify for SSDI.  So one would have to feign disability for a long time to get Medicare.

It's pretty difficult to prove you're disabled enough to get SSDI, so while I'm sure some people are able to fake it, it's not easy to do so.  I got SSDI after providing letters from my psychiatrist and therapist saying I was unable to work due to my condition, copies of hospital records from almost a dozen hospitalizations due to my condition, a letter from my last employer explaining the problems I had working, and a long list of medications I'd tried for depression, along with other documentations.  It would have been difficult to fake being sick enough to need to be hospitalized that many times, and to have faked it during many appointments with my doctor and therapist, and to have faked it at work, and all of that.