From Control to Trust: Rethinking Our Relationship with Health

We can’t control our health any more than we can control the weather.

I know what you’re thinking: “but Asher, we can’t control the weather!”

And that’s my point! Sure, we can check the weather forecast every day. We can carry an umbrellas around with us just in case. But we can’t stop the rain.

And the same thing goes with out health. We can check the forecasts with annual physicals and blood tests. We can take actions to support our health – our metaphorical umbrellas. But at the end of the day, our body’s going to do what it wants, and there’s nothing we can do to control our health outcomes.

This might feel a bit uncomfortable, because for the last hundred years or so, society has been telling us that health is our personal responsibility. It’s something we can achieve as long as we maintain the right combination of diet and exercise, get good sleep, reduce our stress levels etc etc. Peak wellness culture nonsense that promises us youth and longevity (is that even health?)

The Illusion of Control

We’re living in an age of unprecedented anxiety about health. Isn’t that wild? Even though we’re living longer than we ever have before, even though we are “healthier” than we ever have been before, even though there’s enough food to go around and vaccines to prevent major illnesses, we’re more obsessed than ever. 

I believe this anxiety comes from a number of sources. First, we’re bombarded with messages everywhere we turn about optimizing our bodies. You’ve got to track your metrics, eat clean, hack your metabolism etc etc. We’re constantly being force-fed these messages, and after a while they become hard wired into our consciouness. We can, therefore we should. And if we don’t, then there’s something wrong with us.

Secondly, there’s the existential piece. Admitting that we can’t control out health means facing our own mortality, and that’s not comfortable for anyone. In a world that feels chaotic, controlling our health is a way to feel secure. It’s a way to overcome feelings of powerlessness, anxiety and fear of the unknown. It’s a distraction from grief and loss. When we’re focusing on controlling our health, we don’t have to worry about the fact that tomorrow isn’t guaranteed for anyone.

The wellness industry capitalize on our fears.

The wellness industry says, “Aha, I see you’re worried about getting sick or dying, so I’m going to sell you a products or a programs that promise you control over your body, your health, and your destiny.” In other words they take our health anxiety and they use it to sell us lies and empty promises. Which is at the very leat unethical. At it’s worst, it’s responsible for the death of millions around the world. 

Thirdly, I don’t think we can have talk about health control without talking about body hierarchies. Because we as a society have created a system that ranks bodies on several things, including our perceived health status. This person “looks healthy” so we follow them. That person looks like they “don’t take care of their health” so we look down on them.

Close your eyes for a moment and picture what a healthy person looks like. I bet you have an idea in your head. An idea that was given to you by a society that has become obsessed with both body image and health status. I’m willing to bet that the picture in your mind is not Fat or Disabled. That picture in your mind is not Black of Transgender. They’re probably a thin white woman dressed in athletic wear or a lean, strong, muscular white man. Either way, they’ve probably got a six pack. That’s “healthy.”

Some of us have been deconstructing and working on our own internalized biases. Maybe we don’t see that image as much anymore. Maybe our idea of health is no longer strong, or thin, or white and cisgender. But I imagine that wasn’t always the case. And even if you’re a Fat and Disability justice advocate, in your darkest moments I suspect that image finds a way to creep back in. Because we’ve been conditioned to think this way from birth.

We all have an idea of what healthy and not healthy looks like. Furthermore “healthy” has become synonymous with “good” and “not healthy” has become synonymus with “bad”. And it’s not so much whether you’re healthy – it’s whether we believe that you can control your health. Let’s just say you were in a terrible accident and you lost a limb, but then you went on to compete in the Paralympics – you still appear to be in control of your health, so you’re still perceived as good. But if you were in an accident and lost a limb and just happened to be Fat and confined to a wheelchair? Then it appears that you can’t control your health, so you’re downgraded to the bottom of the pile.

The reality of health factors

Here’s the thing that really gets me: most of the factors that shape our health are completely beyond our control. Let’s start with genetics. It’s not just the genes we inherited, but also how those genes are expressed (epigenetics), and the trauma that gets passed down through them (transgenerational epigenetics). 

Then there’s your early life experiences, your family circumstances, the opportunities you were born into. These are factors that are beyond our control: we don’t get to decide where we’re born or who are parents are, yet that has such a huge role in our health.

And that’s just the beginning. Health goes way beyond individual factors, so why is it that we never talk about health as a collective experiences? To start with there are environmental factors to consider, like air quality, water pollution, climate change, and microplastics. These are all collective health issues.

Then there are the so-called “social determinants of health”. Or as I like to think of them, systems and structures that exist to oppress the many whilst elevating a few. We’re talking socioeconomic status, healthcare access, community infrastructure, geopolitics etc. The biggest threat to a cobalt miner in DRC or a teenager in Palestine is not their genetic code. It’s genocide.

What about income inequality?

This quote from a 1999 research article* sums it up nicely:

“The relationship between income and health is well established: the higher an individual’s income, the better his or her health. However, recent research suggests that health may also be affected by the distribution of income within society.”

The article goes on to outline all the potential mechanisms that underly this phenomenon. It’s a free read, but watch out for the stigmatising language.

If you think of all the things that control health as a pie chart, then there’s only a little sliver of pie that represents all the things we have some degree of control over, like how much sleep we get, what we eat, how often we move, and whether we smoke or drink alcohol. Yet we’re completely obsessed with this small slice while ignoring all the other factors that have a much bigger impact on our health.

It hasn’t always been this way

Indigenous cultures throughout the world have always known this. They don’t separate individual health and community health – it’s all linked together. The wisdom of indigenous cultures is that we do not exist in isolation. Our health is interconnected with our community and our environment. You can’t treat one without the other.

Over the last few years in my work and practice, I have been exploring health through the lens of three key relationships: your relationship with yourself, your relationship with other people, and your relationship with the environment. I find this to be much more satisfying and effective than my previous narrowminded and metrics-focused viewpoint. 

It’s important to note that health wasn’t always viewed as an individual responsibility.

In fact, this is a relatively modern, Western concept that really only gained traction in the late 19th century onwards. Looking back through history tells us a different story.

The Roman Empire developed aqueducts, public baths and sewage systems. They introduced public health 2,000 years before it became a priority in society’s agenda. They believed that social structures, environmental influences, and general community well-being were important when it came to health.

During the Islamic Golden Age, hospitals were providing free healthcare as a public service. From what I understand, Islam teaches that health is in part a societal obligation. In fact, for centuries around the world, food and healthcare were provided to those in need by religious institutions.

Throughout Africa, prior to colonisation and the influence of western medicine,  community health was a cultural practice. Traditional healers took care of individuals whilst chiefs and elders took responsibility for public health measures. There were rituals and practices whose sole purpose was to maintain communal wellbeing through a holistic understanding of health. Balance was key, just as it is in Traditional Chinese Medicine (TCM) and Ayurveda.

Then in the mid-19th century, the Global North shifted to individualism thanks to the rise of capitalism and neoliberalism. And that gave rise to diet culture, self-help movements, and privatized healthcare. This shift reinforced the belief that health was both a moral duty and a sign of personal worth. Thanks to white supremacy, this belief was forced upon the rest of the world.

Moving from Control to Trust

In reality, we live in a very toxic world, and this toxic world is making our health worse. We are trying to achieve perfect health in a world that is intentionally working against our well-being. There’s chronic stress, social isolation, financial pressures, political upheaval – all of these things are actively working against our health.

So here’s what I propose: what if, instead of trying to control our health (which is as effective as trying to control the weather), we moved toward body trust? What if, instead of overriding our body’s natural signals and forcing them into submission, we pay attention instead.

When our body tells us that we’re hungry, instead of saying “tough luck, you’ve already eaten too much today,” we just ate something? Or when our body tells us that we’re tired, instead of saying “there’s no rest for the wicked,” we just took a break?

What happens when we start to tune in to what our body is trying to tell us? That’s all we need to do to begin with – just tune in. Practice a bit or curiousity without judgment. You’re feeling tired? Don’t judge yourself for feeling tired. Don’t compare yourself to other people who don’t appear to be tired. None of that matters. You’re just tired. Notice it. Maybe write it down. Maybe even tell other people, “I’ve noticed that I’m tired right now.” No judgment, just acknowledgment.

And then what happens if you take it a step further? Once you’ve noticed what your body is trying to tell you, what happens if you respond with, “I hear you, I recognise that you have needs, and I’m going to meet those needs with compassion.”

And then, what happens if we take it one step further still and actually do what we said we were going do do? What if we actually gave our bodies what they are asking for? Because how are we supposed to count on our bodies in the future, when they have never been able to count on us?

The Path Forward

In order to trust our bodies, we have to make peace with the fact that we are mortal, that we will one day die, and that our health is uncertain. That’s not as simple as flipping a switch or taking a short trip before arriving at your destination. It’s a lifelong journey – a continuous process of learning and unlearning.

I’ve been sharing a lot more about my own experience of chronic pain, which is relatively new to me. I’ve had to do all this unlearning again. But I’m continuring to move in the direction of body trust. And that’s the best I can do.

So folks, we can’t control our health. But we can learn to work with rather than against our bodies. Instead of control, we can chose trust. We can build communities that support our wellbeing, and we can find peace in the knowledge that our inherent value isn’t determined by our ability to control our health.

Because we can’t control our health any more than we can control the weather.

* Kawachi, I, and B P Kennedy. “Income inequality and health: pathways and mechanisms.” Health services research vol. 34,1 Pt 2 (1999): 215-27.

This post was adapted from Episode 6, Season 5 of the Fat Doctor podcast. You can listen to it wherever you stream your podcasts or watch it on YouTube.