Health Does Not Define Worth
Challenging the Moral Hierarchy of Wellness
16th April 2025, Dr Asher Larmie
“At least you have your health.”
It’s a phrase we’ve all heard, perhaps even said ourselves—a well-meaning consolation that inadvertently reinforces one of society’s most harmful beliefs: that a person’s is only inherently valuable if they are useful. But the truth is, health does not define worth, and this belief system needs dismantling.
Because what happens when you don’t “have your health” anymore? What happens when chronic pain, illness, or disability enters your life? Does your worth diminish? According to our society’s unspoken rules, the answer is troublingly close to yes. But here’s the truth none us are willing to face: “good health” doesn’t last forever.
Why Health Does Not Define Worth: Understanding Body Hierarchies
Recently, I came across an article in The Guardian titled “Plot twist. I’m still a fat person. Meet the people proving you can be fit at any size.” On the surface, it seemed like progress – fat people being represented as capable of fitness and health. But digging deeper, I noticed something coded into the language of the article: the creation of hierarchies within marginalized communities.
The article carefully separated “metabolically healthy” fat people from those with health conditions. It celebrated those who exercise regularly while implicitly suggesting those who don’t are somehow failing. Even the term “fat but fit” creates a false dichotomy—the “but” suggesting fatness and fitness are naturally opposed, with fitness redeeming the supposed sin of fatness.
Thank goodness for a yoga instructor named Scottee, who challenged this explicitly: “I’m not here to determine that people need to exercise, that to be a good fat person is to be somebody that moves. Because I enjoy exercise that doesn’t make me a better fat person than somebody who doesn’t.”
This is the crux of the issue: the belief that certain health behaviors or outcomes make someone “better” or more worthy than others. But health does not define worth—not for fat people, not for anyone.
The Foundations of Healthism
This belief system didn’t emerge from nowhere. Historically, our health has been linked to our morality for generations, with layers of harmful ideologies supporting this connection:
- Capitalism has commodified health, packaging and selling it at $39.99 plus tax
- Racism, especially anti-Black racism, as brilliantly documented in Dr. Sabrina Strings’ “Fearing the Black Body:The Racial Origins of Fat Phobia“ and DaShawn Harrison’s “Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness”
- Patriarchal influences that determine whose bodies are valued
- Classism that dictates who can afford to engage in socially approved “health behaviors”
- Ableism that defines health in terms of productivity and function
Together, these forces create a system where health becomes not just a physical state but a moral achievement—one that determines your place in society’s hierarchy. One that states explicitly that health absolutely does define your worth.
When Health Status Changes
For years, I navigated the world thinking, “I’m fat, I’m trans, I’m queer—but at least I’m healthy.” That final qualifier seemed to provide some protection, some claim to worthiness.
Then I developed diabetes. Then came shoulder problems and chronic pain. As anyone who’s experienced chronic pain knows, when one part hurts, everything hurts. My back, hips, wrists—all compensating and eventually becoming painful too.
This affected my mental health, my ability to participate socially, my energy levels—everything. And suddenly, I found myself questioning my value, my worth. Not because I inherently believed health determines worth, but because society had embedded this belief so deeply within me.
I spend my days reminding myself that health does not define worth, even when society tries to convince us otherwise. That human worth isn’t earned or achieved: it’s inherent.
The Science Doesn't Support Healthism
Even the “science” used to support healthism falls apart under scrutiny. The Guardian article I referred to earlier cited a study of “Metabolically Healthy Ob*se and Incident Cardiovascular Disease Events Amongst 3.5 Million Men and Women,” claimingg that even “metabolically healthy” fat people have higher cardiovascular risk.
But this observational study failed to establish causation. The higher rates of cardiovascular events in fat people could be attributed to countless factors: epigenetics, early life experiences, environmental exposures, differences in healthcare access, quality of care, socioeconomic status, psychological stress, weight stigma, discrimination—the list goes on.
The study’s methodology was basic at best, using just three criteria to determine “metabolic health,” assessing participants only at baseline, and relying on often-inaccurate electronic health records.
Even with these flaws, all the study really showed was that fat people were more likely to have cardiovascular events than thin people—a finding that, when contextualized within systems of oppression and discrimination, isn’t surprising at all.
The Trap of Health Pursuit
Someone recently asked me: “How can a person improve their health without attempting weight loss? I want want to be an active participant in my health, even though I know that I cannot control it in the end.”
This question perfectly encapsulates the trap. If health determines worth, then of course we’d want to actively pursue health. And from a “carrot” perspective, better health leads to more opportunities, relationships, and resources. From a “stick” perspective, poor health threatens financial stability, social connection, and access to care.
The cruel irony is that despite this pressure to “manage” our health, we actually have very little control over it. So we spend money on wellness products, chase the latest health trends, and blame ourselves when illness or disability comes anyway.
Why Health Should Not Define Worth in Society
What if, instead or “purusing health”, we collectively and individually declared: “My health has nothing to do with my value, my worth, who I am and who I am to other people”?
What if we rejected the premise of healthism entirely?
This isn’t just wishful thinking—it’s necessary liberation. Because tying worth to health will always create hierarchies: those who can perform “health” at the top, and everyone else somewhere below.
It won’t immediately change how doctors treat fat, disabled, or chronically ill patients. It won’t instantly dismantle systems that privilege certain bodies over others. But it gives us the foundation to start demanding better—to assert our inherent worth regardless of health status.
We All Depend on Each Other
It’s human nature to measure ourselves against each other and look for ways to define our worth. When it comes to body heirarchies, those further up the chain motivate us to keep going, and those below us offer comfort and reassurance. We think of value in terms of productivity and how close we are to the thin, white european, cisgender, heterosexual non disabled ideal.
Those in higher socioeconomic groups are praised and valued more than those in lower ones. But that’s not only harmful but totally misguided, The world doesn’t need another tech billionaire but we can’t survive without refuse collectors. Just look at what happens when they go on strike! The truth is that everyone plays a vital role in our interconnected society, regardless of how well perceived or productive they are.
You have inherent value as a human being, worthy of care, respect, and dignity—regardless of health status. Your worth isn’t determined by your job, the number of zeros in your bank balance or your IQ, any more than it is determined by your ability to function without pain, your blood sugar levels, or any other health metric.
Because health does not define worth. And it’s time we stopped pretending it does.
Moving Forward
The journey to truly believing that health does not define worth isn’t easy in a society that constantly reinforces the opposite message. But it’s a necessary step toward justice, compassion, and human dignity.
When we separate worth from health status, we:
- Challenge harmful hierarchies that rank bodies by perceived healthiness
- Create space for more inclusive healthcare practices
- Recognize the inherent value in all human beings
- Build communities based on mutual care rather than individual achievement
- Free ourselves from the endless pursuit of an unattainable health ideal
Remember: Health does not define worth. Your value as a person remains constant regardless of your health status. This truth is both liberating and revolutionary.
This post was adapted from Episode 15, Season 5 of the Fat Doctor podcast. You can listen to it wherever you stream your podcasts or watch it on YouTube.