Health is Not One Size Fits All: Challenging Traditional Definitions

As I dig into the nitty gritty of weight-inclusive care, I find myself longing to go back to basics and. And here’s the thing – weight-inclusive medical care isn’t something you can just study at university. You can’t get a diploma in it (yet). But I truly believe that during my lifetime, we’re going to see a real shift in how we practice medicine, from a weight centric focus to a weight-inclusive one.

And in order to usher in this era of weight-inclusive medical care, we need to start at the foundations. We need to agree on some basic principles. And perhaps the most fundamental principle is this: Health is not a one-size-fits-all concept. It defies simple definitions.

Ask a dozen people what health means, and you’ll get a dozen different answers. At its core, health is more than just a set of metabolic markers or the absence of disease. True health must account for the realities of aging, disability, environmental factors, and trauma. It’s dynamic, not static – a journey, not a destination.

The Problem with Traditional Definitions

Let’s look at some traditional definitions, starting with the WHO’s 1948 definition: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Already we’ve got problems. Complete? That’s very binary and lacks nuance. Most of us don’t have complete physical, mental, and social well-being and the person who does is either kidding themselves or incredibly privileged.

As far as I’m concerned, the WHO can take their definition and stuff it. It’s 2025 – time for an update. But to be fair, a lot of doctors are so caught up in the the biomedical and focusing on the the prevention and/or diagmosis of disease, that they forget about everything else. If it’s not a physical illness or an injury, they’re very rarely interested. It’s all about measurable physical and biological markers: blood pressure, cholesterol, HbA1c, leptin, CRP, BMI. All those lovely abbreviations we love to throw around because they make us sound more professional. The medical system I work in very much favors this biomedical model, and from what I can tell, it’s getting worse, not better.

When I was studying medicine, I started with two years of non-clinical work. Two years of just studying and going to lectures from nine in the morning until five in the evening. We learned pathology, microbiology, cellular biology, virology, and endless systems – cardiovascular, respiratory, gastrointestinal. For two very long years. But do you know how much times we spend on psychology and sociology? One combined module, that lasted one semester with just two lectures a week. That’s how little importance was placed on the social aspects of health, even though more comprehensive models (like the ones I’ll cover below) had existed for decades before I went to medical school.

Beyond the Numbers

Health is more than numbers on a chart or test results. It’s not a tick boxe exercise. For starters, we know that these metrics exclude large swathes of people (just look at the history of the BMI). We know health is dynamic, not static – it changes over time. We have to make room in our definition for aging, for personal circumstances to change, for unexpected events and injuries.

Enter the concept of Salutogenesis, introduced by a man named Aaron Antonovsky in the late 70s. Rather than seeing health as binary (either healthy or sick), salutogenesis presents a continuum between health (described as “ease”) and disease (dis-ease). I love this because it moves away from binary thinking and focuses on what keeps people on the “ease” side of the continuum.

Antonovsky introduced the concept of “sense of coherence” – the idea that health reflects a person’s ability to see the world as comprehensible, manageable, and meaningful. When we say comprehensible, we mean that life events are structured and predictable. Manageable means having the resources to cope with life’s challenges. And meaningful speaks to having a sense of purpose in life. Sounds way better than the WHO definition, doesn’t it?

The Missing Pieces

But even these more nuanced definitions often miss crucial elements. What about cultural health? Environmental health? Financial health? I would argue that you can’t really be healthy if you’re living in the midst of a genocide, or if you don’t have enough money to support yourself, or if you haven’t had the care and compassion of a supportive community throughout your life.

Indigenous perspectives on health often speak of harmony, balance, and connection – with your ancestors, your community, the environment, and spirituality. And you know what’s fascinating? Science is starting to catch up. We’re seeing medical journal articles that support concepts indigenous communities have been talking about for millennia.

The Role of Resources and Privilege

Let’s talk about resources – both internal and external. External resources might include your family, community, social support, education, financial stability, culture, and traditions. These are often excluded from traditional health models that focus solely on physical, mental, and social dimensions.

Here’s the truth: all resources are limited. There’s enough food in this world for everybody to eat. There’s enough money in this world for everyone to be well and have what they need. The problem is that these resources are hoarded by the minority, leaving the global majority lacking and in need.

If you don’t have enough resources, if you don’t have enough opportunities, if you don’t live in an environment that allows you to thrive, then how can you be healthy? This is why health shouldn’t focus so much on the individual – it’s communal. We need to look at health through an equity lens, asking ourselves does everyone have equal access to the same resources? Devastatingly, the answer is always no.

Systemic Oppression and Health

When I say health is a privilege and not an achievement, what I’m saying is that right now, health is not fair. The deck is stacked against certain groups. If you belong to a group that society has deemed inferior – if you’re Fat, or Black, or Brown, or Indigenous, if you’re Disabled, if you’re Neurodivergent, if you’re Trans, Queer – society has taken one look at you and decided you’re not good enough, you don’t meet the standard.

This systemic oppression permeates every aspect of our lives – not just medical care, but also the justice system, education, employment, housing, travel, clothing – you name it. And then people have the audacity to point at these intentionally marginalized groups and say, “Look, they’re not healthy.” Of course they’re not healthy! By definition, they can’t be healthy, because they’ve been systematically denied the resources necessary for health.

Health as Liberation

Here’s a radical thought: what if we simply stopped trying to define whether a person is healthy or not? What if we stopped trying to dictate how a person’s body should look, feel, or function? Maybe rather than trying to find a definition of health that includes everyone, we should say that real health is freedom from the definition of health itself.

Ask any child to draw what “healthy” looks like. They’ll probably draw someone who looks like Thor or a marathon runner – probably white, probably cisgender, probably heterosexual. That’s what happens when we start trying to define health. That’s the the image we’ve been indoctrinated with since childhood, and is perpetuated by all areas of society, including… no, especially the medical profession.

What about the fat, black person in a wheelchair, doing wonderful things? Or more importantly, just being a wonderful person? Why can’t they be the image we have when we close our eyes and think of health?

Personal Definitions of Health

When I ask people what health means to them, they often say it’s about feeling well in themselves and being able to live a fulfilling life. For some people, being healthy means running 5 miles a day; for others, it’s being able to get out of bed in the morning. And everything in between.

But notice how often these personal definitions are focused on doing rather than being. This isn’t surprising – we live in a society shaped by white supremacy, colonialism, capitalism, and misogyny, all of which prioritize productivity over existence. But what if health could just be about being? What if it didn’t have to be about what we can do for society?

The Reality Check

Health should belong to everyone. It shouldn’t be a privilege reserved for certain people who meet certain criteria or fit in certain boxes. Thin is right at the top of that list of criteria. People often ask me why doctors are still so fixated with weight given all the evidence. But we’re challenging the very definition of health here, folks, and that’s not something people can easily get their heads around. It goes against everything we’ve ever been taught.

We need a holistic approach to health that values both internal and external resources, that goes beyond just mental, physical, and social well-being. We need to start making space for the diverse ways that health manifests. And perhaps most importantly, we need to start by asking ourselves: what does health mean to me as an individual? If you find yourself thinking only about what you can do, be curious about that. No judgment – just curiosity.

Because at the end of the day, health isn’t about fitting into someone else’s definition. It’s about having the freedom and resources to live authentically in whatever body you have, in whatever way works for you. And until we address the systemic barriers that prevent certain groups from accessing the resources they need for health, we can’t pretend that health is equally accessible to all.

Change starts with challenging these traditional definitions and recognizing that true health equity requires dismantling the systems that create and maintain health disparities. It’s not about individual choices – it’s about collective liberation.

This post was adapted from Episode 2, Season 5 of the Fat Doctor podcast. You can find it wherever you listen to your podcasts, or alternatively watch it on YouTube.