What Is ‘Health’? And How Do We Define It?

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What is health and how do we define it? It’s a pretty complex topic and our interpretations will vary as much as our personalities. In 1946 the World Health Organisation defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (1) at the International Health Conference. This definition was put in place as of 1948. I don’t know about you but aiming for complete health in each of these areas feels like quite the daunting task, much like asking your crush out face to face in year 8 it isn’t going to happen.

“It is health that is real wealth and not pieces of gold and silver”
– Mahatma Gandhi (2)

Well-being focus and all the buzz around it is booming. Gone are the days when it’s a popular idea to starve yourself to nothingness in order to achieve a fashionable “look”. The greater the engagement from each of us with our health can only be a good thing. With all this focus on healthy living, healthy eating and “living my best life” what happens when the foundations of understanding what health is and is not are poorly understood? In this sense, striving for health can be like navigating the maze in a Triwizard tournament with an extra catch, you’re blindfolded and there is no cup to be found. Bah ha! You’ve been Tango’d. Except when health is concerned, the consequences can be a bit more dire than a double happy slap. 

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Being aware of and taking responsibility for our health can help us in many ways, whether it’s feeling able and capable, happy and content, experiencing sadness in proportionate bouts and even saving us money on health visits and prescription charges. With the age of the internet however, the health messages we receive can be combobulated and skewed – identifying fact from fiction is a bit of a tough cookie to crack.

So how does the evidence for what is and isn’t healthy translate into simpler ideas? Is it being a certain “ideal” weight? Having the “right” body fat percentages? Is it healthy to living in one emotional state? Is avoiding the GP unless you think you might be legitimately dying mean you’re healthier than everyone sat in the waiting room for said GP? The waters become murky very quickly and it’s easy to lose sight elusive Goblet of Health whilst sashaying amongst the currents and tides of fads, shock factor headlines and public health campaigns that are somewhat not accurate anyway – think Weight Watchers in American schools and the Ob_s__y campaign by Cancer Research UK earlier this year. 

The crux in relation to nutrition and our relationship status with food doesn’t boil down to one measurement, or one aspect of health. What we eat and how we do or don’t eat affects countless aspects of our bodies and functioning. Some very real questions in relation to health and nutrition is currently in an antler head bashing contest amongst those in the field, whether accredited and qualified or not. Is it healthy to marginalise a population group because of a pattern of association without identifying causation? Is it healthy to drill diet culture into young minds, and thus setting them up for a lifetime of living “healthily” on diet culture? Is that even possible? I’m not convinced. I’m also not convinced that everything stocked in Whole Foods is automatically healthy – sorry not sorry. I’m also not convinced about the healthiness of many modern day normalities, such as our phones becoming an extra part of the human anatomy, using social media to gain self worth and validation, or extreme approaches to anything much at all. 

With health food shops donning more supplements than we can possibly afford or swallow, and health influencers donning skimpy clothing to show off abs, glutes that can crush walnuts and who can do more chin ups than an excitable dog can tail wags, does being healthy have to be so extreme? I’m going to go out on a whim here and speculate that there’s no extremes in being healthy. It’s actually more about a balance and happy medium as boring and unexciting as that may sound.

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A little secret not pushed by those cashing in on the trend, you don’t need an extreme diet to eat healthily. You don’t need an extreme exercise regimen to be healthy. You don’t need to always be happy and content to be healthy. Nor do you need to spend crazy dollar on fancy ingredients and farfetched meal plans. Health isn’t even a number on a scale. The BMI is a tool for guidance and definitely not definitive – many athletes have a BMI considered obese and I’ve never seen someone typically considered to be ‘obese’ competing at the Olympics.

Each of us will define health differently drawn from our lived experiences. The most important point to be made though is that health is not a destination but a tool for living. It isn’t the be all and end all, merely a snazzy individualised car for scooting through your days with. Yeah, you want to keep the gear box in check but you don’t want to be obsessing over whether your gears are always sliding perfectly. You also need to keep your oil and waters tanks topped up, but you don’t want to be watching them furtively whilst missing out on the enjoyment of your drive. It would be a shame to not enjoy and take in the views.

Sources:
1. http://www.who.int/about/mission/en/
2. 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705649/

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To The Bone Behind The Mask: Inside Anorexia

*Trigger Warning* – If you are experiencing or have experienced an eating disorder this post may be triggering for you.

The song of the morning birds has just begun, she can see through the crack in the curtain that the morning dawn is about to break. Her partner remains still as the night, unaware of the creeping day ahead. Pushing and kicking the duvet between her legs she rolls over to try and grasp at another few moments of peaceful slumber, “why is it that she can’t stay awake during the day and can’t sleep at night?” Tucking her extra pillow between her jarring knees for padding she twists her body so the least of her jutting angles are bruised from the mattress.

The tranquillity of peace is unbeknownst to her. Her only peace is found when calorie limits are adhered to, when pounds drop or measurements shrink; and despite the constant battle with herself and others, these moments are few. The human body can only lose at such a rate, she can only muster the strength to push herself to such a limit, and below nothing, there is no less to eat. Of course, she does eat, just not every day, but what more can she do to please this need?

The ruminations never desist, they merely quieten in a moment of victory, a moment when she has “done well”; she has adhered to the strict regime set by her demon of X calories, less calories, less calories. The congratulatory prize is small, a minor victory – and after a while does not extend to the praise of those around her as it had done when she began losing weight. No longer is she cooed with, “oh you look so beautiful”, “oh don’t you look marvelous, look at her cheek bones and toned stomach” or, “I’m so jealous, how do you do it?” There is a fundamental issue with society here; she was never overweight in the first place and she was never fat despite repetitious hollers. Her stomach isn’t toned, it’s bordering concave; her legs aren’t sculpted; they’re weak, aching and bruised; her arms possess no strength, they’re minute and painfully angular; her face isn’t chiselled like a catwalk model, but gaunt, lifeless and exhausted.

Her complexion pales whilst she walks through town smelling the foods she can’t have, staring in the windows of restaurant chains and eyeing up menus that she can’t even dream of ordering from. The thought fills her with a fantastical excitement at how good it must taste, but the engulfing fear and dread of actually eating it is too much. She had once felt empowered by her ability to say ‘no’, to deny herself and to not need but now she needed, and she wanted so desperately to say ‘yes’. She had become powerless to her disorder.

Wandering into the supermarket she’d stalk the aisles. Picking up foods she felt intrigued by and looking at it closely through the packaging. Turning it over and looking at the calories and fat grams, 90% of what she picked up had been a far cry from what she was now “allowed”, but with each package the fascination grew: if only she could taste, feel and enjoy food: longing to let herself need, to find true enjoyment and to just eat. Each packet was sat back on the shelf for someone else, someone less greedy, and someone who deserved to eat it. Aisle after aisle: dairy, confectionery, foreign food, it all amazed her. To just read the labels and ingredients engaged every morsel of her obsession until the anxiety and pressure to actually buy something began to creep in and ruin her fun. Leaving with nothing, she tried to sneak out without raising suspicion with security. She hadn’t stolen anything, but didn’t want to be pulled over because who spends two hours in a supermarket looking at food to walk out seemingly empty handed? She was painfully aware that her behaviour would be deemed as unusual.

When she got home, her cupboards were filled with foods she could eat. Feigning enjoyment of these choices to herself she was convinced that water on cereal was delicious and how could anyone not like a bowl of lettuce and mustard? Her demon had tricked her, fooled her into thinking in new ways and instilling relentless rules of survival: cutting up food into the smallest pieces possible, chewing x amount of times each time, no eating after 7pm but no eating before 5pm either, always eat alone, measure everything, weigh ten times daily. It went on. It went on and on. She was governed by barking orders from this voice within.

She had to keep it a secret. She had to lie. She had to remember everything she ate for the last fortnight. She had to count how many items she had consumed. She had to count calories or every bite, medications and vitamins included. She had to walk here, there and everywhere that she could. She had to exercise. She had to listen, she had to comply, because if she didn’t she would be berated to a withering heap. “You’re a fat bitch!”, “You greedy cow”, “You’re a failure and disappointment.”

Once immersed within the health services she has only more people to hide from, to lie to, to fight against. She is a slave to her own game. It’s not working out so well now; she has lost her autonomy, her independence, and her freedom. Caged in a cell of constant torture she is a shell of who she used to be: no longer laughing, no longer energetic, sociable, fun or fulfilling her potential.

What started as a diet to save her from “fat” hollers, what had started as a method of ‘self-improvement’ is gradually destroying everything she was. What started as a means to control her inner turmoil and world has grasped at her every molecule and refuses to let go. Entrenched, she is obsessed and caught up in the relentless need to abscond from greed, to not need and to be less. The “oh you look so beautiful”, has turned into, ‘Is she OK?”, “She looks so unwell.”, “I don’t know why anyone would want to be that thin. It looks disgusting” but the truth is, in her eyes for as long as she is alive, she will always be fat. She will never be thin and never has been thin and that really, ‘thin’ has become irrelevant. All she ever wanted was a bit of control, and to feel a bit better.

– If you want more information or are affected by this story, something-fishy.org and B-eat are good organisations for help, support and more information.

Ditching The Weighing Scales For Good!

How I moved away from compulsively weighing, through the weight anxiety to finally ditching my scales for good.

My set of scales are pretty standard and I’ve had them for years. I don’t even remember where I was in my journey with food when I bought them. I’ve read many times that an important step in recovering from an eating disorder is to get rid of your scales. There were a few reasons as to why I’ve resisted taking this step.
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Initially it was because I know banishing them from the house would not stop me from weighing myself or ease my anxiety when I was still recovering. I knew that I had to get to a place of using them less and placing less importance on their result with them around. Otherwise I would just buy another set, or would obsess when I went to someone’s house who had a set. It just didn’t feel like the right approach for me at that time.

Once I was more recovered I was put on medication that affects weight. A third of people on Quetiapine in the long-term develop diabetes and become overweight enough to negatively impact physical health. I was anxious about this happening to me and how not feeling in control of my appetite and weight could potentially trigger old behaviours. I did gain weight each time I went on Quetiapine.

Despite this, I stuck it out and have been taking it for the longest time that I ever had previously. Finally, I decided that the positive effects of Quetiapine outweigh the weight gain, and potential metabolic alterations it can cause. The decision to push on with taking it despite weight and appetite changes that at times felt bordering on out of control is that those side effects have eventually subsided. Who knew? I have stopped taking Quetiapine many times previously out of fear and anxiety of potentially feeling out of control with my appetite, and the unknown. Each time, I get very unwell again. It’s just a general shit show.

14 months later and I am not scared anymore. I’ve adapted. Yes I gained weight and ironically since I’ve stopped weighing myself regularly or trying to control my diet in any way there have been no drastic changes. I’ve pretty much stayed about the same and in this time, despite being near my highest weight I am more comfortable with my body than I have ever been.

Possibly due to some radical acceptance being practised. Ultimately though, this disproves my earlier theory that I had to monitor my intake and weight because of my medication. It also proves that my body has a way of adapting, staying well and maintaining some form of homeostatic harmony.

According to the BMI chart I’m probably still overweight, and I’m also pretty healthy. Most would agree that the BMI is an outdated and archaic measurement of health but it’s still used. There’s another myth disproved by my own experience, that BMI is important. I could play Bingo with previous misconceptions at this rate!

I fend off infections and illnesses well, I exercise, I enjoy it, I’m not unfit, I eat pretty balanced and I’m partial to a pain au raisin lately. Yeah I’ll look at food labels sometimes to see if it’s particularly high in sugar or saturated fat but it is more of a glance over to understand the composition of different foods. It is not the be all and end all, just more of an awareness about what’s in my food choices.

In general I feel the need to follow the path I’m advocating.  No hypocrisy, no secrets, and full transparency.It’s time to listen to my body. It finally feels like the right time to take such a  step. I feel confident that I won’t buy more in a panic or feel lost without them. This is a pretty big step and hopefully perhaps the final one in moving completely out of eating disordered behaviour, comforts and rituals.