The fat acceptance movement frequently makes the claim that weight is not an indicator of health and BMI is a form of discrimination. This line of thinking has spawned the Health At Every Size (HAES) branding. No matter how many extra pounds, we are told, someone can be perfectly healthy.
What they got right is that loads of thin people are also exceptionally unhealthy, but Heath At Every Size does not stand up to common sense and sense experience. For more perspective on the topic, turn to the ever-insightful Bari Weiss. Her independent “uncancellable” podcast, Honestly With Bari Weiss is perennially engaging with probing topics, interesting guests, and high-quality interview questions. You need not agree with everything Bari stands for to enjoy spending time with her and her ideologically diverse guests.
One such guest, Dr. Casey Means, addressed what used to be called the Obesity Epidemic. Means, the founder of the tech wellness company Levels, has a nuanced perspective on the forces that have driven commercial food production and the institutions of modern medicine to work against the best interests of health and wellness. She rightly notes that the individuals making up these large complexes are not themselves ill-intentioned. Indeed, many are driven by a sincere desire to help people. Yet, the incentives are not aligned to treat people in order for them to heal.
One cannot help but notice that people being “treated” for depression or migraines, high blood pressure or diabetes are usually never healed. Rather a constant state of disequilibrium is corrected with a steady dosage of pharmaceuticals. Given how much environment changes, lifestyle shifts, people change overtime such a stagnant management of disease seems suspect. In order to find healing, one has to look outside mainstream medical practice.
The idea that we are suddenly all very unhealthy after a long history of ideal health cultivated by whole foods and natural living is quickly shattered by biographies of people living long ago, many of them noted to have been in very poor health. Plagued by chronic ailments, haunted by early deaths of parents, siblings, and peers, people who lived long ago were not living in some fanciful Eden of natural plenty. For that reason, we cannot say that largescale commercial food production destroyed perfect harmony of man with nature. It seems some primordial severing rendered man at odds with his environment, unable to be surfeited by the fruits of the earth without great labor or great cost. Man was not well in times past any more than in our current age.
What we can say is that there are clearly afflictions related to the current challenges and excesses of our present age. Dr. Means gives a name to that nebulous feeling of dysregulation that plagues so many of us. Surely, the food we eat that literally becomes the substance of our bodies has an effect on our functioning. Surely, the manner in which we live our lives, so often isolated, sedentary, trapped in circular thinking of narcissistic drudgery has an effect on how our bodies operate.
The disconnect is obvious in the modern medical system. The ever-expanding endocrine office that fails to see all the young women with deformed and diseased thyroids may have something fundamental in common with all the diabetics that move through the revolving door of lifelong medication management. It’s bewildering to sit in the room with experts, doctors who have seen more endocrine disorders than almost anyone in the world. Having jumped through all the hurdles and waited for the moment of clarity, the doctors shrug and reply glibly that all your ailments—hair falling out, joint pain, nails crumbling, fatigue, fuzzy thinking, migraines—have nothing to do with the endocrine system or what you eat. But you should see a rheumatologist and a neurologist they tell you as they are whisked from the rooms with the demands of a waiting legion of similarly afflicted patients.
There’s an analogy for our modern medical practice: It is like walking in the woods at night. Modern medicine, which solves certain problems very well, is like a flashlight sending a stark beam of light out across the forest floor. We can see certain obstacles well, like a root protruding from the ground about to trip us. The harsh light, like certain modern diagnostic tools, however, does not allow our eyes to adjust to the dim surroundings. While our eyes stay fixed on the bright beam, we cannot make out the path as it winds into the trees. We likely cannot even see the nearest trees.
Means, who was on her way to become a skilled flashlight holder, is charting an interesting course in nighttime forest exploration that is the healing of human disease. After leaving a prestigious fellowship, Means worked with patients one-on-one to address their metabolic health. Frustrated by the small scale of her practice and large expense for her patients, Means turned to founding Levels. Her frustration raises the question of whether good health and well-being necessarily require one-on-one attention, which is always small-scale, and great expense, the required investment of such time and attention. Choosing to try something that can scale, Means turned her attention to equipping people with biomarkers to manage their own health.
Levels’ mission is lofty: “To solve the metabolic health crisis.”
The company attempts to do this by giving individuals personal, real-time physiologic data about how food, sleep, exercise, and lifestyle affect blood sugar. According to the website, “Levels helps you see how food affects your health. By leveraging biosensors like continuous glucose monitors (CGM), Levels provides real-time feedback on how diet and lifestyle choices impact your metabolic health. Our Members are using personalized data to discover their optimal diet, control their weight, and reduce long-term health risk.”
There is weight of responsibility that comes with such knowledge. It can seem easier to claim injustice and point the finger at big companies. Driving down an average suburban thoroughfare, you encounter endless mutations of the fried chicken fast food restaurant with a side of super-sugarized beverages and desserts. In an affluent and obese nation, children’s sports and activities are synonymous with great heaping helpings of refined sugar bathed in canola oil. The soccer game at eight o’clock in the morning is followed by the distribution of large packs of Oreo cookies with a side of extremely sweet juice. We are set up for failure. It is too difficult a task.
And yet, there are everywhere people interested in growing vegetables in a small plot of land in their yard, urbanites with a clandestine chicken coop, people with a passion for fermenting their own sauerkraut. We must recall that health and vitality are not all about what we eat; it’s certainly a big part of it, but not the whole story. We all know aged people who seem to survive on a steady stream of nothing but coffee, bacon, and cigarettes yet run laps around people decades their junior. There is some secret source beyond their caloric intake that contributes to such vivaciousness.
As Jesus said, “not what goes into the mouth defiles a man, but what comes out of the mouth, this defiles a man” (Matthew 15:11). What we eat becomes who we are, but more powerfully our thoughts form the substance of our being in ways that are difficult to understand.
Levels seems like a worthwhile tool for some people in pursuit of better health. It is not necessary. Simply recognizing the simple things we can all do to feel better: sleep regularly, exercise often, each simple foods, fast cyclically, and, most importantly, laugh excessively.
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