Why We Need to Stop Labeling Behaviors Influencing a Person’s Weight Ideal or Healthy

This commentary argues that financial incentives for employees who meet body mass index requirements reinforce healthism, a false and oppressive ideology.Healthism is the view that personal health is the vehicle of well-being and that health is achieved by taking personal responsibility for habit modification.Healthist views about body shape and body weight enforce oppressive norms and can lead to pernicious harms, especially to members of vulnerable groups.Overall, this article argues that persons and organizations ought not to label behaviors that influence body shape and weight in normative terms, such as "ideal" or "healthy."The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit available through the AMA Ed Hub TM .Physicians should claim only the credit commensurate with the extent of their participation in the activity.Case X is a large employer looking to reduce number of employee sick days, optimize productivity, encourage adherence to its wellness program activities, and promote "ideal health behaviors."Employees who engage in such behaviors, document them, and maintain a body mass index (BMI) at or below 25 will be eligible for reduced insurance premiums.CR is an X employee with a BMI of 29 and learns after a "weigh in" at a wellness day event that this means she is "nearly obese."CR has never considered herself unhealthy, maintains an overall diet that is about 90% plant-based, and participates in many recommended "ideal health behaviors."CR sees the offer for reduced insurance premiums, views those savings as significant, but feels they are out of reach.CR feels demoralized about being asked by her employer to "weigh in," about being described as "nearly obese," and about her health being deemed not good enough for her employers' insurance premium reductions.Many employees have complained that 25 as the BMI cutoff is discriminatory, encourages body negativity, and expresses views of wellness that are fundamentally racist, sexist, and ableist and that might not be "healthy" at all for many of X's