A Nation of Healthy Worrywarts?

By David Brand

Are Americans really happy in their relentless search for trim, regimented bodies? By most standards, they are the healthiest people in history, generally blessed with low cholesterol levels and normal electrocardiograms and blood counts. Yet they seem to have become so preoccupied with the quest for the elusive perfect physical condition, so haunted by the very possibility of sickness that they are unable to enjoy the benefits of good health. They love to go out in the sun, only to worry about skin cancer. They diet continually, but agonize about gaining weight. They exercise relentlessly, yet live in dread of heart disease. The result of all this worrying, says Arthur J. Barsky, associate professor of psychiatry at Harvard Medical School, is that Americans are "living the life of invalids."

In this renewed season of diet vows and basking on the beach, two provocative new books take out after the often maniacal American pursuit of health and the perfect physique. Professor Barsky's book, Worried Sick: Our Troubled Quest for Wellness (Little, Brown; 266 pages; $17.95), charges that Americans "don't live exuberantly but apprehensively, as if our bodies are dormant adversaries, programmed for betrayal at any moment." Another broadside comes from University of Connecticut Sociologist Barry Glassner in Bodies: Why We Look the Way We Do (And How We Feel About It) (Putnam; 288 pages; $19.95). Glassner takes America to task for creating a culture in which people are perpetually dissatisfied with the way they look and miserable about the way they feel. "All our efforts to beautify and condition our bodies," he writes, "have not made us, as a nation, any happier with the way we look."

In their constant enthusiasm for change, Americans have long been the butt of the rest of the world's jokes for embracing the latest nostrums and potions, from patent medicines to vitamin E. But in recent years, argues , Barsky, Americans have taken their concern for good health to extremes, fretting about every random ache and pain. Over the past 15 years, he reports, polls show people are complaining more about symptoms of illness; those who say they are satisfied with their health dropped from 61% in the 1970s to 55% in the mid-1980s. Americans seem to be on the verge of becoming, as Physician- Philosopher Lewis Thomas warned nearly a decade ago, "a nation of healthy hypochondriacs, living gingerly, worrying ourselves half to death."

Both Barsky and Glassner are quick to point out that they do not deride the value of healthy living, only the obsessive quality that now surrounds staying fat-free and well. "Because health has become synonymous with overall well- being, it has become an end in itself, a paramount aim of life," writes Barsky. In fact, keeping fit has become "quasi-religious" for some Americans, says Boston University Sociologist Peter Berger. With evangelistic fervor, Body-Building Impresario Jack La Lanne, 73, whose name adorns 60 health clubs on the East and West coasts, declares, "When you quit exercising, you let go. The devil will get you."

If today's temple of the body is the health spa, its altar is the Nautilus machine and its Bible is Prevention, the 38-year-old monthly health magazine (circ. 2.9 million). Prevention once ran an article on how to guard against skin cancer; each year, it said, readers should measure every mole on their bodies (with a little help from their friends) and keep careful records on a diagram.

What these acolytes are really seeking is moral purity, says Glassner. Proper eating and exercise, he writes, have become "moral acts." Such is the paranoia about staying well that, in his view, Americans have reverted to "some of the least appealing beliefs found in so-called primitive societies." Illness, for example, is viewed not as a natural process but the result of immoral action. Explains Glassner: "We suspect the illness was the person's own fault: he or she should have exercised or eaten properly."

Psychologist and Author Rita Freedman of Scarsdale, N.Y., sees the emergence of what she calls fattism, an inclination to associate thinness with prettiness and goodness, and obesity with lassitude and lack of discipline. The way to salvation is, in Barsky's ironic words, a "tanned, trim, taut, toned body" that will be an objet d'art, a masterpiece to be "treasured, meticulously inspected and painstakingly maintained in peak condition." Unfortunately for most Americans, who tend to be groaners and sweaters, that remains an unattainable ideal.

Glassner argues that Americans have become so fixated on their bodies because they feel they have little control of the world around them. They are constantly bombarded by news reports of carcinogens and pesticides in food, of asbestos fibers falling from ceilings, of pollutants in their tap water. "The body has always been a medium for expressing attitudes toward the world," says Jonathan Moreno, a medical ethicist at George Washington University, and today's obsession with healthy bodies is no different. "If our bodies are perfectible, then the world itself should also be," he says. "People who exercise want to see the world as a place that can be made as orderly as one's body."

Because of this sense that the world is an unsafe place, says Author Barsky, "we find more things wrong with ourselves. We feel under siege." Everyday ailments, from tension headaches to forgetfulness, that would once have been dismissed as normal are now seen as a symptom of disease. "We're told that everything is an early-warning sign, from night sweats and gas pains to dry coughs," says Barsky. "But it's normal for some people to sweat at night, a dry cough will probably go away, and gas pains are gas pains." Americans, he declares, "have to stop running around trying to cure the ailments of everyday life and make peace with themselves."

Glassner also believes Americans "must find other, more realistic options" to this "tyranny of perfection." He does, however, see some hope in the notion that people are beginning to discover that what they once thought of as the ideal body isn't quite so ideal after all. Instead, "it stands not only for beauty and health," he says, "but also for false hopes and prejudices." Moreover, he notes, "that knowledge may be disheartening at first, but it also frees us -- to exercise and eat in ways that match our own needs rather than the dictates of the latest fad."

The American passion for health may add up simply to the age-old need to stay young, the narcissistic belief that it is possible to keep the body looking more youthful than it really is. But is youth really all that perfect? "We have a paradigm in mind of youth being equated with symmetrical features, perfect breasts, vigor, tone and moist, tanned skin," says George Washington's Moreno. "Go out on the street and look. You just don't see that out there." Even so, the daily battle to stay fit and youthful goes on, even if a high price must be paid in anxiety.

One plump 45-year-old woman Glassner interviewed bemoaned the demands of a society that places such emphasis on youth. Her mother, she says, was allowed to look 45 at 45, "but I'm supposed to look 25." There is "something crazy about expecting me to make pancakes for everybody on Sunday morning and not eat them," she says. "And that's the only way to keep trim, to have dry toast and half a grapefruit, and exercise." And while you're at it, don't forget to take your calcium tablet.

With reporting by Janice M. Horowitz/New York