This week, the NHS revealed a new quiz to rate your wellbeing. But in some cases it may be more harmful than helpful when it comes to promoting healthy habits.
If I were to ask you to rate how you feel out of 10, what would you say? Me? If I’m being honest, I’d have to settle for a mediocre six today. I’ve eaten a couple of nutritious meals and I’ve taken my supps, but I haven’t yet squeezed any movement in and my brain is still fizzing from the poor sleep and anxiety I experienced at the weekend. According to a new quiz by the NHS, though, I’m actually more of an 8/10.
This was the rating awarded to me after I took the new How Are You? quiz, a digital questionnaire that’s part of the Better Health programme. It’s designed to give you an overview of your wellbeing (it’s not a medical assessment) and “point you in the right direction” (when making health-impacting choices, presumably).
Basically, you answer some questions about your diet, your exercise habits and so on, before being awarded a score out of 10 based on your answers. The whole thing only takes 10 minutes but, truthfully, my TikTok algorithm probably could’ve told me more about the current state of my wellbeing and in less time.
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The How Are You? quiz: what does it involve?
Basic data
The quiz begins by asking you to enter your name, age and sex. There are only two options for the latter, so I immediately lower any expectations I had for sensitive and inclusive language. On the next page are six sliding scales for you to rate various aspects of your wellbeing, such as how far you feel you could run (on a scale of “cannot run for a bus” to “can run for miles”) and how happy you feel (from “down in the dumps”, I kid you not, to “over the moon”).
I laugh off the odd use of language, wondering why a quiz aimed at those over 18 would refer to feeling depressed or experiencing grief or heartbreak or any other really heavy emotions as being “down in the dumps”, and move on.
Motivations to move
I’m asked what, if anything, stops me from taking care of myself (a lack of time) and who depends on me being healthy (my partner). It then goes on to question what, besides not being ill, are my three priorities. The options include “fitting into my jeans” and “staying young looking”. I select “having more energy”, “keeping my mind sharp” and “avoiding aches and pains”, before a pop-up informs me that I’m not feeling positive or negative about my wellbeing, which, to be fair, is pretty accurate right now.
Dietary habits
Then there are a bunch of dietary questions, like which is my favourite method of potato-cooking (roasted, obviously) and whether I prefer hard cheese to cottage cheese, which felt like a trick question (does anyone prefer cottage cheese?). I declared that I eat 5+ portions of fruit and veg a day and that I snack on (though nowhere could I specify quantities) everything from fruit and toast to chocolate and biscuits. And that’s when I’m hit with another pop-up.
The results
“You’re not feeling as slim as you’d like, Ab,” – I immediately regret shortening my name for speed as it feels as though I’m being shamed by a loved one – “and that might be because you’re not always choosing healthy options.” I let my jaw hang open while I digest the message, which also says some things about slipping into “bad” habits and foods to “avoid”. I wasn’t expecting super-sophisticated tech which could out-knowledge me on my own body, obviously, but I also wasn’t expecting to be confronted with such harmful language surrounding weight loss – particularly when I had specified I wasn’t looking to lose weight.
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The problem with health quizzes
As a health journalist, I spend my days writing over and over again that size is not a metric of health, and that wellbeing is quantified by so much more than simply what you eat and how you move. Factors such as stress, sleep quality, relationships and your menstrual cycle all have an influence on wellness, which were barely referenced in the quiz. Most days I feel like I’m smashing my head against a brick wall trying to get these facts heard over the misinformation from tabloids and social media stars. It’s particularly disheartening when such flippant and potentially damaging statements come from our national health service.
If the point of this quiz was to encourage health-promoting habits, it couldn’t be more off target. Far from encouraging healthy behaviours, such as reducing stress and eating a balanced diet (including fruits and veggies, yes, but also biscuits sometimes), this kind of narrative fuels disordered eating and unhelpful behaviours.
For years, I measured my waist daily. I cut out gluten, dairy, refined sugar, meat, carbs and fats on rotation until I felt permanently nauseous and missed (what have otherwise been very regular) periods. I passed on outings with friends when the restaurant menu didn’t feel “healthy” enough for me. I skipped meals if I felt I had overindulged or not exercised enough. This was because I had developed an obsession with categorising foods – labelling them “good” or “bad”, “healthy” or “unhealthy”, a result of the overwhelming and BS rhetoric that to be worthwhile as a woman in our society you must be petite.
I don’t do those things any more, but that doesn’t mean I’m not at risk of slipping into old habits. It takes a ginormous amount of mental effort to stop myself from restricting food when I feel like I’ve over-eaten or haven’t got enough movement in. I lift my top up and stare at my soft belly every time I walk past the mirror on my way to the kitchen, and then have to gather the pieces of myself I’ve just torn apart to cook myself a meal.
Being told by an NHS-funded quiz – however basic and lacking in nuance it may be – that I’m “not as slim as I’d like to be” isn’t the “brutal” hot take the tabloids say it is. It’s damaging. And it’s fatphobia costumed as medical concern.
Instead, people need to be encouraged to seek balance and avoid restrictive behaviours that can lead to disordered eating, to prioritise mental wellbeing and to stop using size as a metric of health – but that won’t stop until healthcare providers overhaul the language used when speaking about wellbeing and influencing factors.
After completing the quiz, I was given my results and recommendations, including “healthy” recipes to incorporate into my diet. I think, instead, I’ll just roast some potatoes this evening.
Images: Getty
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