I’m a naturally skinny guy. I couldn’t tell you if it’s a fast metabolism or something else, but no matter what I eat, I tend to stay thin.

That’s a weird way to start, because there’s a really good chance you just read that as me bragging. That’s kind of my point.

Whenever I mention to people that I wish I was more in shape or that I’ve set a goal to get more exercise and eat healthier, I can predict their response with pretty good certainty. “You?” they’ll say, “but you’re so skinny!” Typically I’ll respond with something about how I eat too many tacos and desserts, how I get out of breath walking up a single flight of stairs, how playing with my son exhausts me too quickly. They’ll almost always laugh at the comment about the stairs and then focus back on the eating part.

“Well if you can eat whatever you want and look like that, you’re lucky,” they’ll say.

Here’s the thing that I’ve been stuck on recently: I’m not healthy, but that doesn’t seem to matter in these conversations. The fact that I’ve always eaten poorly, that I’ve rarely ever exercised, that I know how unhealthy I am and want to change it: it’s all overshadowed by the fact that I’m skinny. That’s what really counts.

Isn’t this how we talk about mental health as well? It’s only ‘bad enough’ if it’s noticeable, if it’s impacting how we present ourselves to the world.

The problem with the conversations above isn’t that they’re repetitive, it’s that my very real experiences of being unhealthy are dismissed based on my ability to maintain an acceptable appearance. This makes it near-impossible to have an honest conversation about my health, and it makes me feel dumb or silly for bringing it up in the first place. And despite the extended analogy, this post isn’t about me. It’s about the countless people I know who don’t think counseling or treatment would be helpful because ‘its not that bad.’ It’s about the stories I hear of people who are spending every ounce of themselves just to stay afloat, only to have their underlying pain dismissed because they’re not underwater.

Is it possible to have a more realistic conversation around health? To push against our assumption that appearances are the best indicator of well-being? I certainly hope so.