A Stoic Ethical Framework for Health and Fitness

We are currently living through an unprecedented global health crisis driven by poor nutrition and inactivity. The obesity rate has more than quadrupled since 1990, and today more than 43% of adults are overweight (World Health Organization [WHO], 2025). Being overweight and obese is a major risk factor for developing a variety of diseases, such as heart disease, stroke, cancer, and diabetes (National Institutes of Health [NIH], 2023). Startling increases in these illnesses are driving global mortality rates (WHO, 2024). For example, the world’s leading killer is ischemic heart disease, which was responsible for 9.1 million (13%) of the world’s total deaths in 2021, up from 2.7 million deaths in 2000. Major drivers for these concurrent increases in obesity and morbidity/mortality are increases in sedentary lifestyles associated with urbanization and an increasing abundance of highly refined processed foods, which are associated with multiple health conditions (Lane et al., 2024). Beyond the immense economic toll and physical suffering caused by these preventable diseases and deaths, poor nutrition and physical inactivity also contribute to diminished mental health (Rahmati et al., 2024; Fabiano et al., 2024).

From a Stoic perspective, the drivers of this crisis can be interpreted as resulting from multiple failures to uphold virtue. Beyond a lack of individual self-control or mindfulness in one’s food and exercise choices, corporations and governments often place economics and profit above the well-being of the community. Indeed, despite the need for increased efforts for promoting fitness and health, the response by governments and public health agencies has been uneven (Lan & Sulaiman, 2024). Into this gap have entered a variety of actors and the modern wellness landscape is populated by health gurus and fitness influencers that promote an assortment of lifestyle modifications purported to promote wellness, but that can be inefficacious or even detrimental to health (Zeng et al., 2025; Nickel et al., 2025). With enormous potential financial rewards, the pressure to stand out and hook subscribers/clients encourages wellness plans that emphasize fad diets, quick-fix solutions, and nutritional and fitness advice that is not grounded in science (Collins, 2025). Unjust financial motives, rather than an interest in helping others, drive this phenomenon.

‘There is thus a great need for an ethical framework for health and fitness to help guide individual and community efforts to seek wellness in a virtuous manner. Stoic philosophy can provide an ethical framework for health and fitness by placing virtue as the highest good and providing the discipline needed for a virtuous life. It is natural for this ancient philosophy, given its focus on virtue, to interpret health through an ethical lens. Fitness was important to ancient Greeks, and many Stoics were soldiers and athletes, like the boxer Cleanthes and the long-distance runner Chrysippus. This close association led them to use sporting analogies to make philosophical points.

Marcus Aurelius helps us to be prepared by reminding us that, “The art of living is more like wrestling than dancing, because it requires you to stand ready and firm to meet sudden and unforeseen attacks.” (Meditations, 7.61). In readying aspiring philosophers for the rigors of the Stoic path Epictetus stated:

In every undertaking, consider what precedes it and what follows it, and only then proceed to the action itself. If you do not, you will begin with enthusiasm because you have not reflected on the consequences, but later, when difficulties appear, you will give up in shame. You say, ‘I want to win at the Olympics.’ But examine what comes before and what follows, and only then commit to the undertaking. You must submit to discipline, follow a strict diet, abstain from sweet cakes, train under compulsion at a fixed hour in heat or cold… (Discourses, 3.15). 

Seneca emphasized practical aspects of fitness in cultivating self-discipline stating, “that you indulge the body only so far as is needful for good health. The body should be treated more rigorously, that it may not be disobedient to the mind” (Letters from a Stoic, Letter 8). 

In addition to physical fitness and athletics, the idea of health (or its absence) was also highly important to the ancient Stoics, and they included various medical analogies in describing their philosophy. For example, Epictetus warns about the rigors of practicing philosophy: 

Understand this clearly: the school of a philosopher is a hospital, not a theater. You should not walk out of here feeling pleased; you should leave in pain! Why? Because you come to me sick—one with a dislocated will, another with an abscess of vanity, another with a fever of desire. (Discourses, 3.23). 

Similarly, to understand and rationalize life’s challenges, Marcus Aurelius conceived of the Universe as a doctor:

Just as we understand the phrase, ‘Asclepius prescribed a regimen of horse-riding for him, or cold baths, or walking barefoot,’ so too we should understand, ‘The nature of the whole prescribed a sickness for him, or a disability, or a loss of limb, or something similar.’ For in the medical sense, ‘prescribed’ means that the doctor ordered this specific treatment as suitable for that person’s health; in the cosmic sense, what befalls each individual has been ordered in a way that suits their destiny. (Meditations, 5.8).

While influential to the ancient Stoics, it is important to note that health and fitness were not considered “goods” in the conventional sense; rather, the Stoics considered these things as “preferred indifferents”. Preferred indifferents like health and fitness are neither good nor bad in themselves, as they can be approached in virtuous or vicious ways (e.g., as outlined above). It is important to not confuse “indifferent” with “unimportant;” while externals are indifferent to our virtue in themselves, they still have value—as these are the objects of our moral choices. In this way, it is rational to prefer health and fitness over disease and weakness, but this preference must always align with virtue. Seeking these preferred indifferents is rational because they are conducive to our existence and to the cultivation of virtue. Therefore, our engagement with health and fitness inherently carries a strong ethical component, encompassing our individual interests, the well-being of the human community, and the imperative for rational and virtuous pursuit. This topic will be explored through the lens of the four cardinal virtues. 

Wisdom: Beyond just making good personal choices, applying ethical wisdom and good judgment to health and fitness allows us to promote sound practices that cultivate health broadly. On an individual level, the application of wisdom to health allows us to understand what is within our control (our choices and the efforts that we make that can influence health) and what is outside our control (the actual outcomes of these choices and efforts). Wisdom provides us with an understanding of our own body and its limitations – particularly as we grapple with aging, sickness, and disability. In this way, wisdom protects us from falling into vicious and irrational thought patterns regarding health and fitness. For example, wisdom allows us to apply critical thinking toward health information to avoid adopting false beliefs about health and fitness: e.g., diet “quackery” that promotes unhealthy or even dangerous eating habits like extreme caloric restriction or supplementation with dangerous products (Jaime & Mank, 2024; Berg, 2021). Wisdom informs our decisions, allowing us to make judgments about health that reflect evidence-based approaches grounded in sound science. Essentially, this consists of training what the ancient Stoics referred to as the hegemonikon (command center or ruling faculty) to apply sound reasoning and logic toward these topics. 

Importantly, wisdom allows us to look with clarity on our thought processes and motivations, to understand our reasons for seeking health and fitness. This involves the cultivation of Stoic mindfulness (prosoche) and the application of volition (prohairesis), which together protect us from treating health and fitness as intrinsic goods rather than preferred indifferents. For example, are we exercising to build a stronger and healthier body because we want to impress others and gain their acclaim, intimidate people, or find romantic partners? Are efforts to be healthier due to a morbid or irrational fear of death and sickness? Wisdom plays a central role in guiding our judgments about these things, helping us to assent only to true impressions about the value of health and fitness. If falsely assigned as goods, such judgments will cause irrational cravings and suffering due to their transitory nature, being up to fate, which defines their status as indifferents. This is accomplished through the exercise of our faculty of choice, which ensures that the judgments about health and fitness that we assent to are true—aligned with Nature. 

Wisdom allows us to rationally seek out such preferred indifferents in a way that aligns with reason and virtue. In seeking out health and fitness, we need to consider how these things can contribute to our living virtuously and wisdom provides us with the means of doing so: specifically, by helping us to remain detached from outcomes. While striving for wellness, it is important to understand that perfect health is not guaranteed, and we need to have equanimity regardless of our actual physical condition (accepting illness or the limitations imposed by age). This idea was explored by Pierre Hadot in The Inner Citadel, where he conceptualized this Stoic discipline as the love of fate (or “amor fati” in Latin) that allows the Stoic to meet any outcome with cheerful acceptance.   

Courage: Courage allows us to persist in doing what’s right, even if it “goes against the grain.” In terms of health and fitness, people who want to make healthy changes to their lives can face multiple, sometimes quite significant, barriers to making these changes: such as pain, a fear of injury, lack of social support, physique anxiety, financial and time limitations, as well as others (Tay et al., 2023). For example, many people build social networks based on their lifestyle, and transitioning to a new, healthier lifestyle can stimulate resentment or even criticism from others (Dailey et al., 2023). Recall Epictetus’ warning, about being mocked for practicing philosophy, “If you desire to embrace philosophy, prepare yourself from the very start to be ridiculed and mocked by the multitudes.” (Enchiridion, 22). People trying to adopt a healthier lifestyle should also be prepared for ridicule and mockery. Courage means facing these uncomfortable situations and persevering. 

Courage allows people to face these barriers and tackle the irrational beliefs that can erode their self-efficacy. For example, if “physique anxiety” is keeping a person from going to the gym, courage allows them to persist in the activity, while synergistically calling upon wisdom to break down the irrational belief that other people’s opinions on our body are important—instead of correctly seeing them as indifferents. An example of courage in this context would be an overweight person entering the gym for the first time, enduring potentially negative attention and getting to work. 

Courage allows people to face discomfort and cultivate the discipline needed to persist in healthy habits: for example, by maintaining a consistent exercise program and eating healthy (but not always highly palatable) foods. It provides the toughness needed to persevere through various setbacks, such as injuries, plateaus, or lapses without giving in to negative self-talk or ideation. Courage also provides one with the strength to resist negative social pressures that are promoted by toxic influencers and our ubiquitous consumer culture: e.g., to engage in extreme behavior, take dubious supplements, binge eat, etc. Courage allows one to move beyond these discomforts and challenges, using them as opportunities for growth and development of one’s character. Finally, courage involves using reason to gain insights into the value of a behavior vs. just blindly applying force of will: e.g., one may not want to “work through the pain” if that pain is resulting from an injury to the body. 

Temperance: Temperance plays an important role in guaranteeing that reason is the primary guide to our actions regarding health. It allows us to avoid excesses in diet and exercise to find the moderation needed to pursue health and avoid chasing after false goods such as unrealistically ideal physiques or “perfect” health. Temperance allows one to challenge irrational impulses driven by cravings, which are often fueled by false impressions (phantasiai in ancient Greek). This is particularly important in today’s age of ultra-processed foods, as ingredients such as high-fructose corn syrup can stimulate the reward centers of the brain, acting in ways analogous to addictive drugs to drive compulsive eating (Ravichandran et al., 2021; Lenoir et al., 2007; Conley, 2024). Conversely, temperance allows us to evade dangers such as extreme diets and exercise that can damage health just as badly as a sedentary lifestyle and poor diet. For example, temperance can help us recognize that health requires consistent and challenging effort and not an easy “quick fix.” Health requires careful planning, as well as the implementation of preventative measures and healthy habits that are sustainable in the long term. 

By exercising temperance, we can develop a healthy relationship to food and exercise that can help distinguish between discipline and obsessive behavior. Temperance allows us to avoid perfectionism and unhealthy obsessions focused on healthy eating. Temperance also helps us to maintain equanimity in the face of impediments to our health and fitness goals, such as failures, injuries, and sickness. While wisdom allows us to see the relative value of things, temperance helps to prevent us from going to extremes with how we engage with them. Significantly, this can extend beyond our individual judgments and choices and help inform our behavior toward others. For example, there are cases where parents have imposed extreme diets or exercise routines on children that have led to negative health outcomes, injury, or even death (Fox, 2022; NBC, 2024). In applying temperance as a guide, we need to consider how moderation is also important to our interactions with others (particularly those under our guardianship or care), which will be elaborated in the next section.

Justice: In its broadest sense, justice means acting in accordance with Nature (including our rational and social natures), which involves contributing to the well-being of all and treating all rational beings with fairness and respect. In the context of health and fitness, justice means pursuing our own health and fitness goals rationally, while recognizing our duty toward others in promoting their well-being and cultivating a healthier world. We have a responsibility to others regarding health and fitness. Our health choices impact those around us, most immediately our family and close friends. Depending on our roles, we may be placed in positions where we are called upon to care for others (e.g., as parents or guardians of children or disabled adults) and the ability to do this is highly influenced by our health. A sick person is less able to care for others and could even become a burden themselves depending on the severity of their illness/disability. In this sense, the decision to choose or not choose healthy behaviors doesn’t only impact the individual but also those around them. Extending this beyond the family, individual choices about health and fitness can have ripple effects throughout the larger community. For example, in America alone, the annual economic cost of obesity is estimated to exceed $1.4 trillion per year (Bendix & Lopez, 2020). This massive financial burden is shared between individuals, families, businesses, and society. In the interests of justice, these factors need to be considered when making choices regarding our own health and fitness as they have these wide-ranging effects on others. While the outcomes of our choices are not within our moral sphere, because they are not up to us, our consideration of such implications in making our individual choices is. This is a subtle, but important distinction.  

Our choices regarding health also have global impacts that could/should be considered. For example, this could mean considering the environmental impact of the food we buy and potential impacts on global communities. For example, the South American “superfood” quinoa has become increasingly popular globally for its numerous health properties. This popularity, however, has given rise to concerns about environmental impact surrounding its growth and the potential effects of rising prices on the communities that traditionally depend on this grain (Miller, 2020). Relatedly, we might consider the broader issues of global health disparities. For example, while a person in an affluent country can grapple with the ethical implications of buying exotic superfoods, over 30% of the global population is living with food insecurity (United Nations [UN], 2023)—meaning they can’t access the basic nutrition needed for maintaining a healthy life. Essentially, in our pursuit of health, we need to ensure that it does not come at the expense of the environment or other people.  

In addition to our obligation to avoid harming others (even if indirectly), we also have positive responsibilities. For example, in roles as mentors, parents, or guardians, we have an obligation to set positive examples for the rational pursuit of health. We can also take various actions that may contribute to a healthier society. This could take the form of advocating for public health initiatives (e.g., food programs in schools), supporting ethical agriculture (e.g., buying local seasonal foods), and promoting accessible fitness (e.g., funding for community centers). We can also consider the broader impacts of promoting healthy lifestyles through our interactions with other people or by combating misinformation about health on social media. 

Justice has particular significance to those in positions of influence regarding health and fitness: such as healthcare providers, educators, and fitness professionals. In these positions individuals need to apply justice in the practice of their professions. Professionals need to prioritize patient/client well-being, e.g., by only suggesting necessary services. They need to remain up-to-date on current best practices in their fields and avoid giving outdated or harmful advice. They need to follow the particular ethical and legal guidelines laid down in their professions: e.g., keeping to their defined scopes of practice and avoiding giving unqualified advice. In essence, justice means being mindful about the interconnected nature of the world and how our individual choices can contribute to it (positively and negatively), as well as being attentive to our personal and/or professional duties to others in helping them to live healthy lives.   

It is hoped that this essay provides readers with material for considering a Stoic perspective in their own fitness and health; to appreciate the need to focus on internal control, ethical responsibilities, and the importance of virtue in relation to health and fitness. Adopting a Stoic framework for health and fitness can contribute to the well-being of individuals and society at large. It can protect the individual from falling into errors of judgment regarding the value of health and fitness (e.g., as “goods” instead of “preferred indifferents”), allowing these things to be approached rationally and virtuously. It can also help individuals to see how their choices and actions are not isolated but are interconnected with the world at large. This key appreciation can reinforce the urgency of individual actions and provide an impetus to attempt making positive contributions to the well-being of others.