Is health promotion always healthy?

I have been thinking more about the notion and practice of 'health promotion'(HP). When thinking about health promotion do we need to be mindful that the 'good' in HP sits within a spectrum (all  be it a wide spectrum) and there are limits beyond which HP becomes a risk to health? I was discussing HP with students yesterday and one of  talked about a recent clinical event which caused me to ponder this idea of limits. Within the last month two teenagers had presented to the student's (Mental Health) unit - both suicidal and both citing the extreme demands of maintaining a healthy lifestyle and body. I know that this is a much more complex issue than the inference I am alluding to but i think that it relevant. How difficult (and sometimes for some people read stressful) is it to find time to fit in a visit to the gym 5 days a week for 30-60 minutes or to fit in walking 10,000 steps, or even to try and measure 10,000 steps? What impact does it have if you can't afford or source five vegetables a day and two fruit? Is it a paradox to undertake major and potentially high risk surgery as a  health promotion activity? Recently a study revealed that loneliness is one of the greatest risks to health - are the social implications of the non acceptability of smoking  implicated? I wonder if  Talcott Parson's rights and responsibilities of the sick role underpin some of our societal beliefs about HP and by this I mean; to have the right to be a member of society do people have a responsibility to seek and pursue HP activities? In other words, are smokers, drinkers and couch potatoes deviants?
I am being devil's advocate here and, of course am cognisant of the the evidence and various strengths of evidence linking environment, lifestyle and disease and death but I think that we must remain open to question and critique blanket assumptions that can glaze over the complex detail.

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