TLDR: Modern fitness operates as a "fitness-medical complex" that exerts biopower by transforming the gym into a digital panopticon. Through constant surveillance via mirrors and wearable trackers, we internalize an "expert gaze" that forces us to prioritize external data over internal sensations, effectively becoming our own prison guards. This system relies on a weight-centric paradigm that is currently in a state of scientific crisis, evidenced by the limitations of BMI and the high failure rate of intentional weight loss. To combat this, we must engage in an "epistemic rebellion" by embracing extitutional science—where the lived experiences of marginalized groups, such as neurodivergent and higher-weight individuals, are treated as authoritative knowledge. True health liberation requires a shift toward epistemic justice, where coaches practice humility and recognize that a client's "embodied knowledge" is just as valid as clinical evidence. By deconstructing biological myths and centering the individual as the lead researcher of their own life, we move from a model of disciplined conformity toward one of autonomy, sensory regulation, and joy.

Have you ever felt like your fitness tracker is a boss you didn't hire? In the modern world, "getting fit" is rarely just about health. It is a political act. We are often taught that the gym is a neutral space of self-improvement, but a closer look reveals a sophisticated "fitness-medical complex" that uses knowledge to exert biopower over our bodies. To truly reclaim our health, we must engage in what can be called "epistemic rebellion."

When you hear other creators and coaches talking about how “fitness is political”, they tend to emphasize the social determinants of health, which show that health and fitness are not solely the result of individual choices or “willpower”; they are deeply shaped by the conditions in which people are born, grow, live, and work. They include factors such as economics, education, neighborhood environment, and social support that create a “tapestry” of well-being, often acting as barriers or facilitators to fitness.

While social determinants focus on how the world affects our access to fitness, we’re going to look at how the rules of fitness often ignore the person actually doing the workout. We will also explore how the “facts” we're told about fitness actually shape how we feel about ourselves—often making us feel “broken” when we’re just different. This post will focus on the gym environment as a panopticon that produces “docile bodies”–bodies that keep buying new supplements and trackers because they are never “good enough”. It will then focus on the cracks in the weight-centric biomedical model. Afterwards, I will discuss the rise of “extitutional” science led by lay experts, deconstruct biological essentialism in performance, and reimagine coaching via the liberating lens of epistemic justice. The ultimate goal is to restore the individual’s ability to generate well-being by redistributing power and autonomy back to the client by prioritizing the three pillars of evidence-based fitness.

The Gym as a Panopticon

According to the philosopher Michel Foucault, modern institutions manage people through biopower—a way of regulating populations by disciplining individual bodies. Today, this happens through "anatomo-politics," where an individual body is treated like a machine to be optimized for the sake of productivity and conformity.

A primary mechanism for this discipline is the panopticon, a concept taken from a prison design where prisoners are placed in cells surrounding a central guard tower. Because the prisoners can never know exactly when they are being watched, they eventually begin to police their own behavior. 

Gyms, mirrors, and wearable trackers create a "digital panopticon" where we are always under surveillance—mostly by ourselves. For example, we aren’t looking in the mirror to see if we’re moving well; we’re looking to see if we “look right.” We internalize the expert's gaze and become docile bodies, habituated to constant self-correction and moral judgment based on our data. In other words, we have moved from 'feeling good' to 'measuring good.' This is the 'digital panopticon'—where your watch, your scale, and your reflection tell you who you are before you’ve even had a chance to feel it yourself.

Central to this is Foucault’s power-knowledge, which asserts that knowledge and power are co-constitutive. There is no power relation without knowledge, and there is no knowledge without power. Power here is a productive force; it creates a regime of truth by defining "normal" versus "deviant" bodies. When institutions set "ideal" BMI or heart rate standards, they are not just discovering facts—they are constructing the very metrics by which we are categorized and regulated.

The rise of digital health is presented as a shift toward self-control and self-care. Trackers are marketed as tools for personal agency, yet they facilitate a process of disembodiment, where we view ourselves "from the outside in" as data objects. In this system, we voluntarily sustain our own subjection, transforming our biological functions into quantified evidence of "good citizenship".

The Takeaway: When we track every calorie and step, we stop listening to our bodies and start acting like our own prison guards.

A Paradigm Shift in Fitness and Nutrition

In the context of health and fitness, Thomas Kuhn’s The Structure of Scientific Revolutions provides a framework for understanding how the "weight-centric paradigm" is transitioning from a state of established "normal science" into a full-scale model crisis. According to Kuhn, a paradigm shift occurs not through steady progress, but when a dominant model becomes too apparently flawed to ignore its internal contradictions.

This shift moves clinical practice toward a more weight-neutral paradigm, often championed by the Health At Every Size (HAES) movement. This alternative model focuses on:

• Holistic Wellness: Tracking metabolic markers like blood pressure and lipids instead of scale weight.
• Joyful Movement: Decoupling physical activity from the goal of weight loss and focusing instead on sensory regulation, function, joy, and well-being.
• Individual Expertise: Treating the client as an "authoritative source of knowledge" regarding their own body rather than a data point to be corrected.

In this framework, the weight-centric model is currently failing to account for several critical anomalies:

• The "Obesity Paradox": Numerous studies in patients with prevalent conditions like heart failure or coronary heart disease have shown that individuals in the "overweight" or "obese" BMI categories sometimes have better survival rates and lower mortality than those in the "normal" range. This paradox suggests that metabolic reserves and higher lean body mass in larger bodies may offer protective effects that the current paradigm cannot explain. However, more recent research casts doubt on the idea of being overweight providing a protective effect for certain conditions like heart failure (often due to the limitations of BMI). Still, the research does challenge the usefulness of weight-centric metrics like BMI, as will soon be seen.
• The Failure of Intentional Weight Loss: Research, notably by Traci Mann and others, indicates that deliberate weight loss through dieting is unsustainable for the vast majority of people, with most (33-66%) regaining the weight within a few years. More recent research supports these findings. For instance, a recent meta-analysis and review found that people quickly regain the weight they lost when they stop taking weight management medications. This constitutes a "model drift" where the primary intervention of the paradigm—weight reduction—consistently fails to produce its intended long-term health outcome.
• The Flaws of the BMI Metric: The Body Mass Index (BMI) is increasingly viewed as an imperfect clinical measure because it fails to distinguish between lean mass and fat mass, ignores fat distribution (such as visceral fat), and is derived from the original "Quetelet Index" which was developed in the 1830s using data from Western European men and was never intended to measure individual health. Research shows BMI underestimates certain health risks for Asian populations. For example, the risk of Type 2 diabetes begins at a BMI of 23 for many Asian groups, compared to the "standard" 25 or 30.

A landmark sign of this crisis occurred in June 2023, when the American Medical Association (AMA) adopted a new policy officially moving away from using BMI as a standalone health measure. The AMA acknowledged the "significant limitations" of the metric and its history of "racist exclusion".

While some experts note that "paradigm changes take more than a single statement," the growing body of evidence for the obesity paradox and the failure of traditional weight-loss models indicates that the scientific community is entering a period of "crisis" where the old rules of the weight-centric paradigm are being discarded in favor of more inclusive, health-centric models.

The takeaway: The traditional weight-centric health model is hitting a breaking point because it fails to account for biological diversity and the high failure rate of intentional weight loss. By moving toward a weight-neutral paradigm, we shift the focus from a flawed metric (BMI) to holistic well-being and the individual’s own lived experience.

The Rise of "Extitutional" Science

The concept of extitutional science represents a radical shift in how knowledge is produced, particularly in fields where institutional science has failed to address the needs or lived realities of specific communities. Unlike traditional "participatory science," where laypeople are invited to assist professionals, extitutional science is a bottom-up movement where lay experts detect and correct errors in institutional methodology through their collective experience. Stated differently, institutional science looks at averages; extitutional science looks at you. If 100 people lose weight on a diet but you feel exhausted and miserable, your "data" is just as valid as theirs. You are the lead researcher in the study of your own life.

Steven Epstein’s seminal work, Impure Science, documented how 1980s AIDS activists (such as ACT UP) transformed themselves from "outsiders" into "insiders" within the scientific community. They engaged in "credibility struggles," mastering technical jargon and clinical trial design to challenge researchers' attention to detail and accuracy. For example, activists argued that trial participants should not be forced to stop all concurrent medications for opportunistic infections, as this "pure" trial design ignored the material reality that it was the opportunistic infections—not just the virus itself—that were killing patients. This interference was both an ethical and an epistemic (relating to knowledge) necessity, ultimately forcing the NIH to democratize its research practices. In other words, this is the third pillar of evidence-based practice in action. Just as activists forced researchers to look at the whole patient, “rebellious” fitness requires coaches to look at the whole client. Your lived experience is considered a valid data point.

Today, we see similar extitutional science. This is evident in:

• Fat Activism: Challenging the medical pathologization of fatness and creating spaces for "joyful movement".
• Neurodivergent Fitness: Moving away from neurotypical "discipline" and focusing on nervous system regulation and executive function support.
• Patient-Led Research: Groups like the Patient-Led Research Collaborative for Long COVID, which are defining the symptoms that institutional medicine ignored.

What operates at the heart of this is standpoint theory, which offers a critical lens for understanding health and fitness by asserting that knowledge is “situated”–meaning what we know is shaped by our social location. However, a nuanced understanding requires distinguishing between simply inhabiting a social location and achieving a standpoint. While a social location (such as being higher-weight or a neurodivergent person) is occupied automatically, a standpoint is an "achievement" reached through political and intellectual struggle against dominant ideologies that distort reality. This framework suggests that marginalized individuals possess a unique “epistemic advantage” because they interact with systems (like the fitness-medical complex) in ways that members of dominant groups do not, allowing them to detect errors or omissions in “normal science”.

In clinical practice and coaching, applying standpoint theory transforms the traditional definition of evidence-based practice. Rather than over-emphasizing what research suggests, a nuanced application integrates three pillars: (1) scientific evidence, (2) professional experience, and (3) the individual client’s values and embodied knowledge. This requires epistemic humility from the coach–a willingness to acknowledge that their technical expertise may be “underdetermined” or even misleading when applied to “atypical” patients or clients. For example, when a coach recognizes a client as an authoritative knower of their own sensory load or metabolic responses, they move away from the role of a technician providing "corrections" and toward a model of collaboration. This "epistemic justice" model explicitly removes the coach’s standing as being the only expert in the room. Rather than having the coach holding the clipboard and the “truth”, we want to put that power back in the client's hands.

The takeaway: Extitutional science empowers "outsiders"—like neurodivergent or higher-weight individuals—to move from being passive subjects of study to active experts who correct the flaws in mainstream fitness and medicine. By valuing "embodied knowledge" as a vital part of science, coaching transforms from a top-down lecture into a collaborative partnership where the client's lived experience is treated with authority.

Deconstructing Biological Myths

Biology isn't destiny. Researcher Anne Fausto-Sterling argues that the rigid binary of athletic performance is often more about culture than cells. Through Dynamic Systems Theory, she shows how cultural difference becomes bodily difference; sex and gender are social constructs that "impinge" on the body, having direct physiological effects. In other words, sex is often held up (and socially regulated) as a binary when the reality is that it is best modeled as a spectrum represented by a bimodal–as opposed to binary–distribution of traits (imagine two overlapping hills rather than two separate islands).

Fausto-Sterling’s research found very few significant biological differences between infant boys and girls in brain size, physical strength, or early physical activity. Instead, she identifies "subtle trainings" that begin as early as 3–9 months, such as caregivers stressing the musculature of male infants while holding female infants differently or communicating more verbally with them. These repeated interactions shape neural networks and muscular responses, creating "softly-assembled" (appears stable; but is actually the result of many components working together in a specific context) sex differences that are later mislabeled as innate biological facts.

This "hard essentialism" is policed through institutional biopower, most notably in the case of Caster Semenya. When her performance was deemed "too exceptional" for a "normal woman," she was subjected to invasive gender verification where her body was rendered "disordered" to protect the deterministic binary of sport.

Similarly, the Q-angle (the pelvic-tibia angle) is frequently cited as a biological reason for higher ACL injury rates in women. However, critique reveals that these comparisons often fail to account for gendered inequities in the training environment—such as unequal access to professional-grade rehab, differing training-to-match ratios, and a historical lack of explosive power training for girls.

The takeaway: Physical differences in performance that we assume are purely "innate" are often "softly-assembled" by years of gendered social training and unequal access to resources. Rather than a rigid biological binary, human traits exist on a bimodal spectrum, meaning that institutional "rules" often pathologize natural variations to maintain a social status quo.

Reimagining Coaching through Epistemic Justice

Reimagining the coach-client relationship requires the integration of epistemic justice–fairness in the production, sharing, and validation of knowledge, ensuring that marginalized voices are not unfairly dismissed or silenced in social, academic, or legal contexts. For our purposes, it is the explicit acknowledgment that the client is an authoritative source of knowledge regarding their own body. This framework challenges the traditional hierarchy where the coach is the sole possessor of truth, and the client is a "docile body" to be corrected.

Epistemic injustice (a term first coined by Miranda Fricker) occurs when someone is wronged specifically in their capacity as a "knower". In a fitness context, this manifests in two primary ways:   

• Testimonial Injustice: This happens when prejudice causes a coach to assign a deflated level of credibility to a client's word. For example, a coach might dismiss a higher-weight client’s report of pain or fatigue as "laziness" or "lack of willpower" due to anti-fat bias.   
• Hermeneutical Injustice: This occurs when a gap in language and understanding prevents a client from making sense of their experience. Concrete examples include having a feeling that your doctor doesn’t have a name for yet. Take postpartum depression as an example. Fricker explains that before it was a recognized medical and social concept, many new mothers experienced profound sadness, exhaustion, or resentment after giving birth that often went uncommunicated and (especially) untreated. It was merely understood as “baby blues” or personal instability, and thus, the systematic hormonal and psychological realities of the condition were left unknown for a long time. Another example would be a neurodivergent client experiencing sensory overwhelm in a gym, but because traditional fitness lacks the language to validate "sensory load," the experience remains illegible, and the client is simply labeled "non-compliant".

Remember, true evidence-based practice is a triad that integrates: (1) scientific evidence, (2) professional experience, and (3) the individual client’s values and embodied knowledge. Rebellious (ethical) coaching elevates the third pillar, recognizing that for "atypical" clients, clinical averages often fail to predict individual outcomes. 

To achieve this, the coach must practice epistemic humility—an attitude that acknowledges the possibility of being wrong and values the epistemic perspectives of marginalized individuals. This requires the coach to suspend their inherent interactional advantage. Instead of acting as a technician who "knows better," the coach becomes an ally in a collaborative process of shared decision-making, where the client's internal cues are treated as data points of equal weight to biometric tracking.

The takeaway: Ethical coaching replaces the old hierarchy of "expert vs. student" with epistemic justice, where the client’s internal cues are treated as data points just as valid as a heart rate monitor. By practicing epistemic humility, a coach stops "correcting" the client and starts collaborating with them, ensuring that the client’s lived experience is never dismissed due to bias or a lack of institutional language.

Final Thoughts: The Body as a Site of Liberation

Reclaiming your body from the fitness-medical complex is an act of epistemic rebellion. It requires us to look past the "regimes of truth" that reduce human health to a BMI score, a number on a scale, or a line graph on a wearable tracker. When we acknowledge that the gym has functioned as a panopticon—a space of constant self-surveillance and correction—we can finally begin to dismantle the "docile body" and replace it with an embodied self.

The transition from a weight-centric paradigm to one of epistemic justice is not just a theoretical shift; it is a practical necessity for collective well-being. By embracing "extitutional" knowledge and honoring the lived experiences of marginalized bodies, we bridge the gap between clinical data and human reality. We move away from a world where "health" is a performance of conformity and toward a future where fitness serves the individual’s autonomy, sensory needs, and joy.

Ultimately, the goal of this rebellion is to restore the right to be the primary expert on oneself. Whether you are deconstructing biological myths or advocating for neurodivergent-friendly spaces, you are participating in a redistribution of power. Fitness, when stripped of its disciplinary baggage, becomes what it was always meant to be: a tool for liberation, a celebration of function, and a testament to the resilient, situated knowledge of the human body.