The spiritual state of “naturalness” in Zhuangzi’s philosophy offers profound insights for modern health management. From a health management perspective, this paper argues that Zhuangzi’s “discourse on usefulness and uselessness” helps transcend narrow perceptions of health’s “usefulness,” guiding the establishment of a multidimensional, flexible health risk assessment system that aligns with the Health Belief Model. His philosophy of “equating all things” advocates respecting individual differences, laying the foundation for building an inclusive health promotion environment. The state of “carefree wandering” and cultivation practices like “mental fasting” and “forgetting oneself while sitting” align with self-determination theory and mindfulness training, empowering individuals to achieve self-directed health management. From cognitive and environmental dimensions to practical application, Zhuangzi’s philosophy contributes vital wisdom for enhancing holistic health.