Advertisements, popular culture, and even doctors can talk about health and weight as if they were the same thing: smaller sizes are healthier and larger sizes should be unhealthy.
Still, we often place a lot of emphasis on a person’s appearance when evaluating their health, said Shana Minei Spence, a registered dietitian in New York City. And even as we learn to shed the burden of societal beauty standards, trusting your body can be difficult if you view it as unhealthy.
Experts say it may be time to unravel health and weight and focus more on behaviors that support our health than the number on the scale.
Correlation versus causation
It’s important to understand that studies that point to dire health outcomes for people with higher body fat may only point to correlation, not causation, Larmie said.
Although studies say that people with a higher weight generally have more cases of heart disease, it can’t say that weight causes heart problems, Larmie added.
However, Scherer said the importance of these studies should not be underestimated. The correlations are strong, and “from a physiology standpoint, we work with correlations in the clinic,” he said.
Other factors, such as access to medical care, may still be at play, Scherer said.
Paramus, New Jersey-based body image coach Bri Campos said that getting good medical care for people of larger sizes can be difficult.
It’s not just clients that are afraid of going to the doctor. Despite educating people about their body image and mental health, Campos is often afraid to go to the doctor for fear he’ll be embarrassed about his weight, she said.
“I can go in for sore throat, I can go in for rash,” Campos said.
“Because of my body size, it’s very unlikely that I’ll go to the doctor and get an actual diagnosis that isn’t ‘you should probably lose weight’.”
Sizes are not business cards
Spence likes to remind clients: Sizes are not business cards.
We can’t just look at a person’s body once and get an idea of their health, habits or biology, he said.
“Do we have access to someone’s medical records? Are we talking to their doctor?” said. “And often health, to be honest, is sometimes out of our control. There are a lot of chronic diseases that people just develop.”
While we can see correlations between body size and health conditions on a large scale, it’s not so clear when researchers look at individuals, Scherer said.
“The whole field is truly embracing that not everyone with such a high BMI is a type 2 diabetic,” he said.
People in smaller bodies can develop heart disease or diabetes, and there are a lot of people in larger bodies who are considered completely metabolically healthy, Scherer said.
“It’s just a reflection of our genetic heterogeneity and how we deal with excess calories,” he added.
Does dieting make us healthier?
What does it mean to be healthy anyway? Can dieting help you get there?
It depends on which parts of health you prioritize.
Health consists of many factors. Avoiding illness is one, but so is maintaining mental health, maintaining active social networks, getting enough sleep, and reducing stress, Spence said.
Restricting your calories or cutting out certain foods may not be healthy overall if it negatively impacts your mental health or prevents you from spending time with friends and family, she added. And sometimes these restrictions can cause you to lose weight without properly nourishing your body.
“Weight loss doesn’t equal happiness, and that doesn’t necessarily mean you’ll be healthy, because your way of losing weight can also harm your health,” Spence said.
If our phones didn’t work as they should, most people wouldn’t use them anymore, Campos said.
“But diet culture has fooled us so well that you can get whatever you want. You’ll gain health, you’ll gain fitness, you’ll get praise,” he added.
If we want to be healthy if not losing weight, what do we focus on? Focus on health-promoting behaviors like quitting smoking, moving more, sleeping better, relieving less stress, and eating the foods your body tells you you need, says Larmie.
You may lose weight as a result, but that’s not the goal, they added.
“Not focusing on weight means we can really focus on some really healthy behaviors that are actually a lot more sustainable,” Thompson-Wessen said. Said.