The narrative around weight and health is complicated. When wellness bloggers share detoxifying diet tips, or public health experts caution against the dangers of obesity, it’s hard not to equate healthy with thin. At the same time, a growing body-positive movement is preaching size acceptance, and plenty of doctors, scientists and nutritionists are telling us that BMI — body mass index — is a meaningless measure of health.
In a culture where strong is the new skinny, skinny-fat is bad and fat can still be fit, the meaning of a “healthy weight” might not always be clear. We asked five experts what patients should know about the number on the scale, and what it says or doesn’t say about their overall health.
Linda Bacon, PhD
Professor, researcher and author of Health at Every Size: The Surprising Truth About Your Weight and Body Respect
California
Your weight tells you, well, your weight. That’s about it. It doesn’t tell you anything about your health.
Everyone, regardless of what they weigh, can benefit from taking good care of themselves. When you stop conflating weight with health, you can find much more effective ways to pursue good health. What makes you feel better in your everyday life? Do you feel better when you eat more fruits and vegetables, drink more water, take a walk with a friend, meditate or get enough sleep? The scientific data is clear: Those behaviors enhance your health and well-being, regardless of whether they change your weight.
To be clear, I am not suggesting that people are healthy at any size; instead, I am suggesting that people at any size can be empowered to focus on improving their health by adopting behaviors that are not focused on weight.
Fat isn’t the real problem. A society that rejects anyone whose weight doesn’t conform to arbitrary standards is the problem. A medical establishment that equates “thin” with “healthy” is the problem. The best way to win the war against fat is to give up the fight.
Rachel Brandeis, RDN, MS
Dietician nutritionist
Atlanta
I absolutely believe that weight is one indicator of someone’s health, but cannot be looked at singularly. Weight combined with waist size is clinically significant. If you are overweight by the BMI range and your waist is outside the normative set points, you are clinically at risk for certain diseases and it should be addressed. You also have to factor in family history as well into all of this.
A “healthy” BMI range is anywhere between 18 to 24. You don’t have to strive to be at the low end, but it’s important to know where you fit into the range. However, this range actually does not apply to everyone, especially those that have lots of muscle mass, since muscle weighs more than fat and the standard BMI equation does not account for lean mass in excess of fat mass. If you are an athlete, someone who lifts heavy weights or who in general carries proportionally more lean mass to fat mass, this range is not for you. A better measurement would be waist circumference. A healthy waist size for women is less than 35 inches, and for men less than 40 inches.
With my clients, I tend to focus not on the scale or waist size, but on overall health. Most people know if they are overweight, but the bigger question is “How do I know what weight should I be?” I believe that there is a natural “set” weight that your body can maintain comfortably and a general clothing size that is easily maintained as well. Using clothes as your guide eliminates the scale and allows you to feel good in your own skin.
Overall, it really depends on what works for you as an individual. Nutrition and health are definitely not one size fits all; it’s very individualized. So how do you know if you are a healthy weight? If you want to assess: BMI, body fat percentage, waist circumference or clothes size. They all work, but you need to find the one that works best for you.
Vandana Sheth, RDN, CDE, FAND
Spokesperson for the Academy of Nutrition and Dietetics and author of My Indian Table — Quick & Tasty Vegetarian Recipes
Torrance, California
Health is so much more than a number on a scale. Incorporating a healthy lifestyle and being happy are two important factors contributing to your health, and I love helping clients build a healthy relationship with food. A few ways you can potentially identify that you are at a healthy weight without stepping on a scale include:
- If your resting heart rate is between 60 to 100 beats per minute.
- If your waist circumference is under 40 inches for a man; under 35 inches for a woman.
- [If you have excess] abdominal fat, which can be a risk factor for heart disease, diabetes and other health issues.
Dr. Caroline Apovian, MD
Physician, professor of diabetes and endocrinology at Boston University School of Medicine
Boston
Calculate your BMI first. If your BMI is 25 to 30, you are overweight; 30 and over, you’re obese. However, this breaks down if you are an athlete. Usually you know if you are an athlete or not.
If you are a healthy eater and exercise, you are still not OK if your BMI is over 25.
Body composition is a better way to measure; the iDXA scan measures percent body fat. People with a BMI between 25 and 30 should make sure other parameters are okay, like triglyceride blood pressure and waist circumference. If you have metabolic syndrome in addition to a BMI over 25 to 30, that’s a major risk factor for cardiovascular disease, type 2 diabetes and many other comorbidities, like hypertension and sleep apnea. You need treatment. Treatment can be medications or surgery for patients who have BMIs over 40 or, with a comorbidity, over 35.
Emma Nacewicz, CNC
Nutrition consultant and health coach
Long Island, New York
By definition, health is the state of being free from illness and injury, and I find that definition to be somewhat true when it comes to your weight. If you can perform normal activities of daily living and are free from illness, then it’s possible you are at a healthy weight. There is another side to this, though, because there is a big difference between what you weigh and how much excess “fat” you have.
Your weight is a total of everything in your body, such as water, blood, organs, bones, muscles, etc. Most people strive for a specific number on the scale and apply their worth to that number. Meanwhile, they should be focused more on their overall health and eating behaviors. If you are free from illness, can easily walk up the stairs at work, run in the backyard with your kids or crush your favorite workout class, then I say your weight is just fine and to continue living life without the worry of what the scale says.
Focusing on your health rather than your weight isn’t a new concept, but it has been gaining popularity in the health and wellness world due to its long-term success. The main objectives in focusing on your health is to consume a diet high in fruits and vegetables, eat food that makes your body feel good — and make your soul feel good (without any food-guilt) — move and exercise your body in ways that you find pleasant and enjoyable, tune in to your inner hunger and fullness cues, and focus on positive behavior changes, whether they’re physical, mental or emotional. Applying these health-promoting practices will help your overall physical and mental well-being. And isn’t that what we’re all striving for?
Responses have been condensed and lightly edited.