Greetings from LA! I decided to write a post about how there is no such thing as a “healthy weight”. Then I realized that I wrote one two years ago, so I’m updating and re-posting because I think it bears repeating:
There is no such thing as a “Healthy Weight”. People have a certain level of health (which can be judged through metabolic tests or physical fitness etc) and people have a weight (which can be judged in pounds, kilos, stone etc.). These are two separate measurements.
One easy example of this is the girl who ate a diet of almost exclusively chicken nuggets for most of her life, and then got very sick. News stories actually said that it was surprising because she was at a “healthy weight”, as if this incident wasn’t an indictment against the concept.
The idea of conflating weight and health has a lot to do with the use of Body Mass Index (BMI) (a simple ratio of weight and height) as a measure of health by insurance companies who wanted to save money by not having to perform actual tests. Helping them out were diet and pharmaceutical companies who found that if they could convince people that anyone over a certain BMI would have dire health consequences, it was easier to convince them to buy their stuff.
They got on committees within the CDC, and soon 3 people with ties to pharmaceutical companies that create diet drugs, in concert with the chief “scientist” at Weight Watchers, managed to convince the CDC to lower what was considered a healthy BMI and then recommend their products as a solution to the problem that they had just created. This process meant that about 25 million Americans became “overweight” overnight and we were off to the races. The next day newspapers ran the story “Millions of Americans Don’t Know They’re Overweight”, but failed to mention it was because those millions Americans had been a “healthy weight” less than 24 hours ago.
Now despite having good health by any measurement, many fat people (including me) can’t get health insurance. Healthy fat people who do have health insurance are often encouraged to undergo a risky major surgery with an extremely poor success rate at 20K a pop so that their bodies can be smaller, and the diet industry makes over 60 Billion dollars a year. Meanwhile plenty of sedentary thin people who eat a poor diet are constantly sold the idea that they are healthy simply because of the ratio of their weight and height.
And we are hearing from everyone and their dog that we need to get to a “healthy weight”. Often it’s suggested that we should do this by any means necessary, the implication being that it doesn’t matter what crazy unhealthy things we do to get thin, because once we get there we’ll be automatically healthy just because our bodies are smaller.
Except it doesn’t work that way. (Just ask someone who got thin from using heroin.) The best suggestion that doctors can give us if they are being honest and practicing evidence-based medicine is that healthy behaviors have the best chance of creating a healthy body. But even that’s not guaranteed. Most of us know someone who followed every health guideline and got sick. Most of us know someone who eats like crap, never exercises and is as healthy as a horse. At the extreme ends Marathon runners drop dead of heart attacks at 45 and sedentary Grandmas eat frozen dinners, smoke unfiltered cigarettes, and live to be 102, in the middle it’s an even grayer area. There are healthy and unhealthy people of every weight, shape, and size and the medically responsible thing would be to look at each person as an individual and recommend evidence based interventions specific to their health issues, instead of trying to stereotype people based on how they look and then try to find a way to blame them for their health conditions instead of treating them.
If doctors were honest with us, they would say that the human body is extremely complex and they haven’t yet scratched the surface of everything that is involved in being “healthy”. They would also ‘fess up that even if they could prove that weight loss makes you healthier (which they can’t) they don’t have a single proven method of weight loss. They would tell us that the caloric restriction method (aka “eat less and exercise more”) has an abhorrently poor success record. Were it a prescription, doctors would be forced to remove dieting from the shelves for its complete lack of efficacy and all of its safety concerns. But it’s not, so they just keep recommending the same thing, even though it just doesn’t work. More and more we are finding that physical fitness is a much better indicator of health than is weight.
There are so many things to be improved in this system, but let’s do one simple thing today: Let’s decide to eliminate the phrase “healthy weight”.
As always, this is your decision. If you’re in for this then I suggest that we start with ourselves – check our own assumptions about people’s health based on their size, including people who are very thin.
Then I suggest the following scripting as an example when this comes up:
Person who still buys into the healthy weight myth: “blah blah blah healthy weight blah blah blah”
Enlightened person (that’s us) “Actually, there is no such thing as a healthy weight, and I wish people would stop spreading that myth. There are people who are healthy and people who are unhealthy at every shape and size.”
Now, this can often lead to the VFHT: Vague Future Health Threat. This is when someone suggests that even if I, as a fat person, am healthy now (and it doesn’t seem to matter how old I happen to be) “it” will catch up to me “someday” cleverly using the fact that everyone will die, but insisting even if I die when a group of trained bald eagles drop a piano on my head, it will be because I was fat.
For now: No more saying “healthy weight”: Never ever, never ever, never ever.
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