Editor’s Note: This story is part of a topical series covering disordered eating and dieting culture.
Accepting your body as it is and doing all the dieting may sound great, but will doing so hurt your health?
Advertising, pop culture, and even doctors can talk about health and weight as if they are one and the same: small bodies are healthy, and large bodies must be unhealthy.
But neither health nor body is so simple and equal, and health may vary from person to person. Janet Thompson-WessenA nutritionist in the United Kingdom whose approach does not focus on weight loss.
A high body mass index (BMI) is linked to conditions such as diabetes and heart disease, said Philip Scherer, professor of internal medicine and director of the Touchstone Diabetes Center at the University of Texas Southwestern Medical Center. Although, BMI is a controversial way to measure healthAnd it is one of many factors associated with change in a person’s well-being, said Dr. Asher Larmy, a UK general practitioner and activist.
Medical care, environment, social conditions and biology are the most factors that determine our health. Office of Disease Prevention and Health Promotion Healthy People,
Still, we often place great importance on a person’s appearance when assessing their health, said Shana Meaney Spence, a registered dietitian in New York. And even if we learn to let go of the burden of societal beauty standards, it can be hard to feel confident in your body if you consider your shape to be unhealthy.
Experts say it may be time to sort out health and weight and focus more on our health-promoting behaviors than the number on the scale.
It’s important to understand that studies that point to dire health consequences for people with high body fat may only point to correlation, not causation, Larmy said.
While studies can say that people who are overweight often have more instances of heart disease, they can’t say that the weight caused heart problems, Laramie said.
But the importance of those studies should not be discounted, Shire said. Correlations are strong, and “from a physiology standpoint, in the clinic we work with correlations,” he said.
Other factors may still be at play, though, like access to medical care, Shire said.
And for those with larger bodies, good medical care can be hard to come by, said Brie Campos, a body image coach based in Paramus, New Jersey.
It’s not just her clients who are afraid to go to the doctor. Even though she educates people about their body image and mental health, Campos is often afraid to go to the doctor for fear that she will be embarrassed about her weight, she said.
“I could go for strep throat, I could go for a rash,” Campos said.
“Because of my body size, it’s very unlikely that I can go to the doctor and get a real diagnosis that ‘you should probably lose weight.'”
Spence likes to remind her clients: Bodies are not business cards.
We can’t just take a look at a person’s body and get a sense of their health, their habits or their biology, she said.
“Do we have access to someone’s medical records? Are we talking to their doctor?” he said. “And often health is honestly out of our control sometimes. There are so many chronic diseases that people just develop.”
Although we can see large-scale correlations between body size and health status, once researchers looked at individuals, it wasn’t clear, Sherer said.
“The field at large really acknowledges that not everyone who has a very high BMI has type 2 diabetes,” he said.
Small-bodied people can develop heart disease or diabetes, and many people with large bodies who are considered completely metabolically healthy, Scherer said.
“It’s just a reflection of our genetic diversity and how we cope with the extra calories,” he said.
What does it mean to be healthy anyway? And can dieting help you get there?
It depends on what parts of health you prioritize.
Health is comprised of many factors. Spence said avoiding illness is one, but maintaining mental health, having active social networks, getting enough sleep and reducing stress is one thing.
He adds that limiting your calories or cutting out certain foods may not be healthy overall if it negatively impacts your mental health or prevents you from enjoying time with friends and family. And sometimes these restrictions can make you lose weight without properly nourishing your body.
“Weight loss doesn’t equal happiness, and it doesn’t necessarily mean you’ll be healthy because losing weight can also be harmful to your health,” Spence said.
For most people, restrictive dieting with the intention of losing weight doesn’t work. More than 80% of people who lost weight regained it within five years, According to a 2018 study,
Campos said that if our phones didn’t work the way they were intended, most people wouldn’t be using them anymore.
“But the diet culture has done a great job of tricking us that you can have everything you ever wanted. You’ll get health, you’ll get fitness, you’ll get compliments,” she said.
What should we pay attention to if we want to be healthy if we are not losing weight? Focus on health-promoting behaviors like quitting smoking, moving more, sleeping better, less stress, and eating the foods that help your body, Laramie said.
You may lose weight as a result, but that’s not the goal, he said.
“Not focusing on the weight means we can actually focus on some healthy behaviors that are more sustainable,” Thompson-Wesson said.