Advertisements, pop culture, and even doctors can talk about health and weight as one and the same: small bodies are healthy, and large bodies should be unhealthy.
Still, we often focus on a person’s appearance when judging their health, says Shana Meaney Spence, a registered dietitian in New York. And even though we’ve learned to shed the burden of society’s beauty standards, you can feel insecure about your body if you see your size as unhealthy.
Experts say it may be time to address our health and weight issues and focus on the qualities that contribute to our health rather than the number on the scale.
Correlation with reason
It’s important to understand that studies that suggest worse health outcomes for people with high body fat may indicate correlation, not causation, Larmee said.
If studies show that people who are overweight are more likely to suffer from heart disease, it cannot be said that weight is the cause of heart problems, Larmee added.
But the importance of those studies shouldn’t be minimized, Scherer said. The relationships are strong, and “physiologically, we work with relationships in the clinic,” he said.
Other factors may still be at play, however, such as access to medical care, Siler Scherer said.
And for people with larger bodies, it can be difficult to get good treatment, says Brie Campos, a body image coach in Paramus, New Jersey.
Her clients aren’t the only ones who fear going to the doctor. Although she teaches people about their body image and mental health, Campos says she is often afraid to go to the doctor for fear of being shamed about her weight.
“I can go in for a stroke in the throat, I can go in for a rash,” Campos said.
“Because of my size, I’m not going to go to the doctor and get a proper diagnosis and say, ‘Maybe you need to lose weight.'”
Bodies are not business cards
Spence likes to remind her clients: Bodies are not business cards.
She says that we can’t tell about a person’s health, habits or biology by taking a single look at the body.
“Do we have access to someone’s medical records? Are we talking to their doctor?” She said. “And a lot of times health is really out of our control sometimes. There are a lot of chronic diseases that people still develop.”
Although we can see the link between body size and health status broadly, it’s not as clear when researchers look at individuals, Scherer said.
“The general field accepts that not everyone with a BMI that high is type 2 diabetic,” he said.
People in small bodies are more likely to develop heart disease or diabetes, and there are many people in large bodies who are considered completely metabolically healthy, Scherer said.
“It’s a reflection of our genetic makeup and how we deal with excess calories,” he added.
Does diet make us healthier?
What does it mean to be healthy anyway? And can diet help you get there?
This depends on which part of health you prioritize.
Health is made up of many things. Avoiding illness is one thing, but so is maintaining mental health, maintaining active social networks, getting enough sleep and reducing stress, Spain said.
If restricting your calories or cutting out certain foods negatively affects your mental health or prevents you from spending time with friends and family, you may not be healthy overall, she says. And sometimes these restrictions make you lose weight without actually feeding your body.
“Weight loss doesn’t equal happiness and it doesn’t mean you’ll be healthy because the way you go about losing weight can also affect your health,” Spain said.
If our phones didn’t work the way they were supposed to most of the time, most people wouldn’t use them anymore, Campos said.
“But the diet culture has done a great job of tricking us into thinking that you can get everything you want. You get health, you get exercise, you get compliments,” she added.
What do we focus on if we want to be healthy if we don’t lose weight? Focus on health-promoting behaviors like quitting smoking, getting more exercise, getting better sleep, reducing stress and eating the foods your body needs, says Larmey.
As a result, weight may be reduced, but this is not the goal, he added.
“By not focusing on the weight, that means we can actually focus on some healthy behaviors that are more sustainable,” Thompson-Wesson said.