By: Registered Dietitians of Nourished Routes
Diet culture, society’s perception of weight and fatness, and politics have shaped our idea of what health looks like for decades. However, our general understanding of what determines health is misguided at best and at worst, utterly incorrect. Fat phobia is still rampant in the United States and abroad, even with the surge of body positivity, respect, and love seen in recent months on social media. Under every Instagram post of Lizzo celebrating her body or influencer being candid about their struggles with body image is a smattering of comments about how being fat is unhealthy, and how weight gain should be avoided in the interest of preserving health. We’re going to address some of the most common myths regarding health and weight, and take a look at why body weight is NOT the indicator of health our society has been convinced to believe it is.
Myth #1: BMI is the gold standard for determining health.
Body mass index, or BMI, was developed during the twentieth century and was intended for use as a statistical exercise for insurance companies, not a medical device to be used for clinical evaluation. Since then, it has turned into a well-accepted determinant of health. The equation for determining BMI was created by a Belgian astronomer, using an exclusively white, European population, making the equation unsuitable for use with different ethnic groups who may have different body compositions. Body mass index is calculated based on an individual’s height and weight, and does not account for variations in body composition, which is shown to be a better indicator of one’s health status than weight alone. The information obtained from BMI also cannot be used to predict health outcomes, meaning as a culture we have learned to obsess over a number that does little to provide any useful information. Over the years, scientists and researchers have advocated for BMI to be discarded due to its ineffectiveness for measuring health and outdated science, but it continues to be used in doctors offices and hospitals around the country.
Myth #2: My doctor recommended I lose weight, and they must be right – they’re a doctor!
Other than the fact that most doctors receive less than the 25 minimum recommended hours of nutrition education during school, present-day attitudes about body size and weight are heavily influenced by cultural attitudes and politics of the past. Prior to the 1900s, physicians were not concerned with body weight – in fact, weight gain was considered a normal and healthy part of the aging process. Diet culture and fatphobia predate the notions that fat = unhealthy, and doctors of the early twentieth century were heavily influenced by the attitudes of the culture, as the number of patients coming for advice on how to lose weight continued to grow. Life and health insurance companies also influenced doctors, presenting dubious science regarding BMI and mortality risk – data based solely off of wealthy, white men. With a culture already entrenched in fatphobia and now monetary interest, it wasn’t hard for doctors to hop on board with the theory that higher weight caused poor health outcomes. Today, weight-based discrimination in many doctor’s offices is prevalent, with fat patients being prescribed weight-loss for disease and ailments that thinner people receive more comprehensive care for.
Myth #3: Fatter bodies are inherently less healthy, and have a higher risk of disease and mortality.
There is no evidence to support that body weight alone is a risk factor for disease or higher mortality. Lifestyle habits such as exercise and diet certainly play a role in our health – sedentary lifestyles and diets high in saturated fats, added sugars, sodium, and excess calories have a strong correlation with the development of type 2 diabetes, heart disease, hypertension, and more. However, there is no evidence to suggest that excess weight causes disease. Hypertension, heart disease, and coronary artery disease, for example, are all diseases that appear in thin people as well. In fact, research suggests that more body fat may even be protective in some diseases. For example, one study found that fit obese men have half the death rate of lean, unfit men. Other studies show that obese individuals with hypertension live significantly longer than thin people with the disease, and are at lower risk of experiencing a stroke, heart attack, or early death. An abundance of research concludes that improving lifestyle factors, such as increasing physical activity, giving up dieting and instead eating a more balanced diet, and quitting smoking have a much more profound effect on overall health than weight loss.
Myth #4: Anybody can lose weight, and those who don’t are just lazy.
There are a number of reasons why a given individual may live in a body of a larger size. These reasons range from hormonal imbalances, genetics, medication use, and more. Our weights are influenced more by our genes than by our habits. Numerous studies looking at pairs of twins have found that even when twins live different lifestyles and have different eating habits, there is little variation in their body sizes or weights. This may be explained by what is called our “setpoint” weight – a range of ten to twenty pounds that our bodies are genetically predisposed to settle in. This is the weight your body will maintain when you have a perfect balance of calories you eat and expend, and is the same range of weights your body will naturally want to get back to even after periods of dieting and weight loss. For some people, this may mean a thin body; for others, a large one. It is also worth noting that access to healthcare, weight stigma, stress, access to safe places to exercise, and availability of nutritious food to eat play a significant role in our health as well.
These are just a handful of the misconceptions and myths about health and body weight that prevail in our society, and the dieting industry relies on these myths being regarded as fact in order to continue preying on our fears of weight gain and illness. The truth of the matter is – fat is not the death sentence society says it is, nor is it a marker of moral superiority or health. Rather than encouraging weight loss, let’s shift our focus to encouraging health-promoting habits for everyone, and letting go of the expectation of losing weight to be happier or healthier. After all, there are far worse things to be than fat.
Nourished Routes is a local nutrition consulting company that helps their clients to implement a highly personalized whole foods approach so that they can enjoy food again and achieve a sense of empowerment and food freedom while feeling nourished and ultimately live their best lives. They help their clients feel confident in their food choices, feel less confused about nutrition, and feel energized, all without dieting! Subscribers of Nashville Fit receive a free session with one of their dietitians. You can schedule that here!
Sources:: Health at Every Size, Lindo Bacon | Anti-Diet, Christy Harrison