Is weight loss an important health goal?

Advertisements, pop culture, and even doctors can talk about health and weight as if they were one: small bodies are healthier, and big bodies must be unhealthy.

A higher body mass index (BMI) is associated with conditions such as diabetes and heart disease, said Philipp Scherer, professor of internal medicine and director of the Touchstone Diabetes Center at the University of Texas Southwestern Medical Center. However, BMI is a controversial way to measure health, and it’s just one of many factors associated with changes in a person’s well-being, said Dr Asher Larmie, a GP and campaigner based United Kingdom.

Still, we often place a lot of weight on how someone looks when evaluating their health, says Shana Minei Spence, a registered dietitian in New York City. And even as we learn to shed the burden of societal beauty standards, it can be hard to be confident in your body if you view your height as unhealthy.

Experts say it might be time to untangle health and weight and focus more on the behaviors that promote our health than the number on the scale.

Correlation versus causation

It’s important to understand that studies that indicate dire health outcomes for people with higher body fat can only indicate correlation, not causation, Larmie said.

While studies can say people with higher weight often have more cases of heart disease, they can’t say the weight caused the heart problems, Larmie added.

But the importance of these studies should not be ignored, Scherer said. The correlations are strong and “from a physiological point of view, in the clinic, we work with correlations,” he said.

However, other factors could still be at play, such as access to medical care, Scherer said.

And for people with larger bodies, good medical care can be hard to come by, said Bri Campos, a body image coach based in Paramus, New Jersey.

It’s not just his clients who are afraid to go to the doctor. Although she educates people about their body image and mental health, Campos is often afraid to go to the doctor for fear of being ashamed of her weight, she said.

“I can get strep throat, I can get a rash,” Campos said.

“Because of my size, it’s very unlikely that I’ll be able to go to the doctor and get a real diagnosis that isn’t ‘you should probably lose weight’.”

Bodies are not calling cards

Spence likes to remind his clients: bodies are not business cards.

We can’t look at a person’s body and get a sense of their health, habits or biology, she said.

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“Do we have access to someone’s medical records? Are we talking to his doctor? she says. “And a lot of times, health is honestly sometimes out of our control. There are so many chronic diseases that people develop.”

Although we can see correlations between body size and health conditions on a large scale, once researchers look at individuals, it’s not so clear, Scherer said.

“The field as a whole really understands that not everyone with a very high BMI is type 2 diabetic,” he said.

People in smaller bodies can develop heart disease or diabetes, and there are plenty of people in larger bodies who are considered completely metabolically healthy, Scherer said.

“It’s just a reflection of our genetic heterogeneity and how we deal with excess calories,” he added.

Does dieting make us healthier?

What does it mean to be healthy anyway? And can a diet help you get there?

It depends on what aspects of health you prioritize.

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Health is made up of many factors. Avoiding illness is one, but so is maintaining mental health, maintaining active social networks, getting enough sleep and reducing stress, Spence said.

Restricting your calories or cutting out certain foods may not be healthy overall if it negatively impacts your mental health or keeps you from spending time with friends and family, she added. And sometimes these restrictions can cause you to lose weight without properly nourishing your body.

“Weight loss doesn’t equate to happiness, and it doesn’t necessarily mean you’ll be healthy, because how you go about losing weight can also affect your health,” Spence said.

For most people, restrictive diets with the intention of losing weight don’t work. More than 80% of people who lose weight gain it back within five years. according to a 2018 study.

If our phones weren’t working as often as expected, most people wouldn’t use them, Campos said.

“But diet culture has done a really good job of fooling us that you can get everything you ever wanted. You’ll get health, you’ll get fitness, you’ll get praise,” he said. she adds.

What do we focus on if we want to be healthy if it’s not about losing weight? Focus on health-promoting behaviors like quitting smoking, moving more, sleeping better, stressing less, and eating the foods your body tells you you need, Larmie said.

You can lose weight as a result, but that’s not the point, they added.

“By not focusing on weight, it means we can really focus on really healthy behaviors that are much more sustainable,” Thompson-Wessen said.

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