One of my close friends (who is diving into Intuitive Eating) recently asked me, if dieting doesn’t work, and the goal isn’t weight loss, how do we measure health?
That’s an excellent question. The answer depends on the person. First, I’m getting personal and sharing how I’m a real life example of why those aren’t the best measures. Then, I’ll share some ideas on what you can do instead.
In anticipation of this blog, I decided to check where I’m at on the BMI now (it’s been awhile since I looked). Since I no longer weigh myself, I had to dig the scale out of the garage. I’m writing this post Christmas and have definitely enjoyed more treats than I typically do so my weight was about 5 pounds more than last time I checked. But don’t worry- I don’t associate my value with my weight so I was totally ok with the number on the scale. I know you can’t see me but I’m a fairly medium sized person. I do have wide, strong shoulders, big thighs, and I’m solid. For frame of reference- I’m typically a ten (or a large) in clothing sizes. My current BMI is 29.19. That puts me on the very upper edge of the “overweight” category on the BMI index. If my BMI was 30, I would be in the obese category.
Studies show that millions of people are mis-categorized as unhealthy simply because they fit into the overweight or obese category on the BMI, and millions of smaller bodied people are mis-categorized as healthy simply because they have a lower BMI. Check out this article, from Medical News Today, on how studies are showing BMI to be ineffective.
I am one of the people who would be miscatagorized as unhealthy simply because I have a higher BMI. Let’s look at additional, traditional measures of health. My blood sugar is awesome, my blood pressure is typically 100/60 (on the low end of normal), my cholesterol is low but my good cholesterol is also low so it’s fine but not ideal- however this is related to genetics (not weight related for me). I eat a ton of veggies (I actually eat kale everyday because I love it) and move my body everyday. My health is good. I do have an autoimmune condition that causes me pain, but again, this is not weight related.
You might still be asking- what’s the problem with focusing on BMI or my weight?
Studies show when health care providers focus on weight and BMI, we create stigma. This causes people to not access health care when they would benefit from it. Smaller bodied people who may not be affected by weight stigma, can be harmed as well, as their health issues may be overlooked if the condition is typically associated with weight such as sleep apnea or diabetes. Another potential harm; focusing on weight causes health care providers to miss opportunities to offer weight-neutral health focused interventions for people across the size spectrum.
For example, if I went to a new doctor who weighed me and checked my BMI (you can refuse to be weighed at the doctor by the way*) and they looked at my cholesterol- they may suggest I lose weight to improve my cholesterol rather than suggesting I take fish oil, increase my fiber intake and exercise (all of which are shown to improve cholesterol and have other awesome health benefits). See how that would be missed opportunity to help me improve my health?
The other major impact of telling a patient to lose weight to manage health is the perpetuation of diet culture, the shame/binge cycle and long term effect of weight gain with dieting. If you want to learn more about why diets don’t work and are harmful- check out my past blogs here. For more about the big picture on changing our focus from weight loss to healthy behaviors check out this great article HERE.
So what can we do instead? Focus on focus on weight-neutral lifestyle health based interventions. If you are someone who likes to measure things- You can measure you blood sugar, your blood pressure, labs such as cholesterol, hours and quality of sleep, how much movement you got in a day, how many veggies you ate today, minutes of meditation, etc. If you are not so much a numbers person, focusing on reducing and managing stress, getting in more fun physical activity, getting good sleep and eating nourishing foods are great areas to work on.
*disclaimer-you may need to be weighed if have a serious chronic illness such as heart failure.
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