Can you be healthy at any weight?
It’s a complex question, but the answer informs how we think about everything from BMI and belly fat to body-shaming. WellTuned asked Reena Panjwani, registered dietitian-nutritionist at BlueCross BlueShield of Tennessee, to explain.
“In short, weight doesn’t tell you the whole picture of a person’s health,” says Panjwani. “When you think about what weight actually is — the weight gravity exerts on you, or how you’re anchored to this earth — you realize that only knowing that number doesn’t tell you:
- What a person is eating
- How much they’re exercising
- Their genetics
- If they have any hormonal conditions
- Their body composition (muscle is more dense than fat) or
- If they’re at risk of health problems due to their lifestyle (smoking, being sedentary).”
“Weight is just one physical attribute we can use to develop a picture of a person’s health.”
Here are 5 key questions (and answers) about weight and health.
1. Can you be healthy at any size or is there a limit?
Body Mass Index (BMI) is one tool used to determine if a person is overweight or obese based on their weight and height, and it is just that: one tool.
“Having a higher BMI doesn’t necessarily mean you’re going to get diabetes or heart disease, but it does seem to indicate you are at higher risk of developing those things,” she says. “As dietitians, we look for extremes.”
- A BMI below 18.5 (underweight) may increase your risk for osteoporosis, anemia and malnutrition, while
- A BMI above 30 (obese) may increase your risk of type 2 diabetes, cardiovascular disease, and so on. To learn more about BMI, click here.
2. Are there health concerns connected just to weight?
Yes. Some health issues correlate with a higher BMI such as:
- Type 2 diabetes
- Sleep apnea
- Cardiovascular disease
- Some cancers
“Mechanically, extra weight puts added stress on bones, joints and organs,” says Panjwani. “That stress can lead to chronic health conditions.”
3. What’s the best way to gauge whether you are a healthy weight?
In addition to BMI, health professionals may look at other metabolic indicators including:
- Cholesterol and triglycerides (how much fat is circulating in your blood)
- Blood pressure (how hard your body has to work to pump blood where it needs to go)
- Blood sugar (too much glucose in your bloodstream can make you more likely to get diabetes)
- Genetics (you may be more susceptible to chronic conditions like diabetes or hypertension if those run in your family)
- Visceral fat (which accumulates in the abdominal region and is often linked to chronic inflammation)
4. Is belly fat a good way to measure your health risks?
“Belly fat is connected to inflammation,” says Panjwani. “We call it ‘visceral fat,’ and it’s stored in the abdomen around important organs like your liver. While BMI doesn’t show the distribution of fat on a person’s body, belly fat or waist circumference can, so it’s another tool in getting the whole picture of a person’s health.”
5. What’s the best way for people to look at their weight?
“Weight is such a stigmatized thing, and if you’re struggling with your weight, you may feel a certain way in your body — physically, mentally and socially,” says Panjwani. “It’s understandable why someone might avoid going to the doctor or seeking medical attention if they feel judged because of this one physical attribute. So avoid making blanket statements about weight — to others but also to yourself — and look at your behaviors more than you look at the scale.”
BlueCross members can also take a personal health assessment at this link to get an idea of where they stand and how they can improve their health.
Panjwani suggests paying attention to these 3 things:
- If your energy levels are low and you’re not currently exercising, incorporating physical activity might make you feel better.
- Pay attention to your eating patterns and how they make you feel. Try adjusting one thing at a time in a healthy direction, such as increasing your vegetable intake, to see if that makes a difference.
- If you start to feel depressed, anxious or stressed, think about whether you gave your body what it needed that day, whether that was nutritious food, sound sleep or a little bit of exercise. Identifying stumbling blocks is key to removing them.
To read more about how one woman stopped eating added sugar to address her health concerns, read Libby’s story.