Health · Uncategorized

More Than a Number on a Scale

This Scale Never Lies

Weight is the measure we are taught to use to judge our health first and foremost.  This notion of weight as the ultimate indicator of healthiness is reinforced by our doctors, our television shows, our magazines, and even our friends and families.  When someone says they have lost weight, we celebrate them.  And when they say they have gained weight we console them.

But what does your weight actually mean?  What can you really tell about a person’s state of health from her weight?

In the US, BMI (Body Mass Index) is used to classify people into weight categories which subsequently influence all kinds of important things, especially health care decisions.  But there are major issues with BMI, and a lot of people are very confused about what it is.

Make no mistake, Body Mass Index is not the same thing as Body Fat Percentage.  BMI is a number that is a simple calculation taking into account only weight and height.  Body Fat Percentage is a measurable quantity of the percent of your body that is made up of fat.

Careful not to mix up the two numbers, they are not interchangeable.  Regardless of the number though, is it really possible to categorize people based on these types of things?  Can we make a judgment upon the state of our bodies based up one number?

Take a look at the BMI and Body Fat Percentage charts and their classifications.

BMI Chart
Body Fat Percentage

What do these words even mean?  What is “normal?”  What is “average?”  If 60% of the population is overweight, isn’t overweight average and normal?  I enjoy the idea that there is a magical line you must cross to leave the “overweight” or “obese” categories.  At 168 pounds, I will still be overweight.  At 167 pounds, I will be “normal.”    I understand there will be some error in any system of classifying people, but we could do better than this!  What is fitness and how much does it have to do with body size?  What about cardiovascular health?  If a person with a body fat percentage of 29% runs several miles a week and a person with a body fat percentage of 17% does nothing but sit on the couch, who is healthier?

It is valuable to have a way to tell a person when their weight and body fat percentage fall outside the norm, since this can be an indicator of other health issues.  But weight and body fat percentage don’t tell the whole story of health by any stretch of the imagination.  Sometimes people lose weight, not because they want to, but because of serious illness.

When people read these charts and find where they fall within the confines of the chart, it can drastically change their ideas about themselves.  Sometimes, it can be a wake-up call to someone who needs one.  But sometimes it can be a detriment to the very thing it purports to protect: our health.   When doctors use our weight as their entire initial impression of our health, nobody benefits.  I never had a doctor take my back pain seriously until I still had it after I lost weight.  In reality, my back pain has nothing to do with my weight.

Can’t we come up with a different type of metric?  One that does away with the antiquated notion of BMI and instead takes into account body composition and cardiovascular health?  In my mind, we need to move away from the false idea that the scale is king.  Why can’t our health professionals also measure our body fat percentage as part of a routine check up?  And when we apply labels to the new metric, can we have more of a sliding scale than a compartmentalized chart?  A way of discussing weight with ourselves without moral judgment or shaming would go a long way toward a more rational approach to keeping our bodies healthy.

Possible sliding scale of concern

It is clear that BMI is not a reliable enough metric to base health decisions upon.  While any chart that attempts to categorize will inevitably have flaws, that doesn’t mean our current way of categorizing people based on weight can’t be improved.  The most disturbing factor of all is that health insurance companies use BMI to determine cost, or even denial, of coverage. There has to be a better way to do this.

8 thoughts on “More Than a Number on a Scale

  1. Hi. I’m one of your many buddies on fatsecret, and I wanted to weigh in here…

    As a blunt instrument, BMI can be useful, but I agree that it’s not the end all and be all. One of the last doctors I went to took one look at me and was horrified by my weight. Not dismayed. Not annoyed. Horrified. She could barely look me in the eye, and she could barely talk about anything but my weight. At the time my cholesterol was right at 200, but all my other numbers were actually good and/or normal. (As a kicker, my resting heart rate was low, which was a sign of a person who works out. And I did work out at the time.)

    Weight is important, and it is important for our health to have our weight under control. And I don’t want a doctor not to mention my weight when it’s obviously a problem. With that said, weight is not the only thing that matters about health. The horrified doctor turned me off because I knew that if there were other ailments, she would either miss them or not take them seriously, linking everything to my weight. Much like your doctor and your back pain. Health is far more complicated than BMI, and it’s unfortunate that so many important decisions are based upon that number alone.

  2. Hello,
    I find your journey and blog very interesting and also inspiring for others out there. On this particular issue I agree with a lot of what you’re saying, however your point about the body fat measurement worries me a bit. If you are saying, “Can’t our health care providers take our blood pressure, temp, weight, height, body fat percent, pulse, and other factors to figure out what’s healthy for us” then I’m completely with you. The whole package needs to be looked at, not just one number or a one-two combo (weight, or BMI, or body fat). However, if you’re saying you’d like just body fat percent to replace weight, or BMI, then I’ll have to disagree – one metric alone will never give up a true overview of a person’s health. (I don’t think you’re saying the later, but just wanted to clarify). Thanks for all your great writing and good luck with your journey.

  3. “I never had a doctor take my back pain seriously until I still had it after I lost weight. In reality, by back pain has nothing to do with my weight.”

    That’s so true. In my experience I even prevented myself from going to a doctor because I knew (s)he would blame my problems on my weight.

    Thanks for your blog, and your life. It’s very inspiring.

    Jur.

    P.S. I think (although I’m not English mother-tonged) that you did a small typing error in that quote. Didn’t you mean “In reality, My back…”?

  4. I completely agree! An “underweight” person can still have high body fat if they don’t exercise, and an “overweight” person can be physically fit resulting in a low body fat (bodybuilder). My husband is in the navy and twice a year men are under scrutiny for “weighing in” and there are a handful of guys who are in terrific shape but are very dense because they have so much muscle. These guys are forced to “lose weight” to fit into the BMI standards even though they could kick everyone’s arse! I think that Body fat % should be the first indicator of physical fitness (especially in the military) and BMI should come second.

    1. Agree! BMI is a bunch of nonsense, really. It is body “mass”, so it does not distinguish between a large healthy mass which is muscle and fat,which is unhealthy if it is in excess. Body fat % should be the only criterion, in my opinion!

  5. I completely agree! An “underweight” person can still have high body fat if they don’t exercise, and an “overweight” person can be physically fit resulting in a low body fat (bodybuilder). My husband is in the navy and twice a year men are under scrutiny for “weighing in” and there are a handful of guys who are in terrific shape but are very dense because they have so much muscle. These guys are forced to “lose weight” to fit into the BMI standards or face being discharged even though there are men who fit the BMI standards but are in terrible shape! I think that cardiovascular tests and body fat % should be the first indicator of physical fitness (especially in the military) and BMI should come second.

  6. I actually have to give my doctor credit. I’m about 30 pounds overweight, from a BMI perspective, and when I wanted to talk to her about my cholesterol (heart disease runs in my family) her first solution wasn’t to lose weight. In fact, she actually took some time to look at all of the numbers (not just total, which hovers around 200, which is high end of normal for average, but too high if you have family history). She also looked at my good cholesterol and said, “It’s great that this is so high. I can tell you’re active, wrok out and get good fats and make healthy food choices.” It was so refreshing for her to see that. And she looked back at my past three years and even though my weight hadn’t changed, my numbers had improved and she took the time to tel me I’m doing a good job and said, “You know, weight doesn’t show every aspect of your health.” (I’d mentioned I knew I needed to lose weight but was honestly struggling, I didn’t want meds, but just wanted her to know I was TRYING.) And she said, “Keep up what you’re doing. Your numbers aren’t alarming or even something I’d want to medicate now.” Then she wrote me a “prescription” for things she wanted me to do, like start taking a low dose of niacing, make sure I’m eating fish and taking fish oil, she listed out good foods and foods to avoid, and said at least thirty minutes of exercise, five times a week. And then even circled back to say, “I already know you’re doing the last two but put them on here so you know they’re still important.” It was very refreshing. My doctor isn’t in perfect shape, and has never once talked down to me. But I think if she had I’d somehow feel like I DESERVED It. I even EXPECTED it on this visit, since I was specifically asking for feedback on heart disease-related topics. But when I walked out I told myself that THIS was how I should be addressed. Now, would she have had the same conversation with me had I been 70, 100, 150 or more pounds overweight? I can’t say. But I’d ilke to think so. THere are doctors like her out there, but I think they’re a lot harder to find. It’s hard to get quality time with a doctor who can spend time analyzing the big picture, rather than honing in only on weight.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s