Can You Be Healthy at Any Size?

While new science suggests there's no such thing as 'healthy obese,' think of it this way: It’s not that your weight doesn’t matter. It’s just that it’s not the only thing that matters.

Monica Reinagel, MS, LD/N, CNS
4-minute read
Episode #445

Is carrying a few extra pounds really as big a deal as everyone makes it out to be?

It’s true that body weight is strongly correlated with the risk of various diseases such as heart disease, stroke, cancer, and diabetes. But there are numerous other indicators as well, including blood pressure, blood sugar, blood fats, and inflammation. Some have argued that you can be overweight and still be considered “metabolically healthy” if these other risk factors are normal.

Not true, according to a new study. Even for those with normal blood pressure, blood sugar, and cholesterol levels, simply being overweight increased the risk of heart disease by 28%. “We conclude that there is no such thing as being healthy obese,” said lead researcher Camille Lassalle.

This was a bit of a setback for those who advocate an approach known as Health at Every Size.

What is Health at Every Size?

The Health at Every Size movement promotes acceptance and appreciation of one’s body, even if you’re overweight. It encourages overweight people to shift their focus from losing weight to other healthy habits, such as eating healthy foods and getting more exercise. I’ve noticed more nutrition professionals getting on board the Health at Every Size bandwagon and I think I understand some of the reasons why.

Weight is Just a Number

First, it is true that the number on the scale does not tell the whole story about your health.

Body weight and body mass index (BMI) doesn’t take into account body composition. A very muscular person may have a BMI that’s considered overweight or obese, when they are no such thing. On the flip side of the coin, someone with a low BMI may still have a high amount of visceral fatthe so-called “skinny-fat” phenomonenwhich increases disease risk.

See also: The Perils of Being Skinny-Fat

It’s worth pointing out that the conventional criteria for healthy body weight are based primarily on Caucasian body types and may not be appropriate for people of all races and ethnicities.

Overweight Bias and Discrimination

It’s also true that people who are overweight face bias and discrimination, and this unfortunately extends into the arena of health care. Numerous studies have shown that overweight and obese patients often receive substandard care and less support from their health care providers. Because obesity is more prevalent among low-income individuals and minorities, a bias against patients who are overweight can disproportionately affect these disadvantaged groups and contribute to a downward spiral of poor outcomes.

One of the goals of the Health at Every Size movement is to fight against the stigma and stereotypes associated with being overweight, and to advocate for equal access and treatment, regardless of size.


About the Author

Monica Reinagel, MS, LD/N, CNS

Monica Reinagel is a board-certified licensed nutritionist, author, and the creator of one of iTunes' most highly ranked health and fitness podcasts. Her advice is regularly featured on the TODAY show, Dr. Oz, NPR, and in the nation's leading newspapers, magazines, and websites. Do you have a nutrition question? Call the Nutrition Diva listener line at 443-961-6206. Your question could be featured on the show.