Weight isn’t a habit. It’s not a behavior. Weight is a single metric that tells me the physical mass of a person. That’s it. I can’t assume anything about their day-to-day habits. Trust me, I look at a lot of daily food and exercise logs. I hope the health and wellness fields shift more towards quality of life and less on weight metrics because they have become a muddy, messy field that often triggers disordered eating, self doubt, poor self esteem and a complicated relationship with food. I think we can do better by focusing on lifestyle rather than watching the scale. Here’s three ways to move beyond the scale.
1. BMI is Useless
BMI is a measure of height to weight meant to quickly assess obesity among the general public. In fact, the creator of it, a mathematician named Lambert Adolphe Jacques Quetelet, was specific that it was not to be used on an individual level. A much better tool for assessing risk from excessive weight is to measure waist circumference (less than 40 inches for men and less than 35 inches for women).
BMI also doesn’t tell me anything about how a body is built. For example, at 6’5” and 260 lbs., Dwayne “The Rock” Johnson, a well-known actor, wrestler and owner of very large muscles, is technically obese with a BMI of 30.8! Many of your favorite athletes, actors and gym friends may also fall into the obese and overweight categories – all depending on how muscley they are. The same is true for someone who may be considered skinny-fat; their BMI may be in range but their fat to muscle ratio is off.
More About Waist Circumference
2. Being Skinny Doesn’t Mean You are Healthy
I know many thin people with elevated cholesterol, high blood pressure, and on medications. I also know fat people who have low blood pressure and normal blood sugar readings. So, what gives? Health is dictated by lifestyle, not the scale.
A recent study showed there was no significant relationship between BMI and labs including total cholesterol, LDL (bad cholesterol), or triglycerides. That means that people in the normal category for weight had the same risk of abnormal labs as those who were considered overweight or obese.
An unhealthy lifestyle is fairly standard in the United States, even in the age of self-care. It might be lack of sleep, eating out and drinking too often, or feeling very stressed and tired. Some people might gain weight with these habits; some may not. Regardless, there is long-term damage happening inside of this person that increases their risk for chronic disease, injury, illness, and overall low satisfaction with life.
3. There are Better Topics
If someone comes to meet with me and has weight loss on their mind, I let them speak about it however they want. I also ask them if there are other metrics to gauge their success. After all, their weight is just one metric among many. This question usually surprises them, but it opens the door to talk about how the scale may not reliably show progress or reflect all the beautiful hard work they are doing. If their weight loss plateaus or stalls, we may also assess how well their clothing fits; how energetic they feel; if they are sleeping/eating/connecting well to show progress. If weight is a big part of their goals - and the other areas are in line - we can always make micro adjustments to facilitate further loss but our bodies need to be taken care of and that can’t be done with a simple calories in, calories out calculation.
Article References
https://www.npr.org/templates/story/story.php?storyId=106268439#:~:text=The%20BMI%20was%20introduced%20in,the%20government%20in%20allocating%20resources. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890841/ Hussain, A., Ali, I., Kaleem, W. A., & Yasmeen, F. (2019). Correlation between Body Mass Index and Lipid Profile in patients with Type 2 Diabetes attending a tertiary care hospital in Peshawar. Pakistan journal of medical sciences, 35(3), 591–597. https://doi.org/10.12669/pjms.35.3.7