Weight is not an accurate measure of health

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Low-fat, low-carb, paleo, keto, intermittent fasting – the list goes on. Given that our culture idealises thinness and shuns larger bodies, it’s not surprising that nearly one in five midlife women has dieted in the past few years, according to research. And many have regained the weight and see themselves as having failed. Less than one per cent of very large people got to a “normal” weight at all in a study that included almost 100,000 women, and most who did, regained the kilos they’d lost within five years.

Some medical experts are now saying what many people have been desperate to hear: It’s extremely tough to drop weight long term, for reasons that have nothing to do with willpower – and it may not even be necessary. “The dominant message people get from government, health organisations and the media is that weight and health are connected,” says Dr Jeff rey Hunger, a longtime weight-stigma researcher (and, yes, that’s his real name!). “But, really, there’s no strong evidence to suggest higher weight automatically leads to poorer health.”

If you’re extremely large-bodied, dropping some kilos can protect your joints from arthritis and make it easier to exercise. But, for most women over the ‘ideal’ weight, focusing on other health measures may be much more important than what the scale says. So why isn’t that a message you’re likely to hear? “The evidence has been piling up for years, but experts are so stuck in their beliefs, they don’t accept anything to the contrary,” Dr Hunger says. Add to this all the people and companies with financial interests in pumping out anti-fat messages, from diet purveyors to pharmaceutical companies to book authors. Plus, the message that body fat is bad is such gospel in our society that it’s hard to believe it may not be true.

Doctors oft en worry that heavy women are ‘cardiometabolically unhealthy’, a term that encompasses blood pressure, cholesterol levels, triglycerides, blood glucose and other measures of heart and arterial fitness. But researchers in the US evaluated more than 20 studies and concluded that there was “no clear relationship between weight loss and health outcomes”. In other words, shedding kilos didn’t meaningfully lower blood pressure, diabetes risk or cholesterol.

Equating being heavier with having poor cardiometabolic health and being thin with the opposite is way off the mark, researchers discovered. They pored over data from more than 40,000 participants in a survey and found that nearly half the people classified as ‘overweight’ (and more than a quarter labelled ‘obese’) had perfectly healthy blood levels of lipids and glucose, meaning they were cardiometabolically fi ne. Meanwhile, a full 30 percent of the ‘normal-weight’ participants had unhealthy levels of these markers. The bottom line? Weight alone is not indicative of health, so nobody can tell whether or not a person is healthy based on their weight.

In a paper published in Social Issues and Policy Review, Dr Hunger and his colleagues discovered that healthful behaviours, not fitting into skinny jeans, are what make you healthy and live longer. Heavy people who do healthy things are as likely to thrive as anyone else. On the list: being physically active, eating nutritious foods, not smoking, socialising enough to avoid isolation, minimising stress and managing depression. “Your attention should be not on a target weight, but on how many days you intend to exercise this week and how much fresh produce you’ll be eating,” says weight expert Dr Mary S Himmelstein.

Our culture equates carrying extra body fat with being out of shape, but plenty of large-bodied women can run laps around their thinner counterparts. That’s because, in reality, fitness and weight have little to do with each other, says Dr Himmelstein. A team of international researchers proved this when they followed 43,000 participants across the weight spectrum. At the outset, they measured blood pressure, cholesterol, glucose and the like, then tested the participants’ fitness levels using a treadmill. Those who were metabolically sound and also fit had the same mortality rates during the next decade regardless of their weight. Those who were considered obese and unfit, however, were more likely to die.

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