Is Health Determined by Weight?

Is Health Determined By Weight?
Lori Skurbe, RD


We have all heard the expression: “Don’t judge a book by its cover.” However, in our culture and in healthcare, that is often what happens. If someone looks overweight, we might assume they don’t eat healthy foods, do not participate in physical activity, etc.

Being healthy is a subjective term, meaning it varies from person to person. Healthy can mean someone is free from disease, has a good quality of life, has energy to complete daily tasks and can function well, emotionally and physically.

People of all shapes and sizes can be healthy. While having too much body fat can increase risks of certain diseases like heart disease, diabetes, and certain types of cancer, weight alone is not a total reflection of someone’s health habits or overall health. 

Why Weight Is Not the Only Determinant of Health
Our weight is used as a health screening tool along with other tools to aid healthcare professionals in determining one’s health status. There are significant limitations to some of these tools when used alone, which is why it is important to use screening tools and medical tests together to determine one’s overall health.

The Scale
When we go to our doctor’s office, we usually have our weight checked or we check our weight on our bathroom scale. The weight on a scale gives us limited information about our health, diet or physical activity level. The number on the scale does not take into consideration body composition. Body composition looks at the breakdown of how much of your body weight is fat, non-fat mass (muscle, organs, bone, etc.) and water.  Your body composition plays a role in your overall health. Too much body fat can increase risk of certain diseases; while having more lean mass does not increase risk of these same diseases. 

Body Mass Index (BMI)
We can calculate our Body Mass Index (BMI), which is a ratio of our height and weight. BMI has been used in healthcare and in research for many years as a measure of overweight. Even though BMI is widely used as a health indicator, it has significant limitations.

BMI, like weight, does not take into account your body composition. Someone could be classified as “overweight” or “obese” using BMI, but may have a large amount of muscle weight and low amount of body fat. For example, a body builder or other athlete may have a significant amount of lean mass (muscle) and low amount of body fat, but may have a BMI in the overweight or even obese category.  On the surface, it would appear these individuals may not be “healthy” as their BMIs are higher than the ideal range, when in fact they might be very healthy.

BMI also does not take into consideration differences between gender, age or ethnicity, which can all play a role in body composition. As we age, the amount of body fat that is considered healthy changes, women usually carry more body fat than men, due to childbearing and hormones. Body composition and health can also vary significantly by ethnicity.

Waist Circumference
Waist circumference (WC) is another health screening measurement used to determine health in conjunction with other health measurements. WC is measured by taking a tape measure just above the hip bone around the waist and taken after you exhale. 

Measuring around the waist targets body fat in the abdominal area which is correlated to higher risk of type 2 diabetes, heart disease and high blood pressure. Women with a WC of greater than 35 inches and men with a WC of greater than 40 inches are at a higher risk of developing obesity related diseases.  Where you carry your weight matters in overall health, not just that you are overweight. Carrying weight in the abdominal area has higher health risk than those who carry their weight below the waist. 

Dietary Habits
Our body weight is not always a complete reflection of our diet. We all know people who seem to eat whatever they want and never gain weight. There are also people who swear they can look at food and gain weight. Our weight can be affected by many factors besides diet, such as age, genetics, physical activity, medications, sleep habits and other health issues. There are people who eat a healthy diet, but still may be what is classified as overweight.  There are people that may be considered to have a “healthy” weight that have a poor diet. Dietary habits are important to overall health and wellness, but the quality of someone’s diet is not always obvious based on their weight or size alone. 

Physical Activity
Our body weight is not always correlated to our physical activity levels. Regular physical activity has many benefits besides weight management. It also helps to control blood pressure, improve blood sugar levels, decrease stress levels, improve sleep, aid in cognitive (brain) function, manage depression, improve bone density and so many other things.

If someone has a higher body fat, but they are regularly physically active they may be healthier than their sedentary peers who are at an “ideal” weight.  Physical activity may offset some of the health consequences of having too much body fat. 

Blood Tests
Your doctor may order blood tests to monitor your health. Blood tests can determine if you have diabetes, pre diabetes, abnormal lipids (cholesterol, triglycerides, LDL (bad cholesterol), HDL (good cholesterol) and other values that can tell us more about someone’s health.  Someone’s weight does not always indicate that they will have normal or abnormal blood test results. 

While having too much body fat can increase our risk of developing certain diseases, it is only one measurement of overall health. It is important to look at all the facets of one’s health together to determine someone’s health status. If your diet and weight need improvement – you are advised to seek the help of a Registered Dietitian to help guide you to a more healthful diet and weight that is attainable and sustainable for you.