Advertisements, pop culture, and even doctors can equate health and weight. Smaller bodies must be healthier, and larger bodies unhealthier.

A higher body mass index (BMI) is associated with conditions such as diabetes and heart disease, said Philip Scherrer, director of the Touchstone Diabetes Center and professor of internal medicine at the University of Texas Southwestern Medical Center. But BMI is a controversial way to measure health and is just one of many factors linked to changes in a person’s well-being, says UK-based GP and activist Dr. Asher Larmie says.

Yet people’s physical appearance is often very important when assessing health, says Shana Minay Spence, a registered dietitian in New York. Even if you learn to get rid of it, seeing your size as unhealthy can make you feel less confident about your body.

Experts say it may be time to unravel health and weight and focus more on health-promoting behaviors than the number on the scale.

Correlation and causation

It’s important to understand that the studies showing that people with higher body fat percentages have poorer health only show correlation, not causation, Rami said.

Studies have shown that people who weigh more have more cases of heart disease, but it cannot be said that weight causes heart problems.

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But the importance of these studies should not be underestimated, Scherer said. The correlation is strong, and “we’re dealing with correlation in the clinic from a physiological point of view,” he said.

However, Scherer said other factors, such as access to healthcare, may still be at play.

Buri Campos, a body image coach based in Paramus, N.J., says that getting the right medical care can be difficult for larger people.

Her clients aren’t the only ones afraid of going to the doctor. She said she was afraid to go to

“I can go for strep throat, I can go for rash,” Campos said.

“Because of my size, it’s very unlikely that I’ll be able to go to the doctor and get a real diagnosis that I shouldn’t ‘probably lose weight.'”

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Spence tells his clients: The body is not your business card.

You can’t tell a person’s health, habits, or biology just by looking at a person’s body, she said.

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“Can we access someone’s medical records? Are we talking to their doctor?” she said. “And a lot of the time, health is honestly, sometimes out of our control. There are so many chronic diseases that people just develop.”

The correlation between body size and health can be seen on a large scale, Scherer said, but it’s less clear when researchers look at individuals.

“The whole field really accepts that not everyone with a very high BMI has type 2 diabetes,” he said.

Smaller people are more likely to develop heart disease and diabetes, and many people who are larger are considered to be perfectly metabolically healthy, Scherer said.

“It just reflects our genetic heterogeneity and how we deal with excess calories,” he added.

Does diet make us healthier?

What is health in the first place? And can diet help you get there?

It depends on which part of your health is your priority.

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Health is made up of many factors. Avoiding illness is one, but so is maintaining mental health, maintaining an active social network, getting enough sleep, and reducing stress.

Restricting calories or cutting out certain foods can be unhealthy overall if it negatively impacts your mental health and prevents you from enjoying time with friends and family. And these restrictions can cause you to lose weight without properly nourishing your body.

“Weight loss doesn’t equate to happiness, and it doesn’t necessarily make you healthier, because the way you lose weight can also be detrimental to your health,” said Spence.

For most people, restrictive diets for weight loss do not work. According to a 2018 study, more than 80% of those who lost weight regained it within five years of hers.

According to Campos, if a cell phone often doesn’t work as intended, most people won’t use it anymore.

“But diet culture has done a very good job of fooling us into thinking you can have everything you ever wanted. I’ll put it in and get praise,” she added.

If you wanted to be healthier besides losing weight, what would you focus on? According to Lammy, there are other health-promoting things such as quitting smoking, exercising more, getting better sleep, reducing stress, and eating the foods your body needs. Focus on what you do.

Weight loss may result, they added, but that’s not the goal.

“By focusing less on weight, we can focus on more sustainable, truly healthy behaviors,” says Thompson-Wessen.



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