April Williams remembers when her doctor told her she should weigh 140 to 150 pounds. At the time, she was 326 pounds, her highest weight to date. “I didn’t even weigh that in elementary school, but he still thought that’s where I should be,” says Williams, the founder of BariNation, a website for people considering weight loss surgery.
Nearly 5 years later – after weight loss surgery, following a fastidious diet, daily exercise, and starting an obesity medication — Williams was at her lowest weight of her adult life: 184 pounds. It didn’t happen in a straight line. Like many people, she went through frustrating plateaus and disheartening regains along the way. The scale has disappointed her. And getting over that was a difficult recalibration.
“I’ve had a long breakup with my scale,” says Williams, who lives in Gig Harbor, WA. “I’m not striving for a size, shape, or weight. I want to be metabolically well.” For instance, she wanted to lower her cholesterol level and her HbA1c, which checks your average blood sugar levels over the last 3 months.
Why do so many people have a divide between their “happy” weight — the goal, ideal weight some people (or their medical team) have in mind — and what’s actually their healthy weight?
One of the biggest barriers is the laser-focus on weight in the first place.
“When it comes to one’s ‘healthy weight,’ it’s not the number on the scale I care about. But unfortunately when we talk about weight, it often comes down to that,” says Disha Narang, MD, an endocrinologist and obesity medicine specialist and director of obesity medicine with Endeavor Health in Skokie, IL.
Although it might seem logical to choose a goal weight of the number you imagine is ideal, it’s not necessarily a specific number that’s the ticket to a healthy life.
“It’s very much about the metabolic improvements that are occurring with weight loss,” Narang says. And it doesn’t need to be anything drastic. Despite what a BMI calculator or chart might tell you, there’s no threshold you cross to suddenly become a healthier version of you. Why? Because even a 5% weight loss will improve your blood pressure and cholesterol numbers and make an impact on your risk for heart disease and diabetes, Narang says. That’s true whether you start at 350 or 200 pounds, she says.
If you’re on a weight loss journey, your ideal weight, or goal, may not really be something you determined on your own. Society’s obsession with body size, BMI, and the number on the scale may have influenced you. The culture you grew up in may also have its own standards about what’s desirable.
There are reams of research on body image distortions in the media. When researchers in Spain studied adults with overweight or obesity, they found that women at higher weights experienced more weight-related self-stigma and lower body satisfaction than men. This is likely because females are more likely to be disparaged for their weight, the researchers reported in the International Journal of Environmental Research and Public Health in 2020. (Weight stigma can also affect men, of course.)
If you have a goal weight in mind – one that you think will erase both your health issues and leave you feeling satisfied and confident in your own skin – what did you base it on? It can be tempting to pick a number that you used to weigh, like in high school, before kids or menopause, or on your wedding day. But your life circumstances, which supported you being at that weight back then, may be completely different now. The number you have in mind may ignore something fundamental: what’s doable for your body now.
“People tend to be harder on themselves than they need to be,” Narang says. “Society is so focused on the number and way you look, but it’s important to turn the conversation around to how do you feel.”
Sometimes a “happy” weight can be achieved, but only with extreme restriction, which originates from a sense of deprivation and often punishment. In contrast, a healthy weight isn’t actually a specific number on the scale, but the result of a series of daily habits that you can stick with.
“Arguably the healthiest weight is the one that you can sustain without punishing yourself or compensating at the gym and restricting after periods of overeating,” says registered dietitian Lisa Moskovitz, founder of the Virtual Nutrition Experts and author of The Core 3 Healthy Eating Plan.
The CDC and many health care groups focus on BMI, which is based on weight and height. But there’s not a single data point or number that governs whether you are healthy or not. BMI has many limitations, including the fact that this number says nothing about your body composition or where you’re carrying weight, which can affect your health.
So how do you know if a weight is healthy for you? Narang suggests doing two things:
Track your lab tests. These include measures of your cholesterol, blood pressure, blood sugar, and waist circumference. Are these all in healthy ranges? Assess how you feel. Have you made positive habit changes, even if they didn’t lead to weight loss? Can you now go up the stairs without being short of breath? Do you have more energy throughout the day? Are you sleeping better? Your quality of life hugely matters in this conversation.
You don’t have to ignore the scale completely, although some people choose to do so, and that’s OK. At the very least, give it less weight in your psyche.
“The scale doesn’t tell you your body fat percentage and it doesn’t account for things that naturally cause weight fluctuations, such as menstruation, hormonal changes, eating lots of salt, not having a bowel movement, building muscle, or simply deviating from your daily routine,” Moskovitz says. Instead, you can use the scale to gauge your overall trajectory to understand where your weight is going and how your current habits affect that number.
There is a tool that doctors can use that goes beyond your BMI. It’s called the Edmonton Obesity Staging System, and it has five stages that gauge your weight based on any conditions that you may have that are due to obesity. If your BMI is in the obesity range but you have no related conditions, that’s stage 0 on the Edmonton Obesity Staging System, and no medical treatment is needed. The scale goes up to stage 4, where someone has potentially life-threatening conditions related to obesity.
In the end, though, your ideal weight and your healthy weight may diverge – unless you change how you think about it.
“Finding your happiest weight sometimes means giving up the idea of what your weight should be and ignoring advice from people about how much you should weigh,” Moskovitz says. “Only your body knows. Stop obsessing over numbers and charts and start thinking about healthy behaviors. These are way more important than a specific number.”
Even more reason to be optimistic: People who live a healthier lifestyle are more likely to report greater happiness and optimism as they age, according to a 2019 study published in Preventive Medicine. You may not need a specific number on the scale to reach a happy weight after all.
For her part, Williams is proud of where she is now because her focus is aligned with her goals. “My weight may be more than someone else thinks it should be, but it’s no longer impacting my health,” she says.
Today, Williams is the healthiest she’s ever been, having kept up her lifestyle habits as well as her obesity medication. “I don’t take anti-diabetes medication anymore, my cholesterol has normalized, I no longer use my sleep apnea machine. When I look at my overall health, I’m a freaking rock star.”
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