Why Weight Isn’t the Measure of Health: Choosing Health at Every Size
By: Katelyn Van Hofwegen, ANAD Community Engagement Intern
What do you picture?
Close your eyes for a moment and imagine a person with anorexia. According to Merriam Webster, anorexia is “a serious disorder in eating behavior…characterized by a pathological fear of weight gain… leading to malnutrition and excessive weight loss, most commonly in young women in their teens and early twenties.”
Who do you see?
Probably a very thin teenage girl who “never eats,” right?
Now, picture someone with type 2 diabetes. We often hear that type 1 diabetes is genetic or autoimmune, while type 2 diabetes is “caused by poor lifestyle choices.” Maybe you’re picturing an older adult who’s overweight, inactive, and always eating junk food.
But what if I told you real life doesn’t always match these stereotypes?
- My six-year-old daughter, tiny and full of energy, was diagnosed with diabetes due to a genetic mutation.
- My friend, a thin older woman who has run more than 13 marathons, has type 2 diabetes.
- And at 16 years old, I was active, fit, and obsessed with eating “healthy.” I barely touched sweets — yet I was diagnosed with prediabetes.
None of us fit the stereotype.
And what about anorexia? Celebrities have shared their struggles — men, older women, and people in larger bodies. Even me. Most people would not look at me and think that I struggled with anorexia? Even I didn’t believe it at first. I thought, “There’s no way. I’m too fat to be anorexic.”
Why do we think this way?
Because it’s what we’ve been conditioned to believe.
Diet culture surrounds us: billboards, commercials, fitness apps, and casual conversations. We’re told smaller is better, weight loss equals health, and gaining weight is failure. Unfortunately, many of you reading this probably have your own painful experiences with these messages.
A few years ago, I was training intensely for a marathon—working out too often, running significant distances several times a week. I was also eating what I thought was “clean,” severely restricting my food, and purging. And what did doctors say during routine checkups?
“You need to lose weight.”
“Eat less and exercise more.”
Even at my unhealthiest, no one questioned whether restriction and overexercising might be hurting me. I never felt “good enough” to meet the unrealistic expectations of this world.
Weight is not the problem — and losing weight isn’t the solution
We’ve been told that gaining weight automatically means poor health. But research doesn’t support that idea.
Dr. Linda Bacon, author of Health at Every Size, explains:
“Little evidence supports that weight is the primary cause of many diseases for which it is routinely blamed… except osteoarthritis, sleep apnea, and possibly a few cancers.”
Christy Harrison, in Anti-Diet, tells the story of Kai Hibbard, a former Biggest Loser contestant who was misjudged by doctors simply because of her body size. An endocrinologist assumed she had diabetes on sight — but she didn’t. What she actually had was rheumatoid arthritis, an autoimmune disorder that went undiagnosed because her provider focused on weight instead of her symptoms.
This is a classic case of correlation vs. causation. Just because weight and certain conditions sometimes appear together doesn’t mean one causes the other. Other factors — genetics, environment, age, gender, stress, and access to resources — all play significant roles in health outcomes.
And ironically, focusing on weight can backfire. Research in the International Journal of Obesity shows that when parents label their child as overweight, that child is more likely to gain additional weight later, not less. Shame and stigma only make things worse. So what’s the alternative? Health at Every Size.
The Health at Every Size (HAES®) approach shifts the focus from weight to true well-being. It’s based on five principles:
- Weight inclusivity: All bodies deserve respect.
- Health enhancement: Everyone should have equal access to care and resources. • Respectful care: No assumptions about someone’s health based on size.
- Eating for well-being: Listening to your body’s needs instead of dieting. • Life-enhancing movement: Choosing joyful, sustainable ways to stay active.
Johns Hopkins University confirms this approach works — HAES improves cholesterol, lowers blood pressure, increases physical activity, and boosts body image without the harmful cycle of weight loss and regain.
Even more important? It teaches us to see ourselves — and each other — as whole people, not numbers on a scale.
Your worth isn’t measured in pounds
You are more than a number on a scale. Your value isn’t defined by weight, body shape, or how you look in the mirror. You deserve respect, love, and care exactly as you are today—not just when you meet a goal, drop a size, or fit someone else’s idea of “perfect.” Healing starts when we stop treating our bodies like problems to solve and start honoring them as part of who we are.
Why this matters — and why we can’t wait
The Eating Recovery Center reports that 10,200 deaths occur every year as a direct result of eating disorders — that’s one every 52 minutes. Hospital admissions for eating disorders in children under 12 have increased by 119% in less than a decade.
This isn’t just about weight. It’s about survival. It’s about changing a culture that harms people of all sizes, ages, and backgrounds.
Final thoughts
We’ve explored:
- Why is focusing on weight as the primary measure of health harmful?
- How the Health at Every Size approach offers a better way.
- Why are our worth and health not tied to a number on a scale?
The question now is: Can you see people differently? Can you see yourself differently? You are not just a body. You are not a problem to be fixed. You are a masterpiece — loved, worthy, and enough exactly as you are.
References
- American Diabetes Association (n.d.). Understanding Type 2 Diabetes. Retrieved December 6, 2024, from https://diabetes.org/about-diabetes/type-2
- Association for Size Diversity and Health (n.d.). The Health At Every Size® Approach. ASDAH. Retrieved December 8, 2024, from https://institute.welcoa.org/wpcontent/uploads/2020/06/ASDAH-HAES-Principles.pdf
- Bacon, L., PhD (2010). Health at Every Size: The Surprising Truth About Your Weight. Benbella Books, Inc.
- Bhandari, P. (2021, July 12). Correlation vs. Causation | Difference, Designs & Examples. Retrieved December 8, 2024, from https://www.scribbr.com/methodology/correlation-vs causation/
- Harrison, C., MPH RD (2021). Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating. Little, Brown Spark.
- Holy Bible, New Living Translation. (2021). Tyndale House Publishers. (Original work published 1996)
- Merriam-Webster, Incorporated (2024). Anorexia nervosa. Merriam-Webster. Retrieved December 6, 2024, from https://www.merriam
- webster.com/dictionary/anorexia%20nervosa
- Nairn, R., MS, RDN, LDN (2023, February 20). Health at Every Size: A concept to reduce weight-centric thinking and to promote body positivity. Retrieved December 8, 2024, from https://wellbeing.jhu.edu/blog/2023/02/20/health-at-every-size/
- Pike, E., MA, LPC (2024, February 14). Eating Disorder Statistics 2024. Retrieved December 8, 2024, from https://www.eatingrecoverycenter.com/resources/eating-disorder statistics#eating-disorder-statistics
- Robinson, E., Haynes, A., Sutin, A. et al. Telling people they are overweight: helpful, harmful or beside the point?. Int J Obes 41, 1160–1161 (2017). https://doi.org/10.1038/ijo.2017.85
