Weight, Health, and Weight Stigma

If you’ve been told that your weight or Body Mass Index (BMI) falls in the “overweight” or “obese” range, you may be experiencing a variety of emotions. It is important to keep in mind that while a weight associated with the terms overweight or obesity has been associated with some health concerns, the risk of any health problems decreases as a person makes lifestyle changes to become healthier. Even if your weight doesn’t change, behavioral changes will make you healthier! It’s also important to remember that having a positive body image is more important than any number on a scale. Focus on the parts of “you” that you love and that make you special.

How do I know if I my weight is classified as overweight or obese?

Health care providers use something called Body Mass Index (BMI) to calculate overweight and obesity. BMI is a tool that shows a ratio (or comparison) of height to weight and can be used to estimate body fat. However, BMI doesn’t always accurately estimate body fat and it shouldn’t be used alone to determine how healthy a person is. If you are under the age of 19, your BMI is plotted onto a growth chart. Whether your weight falls into the “underweight,” “normal weight,” “overweight” or “obese” category depends on where your BMI falls on the chart. While categories have been given these names, the term “normal” does not necessarily reflect what a “normal weight” should be for each individual.

Remember, BMI is not a perfect tool. Even if your BMI places you into a category other than “normal”, ask your health care provider if you need to make any changes to your health behaviors for your overall health. A health care provider will assess your weight history, activity level, diet, sleep, mental health, family history and body composition (such as how muscular you are) before they decide if you need to make any changes.

Why does it matter how my weight is classified?

Body weight is often framed in two different ways:

1. Body Diversity. Body diversity recognizes that body sizes are similar to any other personal trait, such as eye color or hair. Higher weight does not necessarily equal poor choices or unhealthy behaviors.
2. The idea that excess weight is a preventable health risk. This second way holds individuals with higher body weights solely accountable for their body size. This idea, known as “personal responsibility”, is the foundation of weight stigma. Weight stigma, also called weight bias, is prejudice and discrimination based on body weight, often against those who live in larger bodies. People might discriminate against someone because they believe that weight is a choice.  This thinking follows common misconceptions that individuals living in larger bodies eat more, eat unhealthy, and aren’t active.

Is it unhealthy to have a BMI classification of overweight or obesity?

While it was previously believed that having weight in the range classified as overweight or obese is associated with increased risk of some health concerns or diseases, more recent research has illustrated that health behaviors, not weight status, are a better representative of your risk for disease. When we don’t take care of ourselves (both our mind and body) we can see negative health outcomes in the forms of:

• Type 2 diabetes
• Asthma
• Sleep apnea
• Hypertension
• High blood pressure
• Cardiovascular disease
• Joint pain
• High cholesterol and/or triglycerides
• Fatty liver disease
• Metabolic syndrome

These health concerns don’t always affect someone as a teen, but without healthy behaviors a person may be more likely to have them as an adult. There is increasing awareness that people can be healthy at any size or weight; however, health care providers are encouraged to screen patients for possible future problems that can be prevented.

What factors contribute to weight?

Studies have shown that weight is closely tied to genetics (your biological parents or other family members) as well as individual metabolism (how quickly your body turns food into energy)  and environmental factors such as diet and exercise. There is nothing that you can do to change your genetics (the genes or body blueprint that you inherit). But if you are interested in getting more exercise, eating healthier food, getting more sleep or making healthier drink choices, talk to your health care provider to set goals around what feels comfortable and helpful for you.

My health care provider (HCP) told me to lose weight, what should I do?

If your HCP told you that your health would be improved by losing weight, tell your HCP if you would prefer not to talk about weight and instead ask how you can make changes to benefit your health regardless of weight status, given that most weight loss is unsustainable. If you feel ready to make lifestyle changes but aren’t sure where to start, you can ask your HCP for a referral to an exercise program and/or an appointment with a registered dietitian. These small changes can make a big difference, and help you become a healthier person.

• Staying Hydrated.  Water and seltzer can be a great way to keep you hydrated throughout the day.
• Eating breakfast. Starting your day with a nutritious meal will prevent you from getting too hungry during the day and will give you energy to think at school.
• Packing a snack. Eating snacks that are made up of a protein (nuts, cheese, meat) with a carbohydrate (crackers, fruit, vegetables) can be helpful in fueling the body for longer. .
• Eating more whole grains. Choose whole grain bread, whole grain pasta, brown rice, and high-fiber cereals.
• Choosing lean proteins. Chicken, turkey, fish and vegetarian sources of protein, such as beans and tofu.
• Eating more servings of fruit and/or vegetables. Aim to include one or both at most meals and for snacks.
• Paying attention to your hunger and fullness cues. We are often taught to follow external cues around food but it’s actually more important to check in with yourself. Do you feel hungry? Do you feel full? Are you satisfied?
• Include exercise as part of your daily routine.

While the American Academy of Pediatrics recommends 60 minutes of physical activity daily, you can start by trying small changes:

• Taking the stairs instead of the elevator
• Walking instead of taking the bus
• Joining a sports team or a dance team
• Going for a walk with your family or friends
• Dancing to music
• Joining a gym
• Playing with your friends

If you’re feeling overwhelmed by the idea of making changes to your eating habits and physical activity, remember: you are not alone. There are hundreds of thousands of teens and young adults dealing with this issue and plenty of resources and support. You can reach out to your health care provider to ask what resources are available to you such as: support groups of peers your age, discounted gym memberships, or meeting individually with a counselor or dietitian.