If I could wave my magic wand and change one thing about how people thought about health it would be this. You cannot look at a person and know whether or not they're in good health. You know nothing about their eating patterns, exercise, stress or anything other health-related behavior by the way they appear.
There are so many reasons why it's toxic to equate thinness with health. I'll go through some of the most salient reasons here in this post. I recognize that the way our culture talks about bodies is exactly opposite of what I'm exploring in this post. I can understand if this post might be hard to read given the fact that it's a huge paradigm shift from how we usually talk about bodies. But, I encourage you to lean into the discomfort you may experience while reading and continue to honestly explore what I'm explaining here. It really could save a life: your own, or someone else's who you love.
First of all: let's be clear about what the word healthy even means. Go back to this post to read more about the expansive definition I wish we all had about this word. To put it short: health is more than what we put in our mouth—many factors of one's health status relates to elements out of their control while other elements are within the sphere of influence. We can't control our genetics, environmental factors, oppression, socioeconomic status, etc.: all which play a role in a person's health and well-being. Really, the only thing that's in our sphere of influence on our own well-being is our behaviors: how are you caring for yourself?
Equating thinness with health is damaging for the person who is suffering from anorexia who happens to be at non-emaciated weight. I wish our collective society could recognize that their struggle is as real and as valid as someone in a smaller body. Having a non-emaciated body and suffering from anorexia is the more common scenario than the one we typically see in the media. When we assume that eating disorders have a "look", people fly under the radar who are sick but appear "healthy". Let me be clear: in order to know whether a person is getting adequate nourishment or not, you have to ask them questions about their eating, self-care and other behaviors. You simply cannot look at their body size and determine whether or not they are eating adequately.
When we assume a person with a BMI of 22 is automatically healthy, we don't ask questions about their nutrition, sleep, stress, movement, etc. because we already assume everything is fine. But what if that person is engaging in dysfunctional eating patterns and doesn't have a period anymore due to the overexercising and undereating she is doing to be at that weight? I've heard countless stories of true eating and health pathologies going undetected in routine doctor visits due to the way their body appears.
Equating thinness with health is dangerous for the higher weight person who is constantly dealing with stigma associated with their size and feeling the need to “fix” their bodies with diets. Weight discrimination can activate the fight or flight response, which is adaptive in times of acute physical threat but is maladaptive if chronically activated in response to social threat. This could lead to cortisol secretion and stress-induced eating, detrimentally affecting metabolic and cardiovascular system functioning. Weight stigma is related to higher blood pressure, binge eating behaviors, bulimic symptoms, negative body image, low self-esteem and depression in children, adolescents and adults. Further, identifying oneself as overweight, irrespective of actual body mass, predicts impaired physical and psychological health outcomes long-term. Weight stigma does not promote well-being and it's up to all of us to take an honest look at how we may be perpetuating these harmful effects on others.
For the countless other ways it harms each of us to assume we know anything about a person by the way they look. I wish we thought about health and well-being more holistically. If you love someone who is struggling with food and you want to know how you can help, my advice would be to suspend any ideas, assumptions or judgments about the way they appear. Ask questions, don’t assume you know about their behaviors and really take the time to understand their struggle. It is so toxic to equate thinness with health, and I hope to get the ball rolling and the conversation started with this post. If you’re the one struggling with food: please know that your health is not your weight. If it’s important to you to engage in your well-being, consider how you might pursue behaviors that promote health for you like sleep hygiene, hydration, regular consistent adequate tasty pleasurable meals, movement (remember: there’s such a thing as too much) and more. The best part? These are available to you now (in whatever way that looks for you in your own life) and you don’t have to wait for some magical number to determine whether or not you’re worthy of care. You are! Right here, right now.