Should We Really Be Calling People “Overweight”?
I write about weight every single day. Whether it’s a blog post, a patient’s progress note, a journal entry, or a conference proposal, I’m constantly putting pen to paper on the topic of weight.
And without fail, every single time I write the word “overweight” – which let me tell you, is often – I internally cringe. It just doesn’t feel right in my body or my mind. And I think I know why.
It’s not even so much that I think the word is mean or hurtful, though it most certainly can be. It suddenly lumps an individual person into a category of people whom have been stigmatized at every single turn. I think that there are plenty of people who, like myself, use the word clinically to describe a person of a certain size, but do not have any intention of harming someone.
Of course, there is also a large sector of people who use the word with little regard for the person who is tied to the other end of it. They say it with disgust, disdain, or dismissiveness. It’s used as invective and meant to imply something about the individual.
So those things are true. But what I actually don’t like about using the word “overweight” is that it implies that there is a normal weight at which this individual should be. Plenty of physicians might argue with me (and I’d tell them to read Health at Every Size and get back to me next week), but after years of observing people managing eating issues, I can assure you that there is no one right weight.
In the eating disorders field, we often talk about a “healthy weight range,” and many suggest that range to be within maybe pounds. But the truth is that a healthy range is much, much larger than that.
And in fact, research shows that the underweight are at higher risk of premature death than overweight or even obese (the extremely obese are also at higher risk). Scientists believe that a little extra weight can actually be very protective. So if we’re really concerned about the health of this nation, why do we focus on “overweight”?
How often do you hear the term “underweight” thrown around? I’ll tell you. A quick non-scientific review of google search results shows 8,520,000 results for “underweight” and 54,200,000 for “overweight.” That’s almost 6.5 times as many results.
So in all this talk about achieving a healthy weight, the idea of what a healthy weight even means often gets lost. The National Institute of Health defines it through Body Mass Index (BMI). This measurement has inherent flaws, however. For one, BMI makes no distinction between weight from muscle and weight from fat. That means that people like Tom Cruise, George Clooney, and Tom Brady are all in the “overweight” range.
Drs. Yoni Freedhoff and Arya Sharma have a definition of what they call “best weight” that I really like. They say that one’s best weight is, “whatever weight they achieve while living the healthiest lifestyle they can truly enjoy.” Got all that?
What I like about this definition is that it incorporates the most important factor in this entire equation – living a healthy and enjoyable life. If you’re in the “ideal weight range” but sedentary, depressed, and/or have poor health indicators (e.g. blood pressure, cholesterol), what’s so ideal about that?
I also love all of the amazing reader responses to the question of “How do you define a healthy weight?”
As I’ve said at least a hundred times on this blog, language is crucial. Words create our realities, and so throwing around terms like overweight that may not mean, well, anything, seems dangerous.
What do you think of the term “overweight”? If you have been called this, what is it like for you? If you use this term, why?
Patsy Nevins
286 days ago
I hate the word overweight almost as much as I hate obese & I do not use either of them, for they are judgmental, suggesting that there is a right weight someone should be or that being fat is a medical diagnosis & a disease, none of which is true. I am a long-time fat activist & I am definitely ‘fat.’
I have never had an eating disorder, though I have several times at least bordered on exercise bulimia. I am fat because I am fat, at least 80% of my body size is genetic, the rest is affected by childbearing, breastfeeding, aging, menopause. I don’t believe in the term ‘healthy weight’ because people can be healthy or unhealthy at ANY weight & because suggesting that someone has a particular weight he or she should maintain means a weight that will need to ‘worked on’, that you need to adjust your food intake, exercise, etc, to reach or maintain this weight. That, to me, is just more diet talk. Whatever you weigh is the right weight, especially if you weigh this living your life, not trying to do anything special to change your body size or shape.
Being fat does not cause health problems or premature death. Several studies have established this. Fat is protective, especially as we age & just yesterday I once again saw a report on tv about the finding that, for people with Type II diabetes, fat people live longer than thin people. We tend to heal faster & to deal better with the illnesses which do come to aging people of all sizes & Shapes. Weight loss itself carries many risks, dieting is NOT a healthy behavior, & once we pass 60 especially, weight loss increases the risk of early mortality by several hundred percent.
I don’t live in the world of eating disorders, but I don’t believe that labeling anyone’s weight as ‘healthy’ or ‘unhealthy’ is a good idea. Would you do that with height or eye color or the shape of our ears? In my world view, we should accept & respect people of all sizes & shapes & our size should just be a part of who we are, not something to constantly try to change, not an enemy to fight. And if I never again hear someone calling a fat person ‘overweight’, thinking to be kind, it will be too soon.
Sarah
286 days ago
The main problem I have with “overweight” is that its not a factual statement, but an opinion and a value judgement. Over what weight? Obese works slightly better because at least its based on fact (the ratio between height and weight), and while I don’t feel that ratio has any clinical significance, it does use actual numbers. Fat works for me, because that’s a descriptor, like short or tall.
I don’t think medical records should indicate any value judgement on weight. It should be tracked, as other health indicators, like blood pressure, but it should only be a factor when there is significant change either up or down.
Dawn
286 days ago
…I just try not to mince words in life. If I’m overweight, I’ll call myself that. If I’m fat, I’ll call myself that. Pussyfooting around an issue never helped anyone.
Matt Wetsel
286 days ago
Love this post! I, too, cringe whenever I find myself using/saying/hearing the word “overweight.” While it’s sometimes appropriate in medical language and, sometimes, weight loss is a part of getting healthy for some people, in popular culture the word has no actual meaning.
I say that ‘overweight’ has no actual meaning because every person seems to have a slightly different idea. It’s a concrete concept that we’ll all agree on – it’s simply this thing that no one wants to be. It’s used to generalize and judge the bodies of others, and make assumptions about the health, life, activities, and sometimes even the character of others.
There are so many other ways to measure one’s health that, by comparison, body weight is fairly arbitrary. I wrote on the subject last year about health and weight not being equatable, which you might find interesting:
http://arenomore.wordpress.com/2011/08/10/no-numbers-no-compromises/
Anyway, thanks again for this wonderful post!
-Matt
Matt Wetsel recently posted..Fit, or Fitting In?
lori lieberman, rd, cde, mph, ldn
286 days ago
I do love that definition of best weight as well! And you’re right on that our assumptions about “normal” weight are often misguided. That said, perhaps we can see a weight description as specific or relative to the individual’s need. For instance, someone may be overweight–higher than that “best weight” described, because their behaviors have adversely changed. The weight description, then, is merely a flag, a marker for identifying that something may be amiss for them.
Do you have an issue with referring to an individual as underweight? Again, a child who has always been on the 5th percentile may not be inappropriate low. But if they fell down to that place they are clearly underweight. Sometimes labeling has its benefit, because it allows us to explore what lies beneath, what resulted in the shift. Most MDs for instance have and take little time to explore behaviors and details around eating. But seeing a shift from a patient’s normal weight and labeling it can be quite useful to address what needs to be addressed–and, to get insurance to cover it!
lori lieberman, rd, cde, mph, ldn recently posted..Forgetting to Remember: The Key Obstacle to Eating Disorder Recovery
Bek @ Crave
285 days ago
I love this post! It’s such a thought provoker. Best weight sounds good- it has such a nice attached stigma. I use the word overweight but usually I feel it is a nice word for the more derogatory term ‘fat’ :S Not sure if that’s a good thing though. I usually only generally toss words like that around when I refer to my past, current and future self etc.
Bek @ Crave recently posted..Loving myself
PTC
283 days ago
I think the medical professionals should do away with BMI, because like you said, it’s not an accurate measurement.
I don’t think there’s anything wrong with the word, if it’s used properly. I do think it gets thrown around a lot though, when unneccessary.
PTC recently posted..I want to hop on the scale