• Staci Gulbin, MS, MEd, RD

Who said being average was a bad thing: the effects of weight on life expectancy

When you hear the word "average," you might think of mediocre, unexceptional, or ordinary. In today's society, average is not the American dream. More money, more material things, bigger portion sizes, and bigger houses are all desired more than not. And unfortunately, the "ideal" body weight as decided by the media is "less is more." Although some social media leaders are trying to change this standard to "strong is the new skinny" or encouraging body acceptance, the "thin is in" concept is still going strong after many decades. However, a new study on weight and life expectancy may help put this concept to rest.

A recent study in Lancet's Diabetes and Endocrinology journal looked at the link between body mass index (BMI) on various health outcomes. Body mass index, as you might be familiar, is an estimate of a person's body fat by taking the ratio of weight to height. It's not the perfect estimate since some people with more muscle may have higher BMIs. This can falsely identify someone at risk for obesity or overweight. However, for a majority of the population, the BMI is an effective estimate to let health care providers know if someone is at risk for overweight, obesity, or even underweight,

The study, which is the largest of its kind, looked at over 3.6 million patients in the United Kingdom. Study results show that those who have a BMI of 30 or above, which indicates obesity, as well as those who have a BMI of 18.5 or below, which indicates underweight status, have a lower expectancy than those considered of normal weight. In fact, those who are obese or underweight had a life expectancy about 4 years shorter than those with a BMI between 21 and 25. When smokers were included in this analysis, there was an even stronger link between low BMI and lower life expectancy.

Therefore, this goes to show that just because someone is thinner, it does not necessarily mean they are healthier. Just because someone is thin, that does not mean that they eat a healthy diet, or exercise, or lead a healthy lifestyle in general. I guess what I am trying to get at is that the number on the scale is not a full representative of the health of someone. However, traditional thinking suggests that if someone is thin, then they must be healthy, or if someone is overweight then they must be unhealthy. This type of thinking needs to change, and healthcare providers especially need to stop assuming that those who are overweight are lazy and unhealthy eaters. This thinking can potentially prevent an accurate diagnosis from being discovered in some cases because healthcare providers may dismiss symptoms as just the result of being overweight.

Overweight status can be caused by many factors such as genetic, environmental, medical issues like thyroid conditions and hormone balances, or gut microbiome issues, to name a few. Therefore, if someone tells you that they are eating a healthy diet most of the time, staying active, and practicing healthy lifestyle behaviors such as managing stress and sleeping enough each night (about 7 to 9 hours a night), listen to them. Take a closer look at their labs. Have them keep a food and activity diary. Try to confirm these behaviors and see if their symptoms could be caused by someone else.

The bottom line is that there is not just one picture of what healthy is. Healthy can come in many shapes and sizes. Unhealthy can come in different sizes too. So, before we assume someone's health status by their appearance, let's think again and keep our minds open to learning more about the body. This is the only way that we as a society will start to conquer the health issues, and issues in general, encompassing our country and world.

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