Health at Every Size: What Does “Healthy” Really Look Like?

Kristina LaRue, RD, CSSD, LDN
by Kristina LaRue, RD, CSSD, LDN
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Health at Every Size: What Does “Healthy” Really Look Like?

People seek weight loss as a means to improve health and reduce their risk of chronic disease. But, does looking skinny really equate to better health? An emerging body of research is actually suggesting quite the opposite. Glenn Gaesser, PhD, an exercise physiologist and author of “Big Fat Lies: The Truth about Your Weight and Your Health,” says “the number on the scale may be a poor predictor of health as it fails to consider cardiovascular fitness, physical activity and diet.” That is: Being fit and fat can be healthier than being skinny and out of shape, aka “skinny fat.”

The Link Between Weight & Health
As they say, you can’t judge a book by its cover. Just because someone is overweight doesn’t mean their health is at risk. In fact, according a review by Linda Bacon, PhD, author of “Health at Every Size,” except in extreme cases, body mass index “only weakly predicts longevity.” Her review discovered that most studies following large groups of participants over many years “find that people who are overweight or moderately obese live at least as long as normal weight people, and often longer” with the greatest longevity in the overweight category.

New research has revealed yo-yo dieting or weight cycling to be associated with increased markers of inflammation, high blood pressure, low HDL (the “good” cholesterol) and premature death from heart disease. Obesity may not be the underlying cause of disease, as traditional medicine and health policy suggest. Diet quality, exercise and sleep habits have more impact on health than weight. Instead of fighting the war on fat, focus your efforts on eating healthy, being active and forming good sleep habits.


“Diet quality, exercise and sleep habits have more impact on health than weight.”


The Alternative to Weight-Centric Goals
The alternative approach to weight-centric health goals looks at health holistically and through a different, body-positive lens, which can be very motivating for many people. The Health at Every Size movement promotes weight acceptance and addresses the stigma and cultural obsession with weight that makes it challenging for many people to be healthy. Some experts even believe that the focus on fat and obesity is making the population more obese. How? Research has shown a potential relationship among weight stigma, emotional eating and poor self-esteem.

Shifting the paradigm in how we view weight can be an effective way to encourage small tweaks to lifestyle that makes health even more achievable. This doesn’t mean that you can throw in the towel, sit on the sofa and eat potato chips all day long. The Health at Every Size approach is about being the best person you can be no matter what you weigh. It’s about seizing the day and working toward health — physically and emotionally. Instead of making weight loss the goal, allow it to be a side effect of a healthier lifestyle.

If you want to challenge the status quo and face these weighty issues head on, find further reading about the Health at Every Size movement at LindaBacon.org, or check out Gaesser’s book, “Big Fat Lies.”

About the Author

Kristina LaRue, RD, CSSD, LDN
Kristina LaRue, RD, CSSD, LDN

Kristina is a board certified sports dietitian located in Orlando, Florida where she specializes in intuitive and mindful eating. She is the author of the food and nutrition blog, Love & Zest where she shares {mostly} healthy recipes with simple ingredients that are meant for real life. As a new mom, she knows that eating well and living an active lifestyle isn’t always easy… but it’s always worth it!! Kristina loves spending time outdoors with her family, sweaty workouts, and a good cup of coffee. Get in touch with her for one-on-one nutrition coaching (virtually or in person), or connect with her on PinterestInstagramFacebook  and YouTube.

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35 responses to “Health at Every Size: What Does “Healthy” Really Look Like?”

  1. Avatar Val says:

    Wonderful article! Thanks!!!

  2. Avatar Sarah LaCroix says:

    Nice stock photo of fitness models. Really drives your point home.

  3. Avatar Jackal says:

    This is wrong on so many levels.

  4. Avatar cestmoi says:

    Some people might be obese with a clean bill of health (blood pressure, cholesterol etc.) for now… but there’s no way that doesn’t catch up to you. Plus if you’re exercising and having a “quality diet”, you probably will fall into a healthy weight category anyway

    • Avatar Danielle Letina says:

      No, you don’t. I’m living proof. I’m buying my own gastric sleeve because I’m sick of being healthy and looking like a junk food junkie.

  5. Avatar Tummisauruswrecks says:

    Your message: “Being mediocre is better than being bad”

    HAES movement is the equivalent of giving out participation prizes to kids who lose their basketball tournament.

    Stop coddling and encouraging mediocrity. And using the HAES author as a source? Ugh…

  6. Avatar Alice says:

    Actually you’re wrong. My sister is 3 times as big as me but runs half marathons regularly and eats healthy. I can only run 3 miles! It’s to do with thyroids and metabolism for some people. Don’t judge and listen to the experts!

  7. Avatar godawgs2477 says:

    This article is incorrect.

  8. Avatar Jaymind says:

    The science of this is pretty sound. Weight is much less important, within a range, than being and acting in a healthy lifestyle. Working out, eating “healthy” and being active are no guarantees of actually being at what some consider a healthy weight. Not to mention that there is no such thing as a “healthy” weight. Be active, eat in moderation and everything else will take care itself.

  9. Avatar Aaron says:

    Weight matters…now if we were talking body fat percentage that would be different. Don’t buy into the fat but fit BS…it will kill you.

    • Avatar Danielle Letina says:

      Fat but fit isn’t BS. It is only if you stop living healthy.

      • Avatar Aaron says:

        Yes it is. Abdominal fat is the largest indicator of heart disease. You say that you eat healthy? Are you sure? Do you actually know how much you eat? Because the only way to do that is to have a food scale and count your macros. Then, how many times a week do you work out; then, what is your intensity. Have you gotten your actual Body Fat % and Metabolic Rate done…because I thought I was back to being in shape and then found out I was still 22%. A long time ago I was obese, and the only thing that got me to being relatively fit was eating well and working my ass off. Gastric bypass is so good that unless you eat correctly the rest of your life you’ll become obese.

  10. Avatar worldwide_webster says:

    The HAES doc is named Dr. Bacon? For real?

  11. I would suggest that you must have used bullet points in your post that could have been more helpful.

  12. Avatar Loser says:

    I’ve removed (won’t say lost cause I know where it went) almost 100 lbs of fat from my body over the past year. All my numbers improved substantially. It required altering my diet, my lifestyle, and my way of thinking. Watching the scale change has been my biggest motivator. Thanks HAES movement for making me feel bad about it. And thanks MFP for rubbing this useless bulls*it in my face and sabotaging the goals of everyone on here that buys into this garbage pseudoscience.

    • Avatar cestmoi says:

      amen… and good for you dropping 100 lbs!

    • Avatar Leslie says:

      I don’t think the article is saying that losing weight isn’t worth it. I read that that’s not the only thing that we need to focus on – and altering your diet to a healthier one, your lifestyle and your way of thinking is exactly what the article seems to say. Just as you’ve done, using correcting our body to be slimmer is just one factor in becoming healthy. I, too, use the scale as my motivator – but, just as you have done, recognize that altering my lifestyle has to be a companion piece to our health goals.

      • Avatar Exadyne says:

        Plenty of the Healthy At Every Size movement (HAES) do say losing weight isn’t worth it, doesn’t work, and that you’re shaming other people by choosing to lose weight instead of staying the same weight and joining them in their disbelief that adipose has anything to do with human health.

        • Avatar Jen says:

          You can’t take some random people on the internet associated with it as if the speak for the whole concept. This article doesn’t say anything like that.

          • Avatar Exadyne says:

            Not taking random people, I’m talking Ragen Chaistan among the people saying this.

            I’m personally in favor of body acceptance, but a lot of the HAES movement is filled with people perpetuating false information.

            And the above is doing it. A healthy diet and exercise won’t improve health markers more than losing weight if a person is actually obese. I’m talking active as in Sumo wrestlers (light weight divisions) who are just barely obese have worse markers than typical similar age normal or overweight BMI, despite highly active.

    • Avatar Jen says:

      Maybe not everything is about you and you don’t have to take it so personally? Everyone here is struggling to establish reasonable goals and develop a positive, healthy relationship with food and exercise. This may mean dropping 100 lbs for some, but for others it may mean worrying less about the scale and more about eating well and exercising without having weight be a motivating factor. Someone else choosing different goals from you doesn’t take away your accomplishment. It’s not about you. Honestly your attitude is what’s most toxic about this forum and what makes it so unsafe and unproductive for people just trying to figure out what they really want out of a lifestyle change and what goals are best for their personal needs.

  13. Avatar Derick Bernat says:

    Hey I admit the following might just be bro science since all my research is internet based, but having excess fat is wasteful. Excess muscle can still be used to make mobility easier, but excess fat is as crazy as apocalypse preppers. Fat is created when too many calories are consumed in a day and the surplus is stored in the body. The body can’t eat dead tissue so the more fat you have, the more resources your body will have to use to maintain the fat as living tissue. The more fat you accumulate, the more difficult it will be for your body to maintain this and that’s why people develop diabetes, and also occasionally lose fingers and toes to gangrene. No matter how much you pay an overworked employee in calories, too much stress can kill a person prematurely.

  14. Avatar Ray Shan says:

    I think it’s important to see it in context. Most sportsmen weigh more than the ideal weight. But it’s all muscle.

    Similarly, a lot of people can be technically overweight, but have less body fat. This is usually true for young people. But, as you grow old and you start losing muscle, it will catch up! So of you are one of those who weigh more but who are otherwise in the normal range, please start strength training and activity to ensure the situation doesn’t spiral out of control! 🙂

  15. Avatar John says:

    Any normal person who eats clean and exercises will not be fat for long.

    I have coached dozens of people who blame metabolism for why they are fat and every single time I have gone over what they eat and you find out they are simply eating too many calories.

    Some people do have real medical issues, but lots of people think they do when they don’t. They just eat too much. It really isn’t fair to the people who truly have medical issues.

  16. Avatar Brandon says:

    Really bad blog post, Kristina LaRue. Very awful.

  17. Avatar Danielle Letina says:

    I think it’s the opposite ⬇
    I’m considered obese, but am healthy. I think the point is not to make overweight people panic. My cholesterol is great, my sugar is low, my blood pressure fantastic. I teach Zumba, am 99% vegetarian (love my chicken breasts) and go to the gym. But after dropping 100 lbs over the last few years, I can’t get to my goal weight. I should be a size 0 for how healthy I live. But I’m not. But I know I’m healthy, and this article I think is trying to convey that there are people like me. Chicken breast and kale, but junk in the trunk ☺

  18. Avatar Dude says:

    What does a fit man at 500lbs or a fit women at 400lbs look like? Just curious.

  19. Avatar CurveyKate says:

    I wonder you, whom have such strong opinions, have any medical or scientific background. I’m a nurse and have seen it. The outside doesn’t always tell you how healthy the inside is. Basic fact. Just because people are overweight doesn’t automatically make them unhealthy. That’s a prejudice just like any other prejudice. This research, this article is one of the first of many you’ll see that say this. ‘Mericans will call BS and try to stuff the completely incorrect, unhealthy USDA food pyramid we still teach our children down your throat. Stop being such sheep. Stop hatin.

  20. Avatar Heather Usrey Clements says:

    I have to weigh in here (pun intended!) I weighed in excess of 250 lbs, and was a 2nd degree black belt. My heart rate and blood pressure were those of an athlete. Nurses used to take my readings twice, because they didn’t believe it the first time. The only meds I took were for allergies and a hereditary condition. I would say that qualifies as fit. Having said that, though, my weight was taking a toll on my knees, leading to an injury that has kept me out of my martial arts practice for nearly two years. In that time, all those measures of health have deteriorated. Although it is possible to be both fit and fat, in the end, it is easier to be fit if one is not also fat.

  21. Avatar Slow and steady wins the race says:

    I initially desired losing fat and looking “skinny” when I started seriously exercising and changing my diet a little over two years ago. Now I admire my strength and the muscle my body has built up. I no longer focus all of my attention on losing fat and instead shifted my goals to simply eating better and gaining muscle. The fat has slowly disappeared without me even thinking about it. I’ve gained 12 lbs in muscle and my body fat dropped 11%. The scale reading hasn’t moved!

    Health is not measured by a scale. Maybe at first or if you have 200 lbs to lose, but for me now it’s a waste of time. Horray for being dense!

  22. Avatar aajmon says:

    exactly!

  23. Avatar Bunnytor says:

    Is it just me, or do the detractors of this article sound like fitspo nazis?

  24. Avatar Animal SoulBonder says:

    Healthy can be a specific look because we all will never look the same.

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