Why Current Weight Is (Almost) Meaningless

The Letter ScaleWeight continues to be a subject for hot debate in popular culture. Most people live somewhere between the extremes of fat shaming and fat activism, just navigating life and sometimes feeling judged because of implicit ideas that people have about the normal human diversity of body size and shape. For population health, it’s indeed a problem that body weights are trending higher because excess or abnormal adiposity brings brings us more metabolic disease. But for an individual, a single reading of a person’s current body weight – by itself – can be almost meaningless for understanding that person’s health.

A Weight of 300 Pounds
Might Be Just Fine

In a conversational essay for Insider, Marianne Guenot shares perspective from obesity medicine physician Fatima Cody Stanford, telling the story of a large man with a very active work life. When he came to her for help with obesity, she already knew him from seeing him hard at work in the Boston transit system. But he wanted help with the health problems that his 550 pounds of body weight was causing.

With respectful and effective care, he has his condition under control, but he’s still a big man, weighing 300 pounds. Stanford explains:

“Now, when we hear 300 pounds, that sounds like a large number. And it is, even for him – he still has obesity. But 250 pounds down from his original weight, he no longer has blood sugar, sleep, or cholesterol issues. These weight-related diseases are all in remission.

“So I am comfortable with him being at that weight.”

History Matters

This story serves to illustrate a point that Bruno Halpern and colleagues recently made for the Brazilian Society of Endocrinology and Metabolism, as well as the Brazilian Society for the Study of Obesity and Metabolic Syndrome. They propose that weight history is essential for understanding if obesity is well-controlled in an individual. Someone whose weight is rising to 300 pounds is in a very different health status from someone living at a reduced weight of 300 pounds.

In other words, history matters. So indeed, without knowing a person’s history and having a full picture of other health indicators, a single point measurement of weight – by itself – can have little meaning for understanding a person’s health.

Click here for the Insider essay and here for the paper from Halpern et al.

The Letter Scale, painting by Gosta Adrian-Nilsson / WikiArt

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October 13, 2022

3 Responses to “Why Current Weight Is (Almost) Meaningless”

  1. October 13, 2022 at 7:05 am, Al Lewis said:

    As you know, having met me, I am quite thin. However, if my weight increases by even 5 pounds, my Hb a1c gets into the prediabetic range. We all have different tolerances for how weight affects our blood values, it would appear.

  2. October 13, 2022 at 4:16 pm, John Dixon said:

    Todays message is so important. The benefit of sustained intentional weight loss is so beneficial to health. The data from bariatric surgeries numerous case controlled studies indicates modest weight loss saves lives. More makes little difference. It’s not where you are today but the journey that’s so important.

    • October 13, 2022 at 7:28 pm, Ted said:

      Thank you, John.