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At almost every doctor’s visit I have ever attended, my weight has been measured. In fact, the only time I have not been weighed was when I have specifically asked not to be. And to be quite frank, I am over it. My weight does not affect my health.

My body mass index classifies me as “obese.” Every time I sit down on that examination chair to speak with my doctor, this is the first concern brought up. There’s no mention of my blood pressure or my cholesterol levels. But my BMI is always a matter of concern. When we do finally get past the doctor’s concerns about my BMI and look at the actual numbers from blood tests, everything is within a perfectly healthy margin. Yet, I am still told to lose weight. Why?

It’s because weight is constantly associated with health. Many people justify fatphobic remarks by following with the phrase, “I’m just worried about your health.” Many thinner people’s health concerns get glossed over because they “look” healthy. This false equivalency between weight and health leads to overlooked and poorly-treated patients.

“Weight is a barrier to health — not because weight is a health marker, but because fatphobia runs deep in healthcare.”

For many patients, this poor treatment comes in relation to eating disorders. Fat patients are told they are not thin enough to have an eating disorder. Thin patients are told that they look incredible, emphasizing appearance over actual health. On the podcast Maintenance Phase, Professor Erin Harrop said, “We have this preconceived notion of who are the people with eating disorders.” 

If someone was asked to describe the physical appearance of a person with an eating disorder, many would recount an incredibly thin teenage girl with possible white-presenting features. This assumption results in many problems for patients seeking treatment: Some patients cannot get insurance coverage. Others get the wrong diagnosis, being told they have a binge-eating disorder, when in reality they have anorexia. Others have had their eating disorders reinforced by the intense weight stigma from providers.

For some, the weight stigma they faced in healthcare was the cause of their health issues. For activist and author Aubrey Gordon, it caused her to develop orthorexia, an eating disorder that strictly counts and measures every piece of food eaten. Internalized weight stigma, often stemming from the idea that a person’s weight is their fault and a personal failing, can contribute to depression, anxiety and even suicidal ideation.

Weight is a barrier to health — not because weight is a health marker, but because fatphobia runs deep in healthcare. Fat women are less likely to be screened for various cancers, including breast cancer. This results in fat women being more likely to die of cancer than nonfat women. A majority of nursing students in a 2019 study also exhibited unconscious weight bias against fat people.

This bias present in healthcare stems from the idea that being skinny is equivalent to being healthy. Clinical researcher Karen Manias said, “I personally have been at my unhealthiest … when my body was at its smallest, despite receiving endless compliments for looking ‘fit’ and ‘athletic.’” Weight stigma directly affects thin people as well. They are told that their body looks great, that their body is enviable, without being asked about their health.

At the end of the day, weight is not a health marker. There are far better indicators of health that do not include the number on the scale. One study from Current Sports Medicine Reports found that cardiorespiratory fitness is a more accurate indicator of mortality than BMI, and it’s more important for reducing cardiovascular disease than losing weight. Lifestyle choices also have an equal impact on your health, such as smoking habits, the number of fruits and vegetables consumed and how many hours of sleep one gets.

I would much rather take some extra time at my doctor’s office to get a blood test and see my actual cholesterol levels than to assume I have high cholesterol because of my weight. My weight is not a reflection of my health.

Reach Audrey Weishaar at letters@collegian.com or on social media @RMCollegian.