Does your doctor comment on your weight?

CurvyEmmy wrote: »

I gained 80 pounds in a year and a half so it was hard to ignore, but I’m so thankful my doctor didn’t call me “obese”. That word is very triggering and carries a lot of stigma. I am over 240 pounds now so I know that I am overweight at this point but “obese”
is a word that still feels very, very hard for me to accept and I definitely don’t identify myself with that label.

My previous doctor said I was “overweight” back when I was only 160 pounds which is a totally average weight for a 5’5” woman (most of my friends are in the 170s of 180s) and doesn’t seem big to me at all… I had an average fitness level and wasn’t too out of shape, so being labeled “overweight” was a big shock to me and just felt really, really unfair. I deserve better than being called “overweight” in a way that’s so insensitive to my feelings about it. Needless to say I changed doctors after that!

Everyone knows the BMI system is crap because it doesn’t account for muscle mass. A muscular woman could have a high BMI due to the muscle weight, but still have very low body fat, and BMI will classify her as “obese”. So yes, you can be “obese” according to BMI and be perfectly healthy. We need to be a lot more careful with words like “obese” because it can really hurt a person’s self-esteem and body image!

To really evaluate someone’s health you need to look at way more than just weight alone. But doctors are lazy and they throw around these very unfair labels of “overweight” and “obese” based on height/weight alone. Women are constantly judged and labeled based on a number on a scale that doesn’t tell you the whole story. It’s so unfair and really pisses me off!!

It's true that many people use BMI for purposes that it was not intended for. It is a population statistic that suggests that there is a weight range based on height where you either are or are not more likely to suffer health impacts from your mass. That doesn't mean it's "crap." It means it is misused sometimes.

There's now a "smart BMI" available that takes your age and gender into account. Typically, women have lower BMI numbers than men because of bone mass and muscle mass. When I realized this, I realized that having a goal weight mid-way through the healthy BMI range was maybe not the best goal. Aiming for 75% of the range was probably better (i.e., halfway between the midpoint and top of the healthy range). That would be a BMI of 23.3. My Smart BMI says I'm clearly in the healthy range as is. That puts me much closer to my goal than I think!

That said, BMI is just a number. It's not insensitive; it's just a number that describes a ratio. At 5' 5" and 160 pounds, you were in fact overweight, but only by about ten pounds by BMI. That fact may trigger some feelings and emotions, but that doesn't change the number. At 240 pounds, you are no longer obese; you are morbidly obese.

Fortunately you can do something about it. Since you're here now, it's good that you ARE doing something about it. I bet you start to feel physically better as you approach your goals. I know I did. You can do this. Just drop the idea that it is insensitive for a ratio to be the number that it is.

If you aren't a fan of BMI or Smart BMI, there are other methods of assessment. Two simple ones use a measuring tape. It uses the ratio of your hips to your waist. This method takes gender into account. There are a few interpretations of the health implications. A woman is considered obese if she has a waist to hip ratio over 0.80 or 0.85 depending on which interpretation you use. Another method is waist to height ratio. As a woman, a waist to height ratio over 0.58 is obese.

I don't love BMI as an indicator of individual health. I think it's a good population tool but for actual individuals smartbmi does it better.

That said I hate "average" as a ... measure or guideline in the US.

Average is something companies and businesses need to care about, but average does not mean not overweight, not obese, not fat.

When I was 190lbs at 5'5" I was about on par or smaller than all but a handful of people I knew. Because we were all fat. I'm now 136 and smaller than all but a few people I regularly see. Because they are (loved, cherished, important to me, wonderful people who's worth is not determined by their weight) overweight or obese. I am NOT objectively skinny.

The AVERAGE is a lousy, lousy, health metric.

especially lousy as a health metric when you're young or relatively young and using it in a 'everyone I know is this weight and healthy'. ...those percentages change as age increases. Young you have more physical... resilience than when you start stacking age on top of weight.

@CurvyEmmy

It is clear you don't understand how BMI works. It's objective, not subjective. There's no judgement. There's no shaming. There's objective measurements.

My hair used to be brown, and I used to have a lot more of it. It's an objective fact that I'm a middle-aged balding grey-haired human. Is that fair? No way. Is it true? I'm afraid so. Is there anything I can do about it? I could dye it, but... nah. I could get a rug, but... nah. Just wear a hat or use sunscreen up there.

If you do the calculation, the results are that you are morbidly obese. Does this present a higher risk of poor health outcomes? Yes it does. Is there anything you can do to reduce your mass? Yes, there is. Can you get your weight down to a "healthy" BMI? Only you know, and if you don't try you won't succeed. If you are happy in your body and you don't want to get to a healthy weight, that is your choice. It is your body. There is no shame in being happy with who you are. To claim that BMI is "broken" and that is "unfair" to "judge" you based on it is disingenuous. These statements are subjective. BMI, and other measures of health as relates to weight or size, ar objective. Claiming to not be obese with a BMI of 39.9 is like me claiming that this text is fuchsia and this text is chartreuse

Some people are truly outliers on BMI, but it is a small number. Have you done the hip:waist or hip:height measurements? Those are other assessment methods. What are your results? Have you had your body fat percentage reliably measured because you are correct, we can only guess based on what you've written.

Average is somewhat irrelevant in this context. Even if we dial in what average we're referring to (median, mean, mode), it's still not relevant. You probably don't consider yourself tall. The average woman in the US is an inch shorter than you, so does that make you tall? Actually it might, but not by much. Bad example. Because some people don't have two arms, the "average" (mean) number of arms on a human is less than two. Does that mean I have an abnormally large number of arms? Nope. The median and mode for number of arms is two, so I am normal by those measures. The term "normal" can be misleading. Statistically, since 69% of American people are overweight or obese (with more obese than "just" overweight), being overweight is "normal." It is not healthy.

I wish you success with your goals. I sincerely hope you can step back and recognize there's no judgement here, just factual information. People here will support you on your journey, but you have to recognize that you don't get to make up facts that aren't true. Well, you can, but they're not facts and they're not true.

I sincerely wish you success in ALL your endeavors.

I.

I think this thread, and the last bit of it in particular, really sort of highlights what one of the many problems we have is.

Size is not an identity (or, well I suppose some plus sized/health at every size influencers have made it one, but that's not a good thing)

Obesity is not an insult or a slur. It's just not. It's an objective - not subjective - thing.

Obesity is a medical condition/state/term.

Identity is who you are. Inside. Not what you LOOK LIKE, or how heavy you are. That's sort of part of why your weight should not determine how people treat you and why people ACTUALLY being awful to someone based on their weight is *kitten*.

When you make how big you are your identity, and resist a medical classification of a medical issue, you're in for a really bad time