Diet & Weight Magazine

When is Weight a Symptom?

By Danceswithfat @danceswithfat

Bad DoctorI received a question from a reader that I want to address :

Is there a point at which you think that it’s reasonable to view a person’s weight as an outward symptom of a health issue? …I don’t ask because I want to get into someone else’s business, but only because I’m trying to make sense of it as representative of the human condition. …I realize that there is a wide range of normal human size, shape, height, weight, and so on…. but there must be a point at which a person’s appearance becomes a concern. BTW, that goes the other way as well; how do we tell when someone is naturally thin, and when they may be anorexic and need help.

First and foremost other people’s health isn’t our business unless they ask us to make it our business, (or it is legally our business and even then I think we should be cautious to take people’s choices into account when we consider what is in their best interest.)

I think that there are times when body size can be a symptom of a health issue – several health issues have unexplained weight changes (both increases and decreases) as a symptom.  There are some health issues that cause weight gain and make even the short-term weight loss that most people are able to achieve difficult.  There are some health issues that cause weight loss and/or make weight gain very difficult. There are some health issues that can lead people to be very fat or very thin.

Of course there is no shame in any body size, health issue, or combination thereof. If someone is experiencing one of the issues above and wants to explore it, I don’t think it’s a problem to take it into account within the picture of their health, to do any necessary tests and see if there is a medical issue etc.

There are, however, a bunch of ways that this can, and often does, go wrong – like when we consider body size a definitive diagnosis.  When body size as a symptom gets reinterpreted as body size as the medical issue and medical professionals “diagnose” people as fat “prescribe” a diet. When fat people with health issues are told to diet first and that they will be given actual interventions for their health issues after they’ve lost weight.  When we believe in Size Acceptance and/or practicing Health at Every Size unless someone is “really fat.” When we (especially health professionals) confuse our stereotypes and preconceived notions about people of a certain size with what is true.  When we treat thin people with a health issue by giving them interventions that are shown to help that health issue, but we treat fat people with the same health issue by giving them a diet.  When other symptoms are ignored, or take a back seat, because the health care practitioner focuses on body size to the exclusion of anything else. When we understand that long term weight loss does not meet the criteria for evidence-based medicine since it only works for a tiny fraction of people, but somehow think that magically changes if people are a certain size and suggest that those people should go ahead and diet.

So, in short,  if someone hasn’t asked you to be involved in their healthcare, then their body size and what it does or does not mean doesn’t have a thing to do with you, so if you’re looking for your beeswax, you’ll need to look somewhere else.

If someone has asked you to be involved in their healthcare (or if it’s your health we’re talking about) then, while there are situations where body size or changes thereof can be a symptom, I would be very cautious about foregone conclusions (ie: at your body size [insert health issue here] must be an issue) or trying to treat health issues by attempting to manipulate body size.

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