Weight, Health, and Weight Stigma

  • Young men's version of this guide

If your health care provider (HCP) told you that your weight or BMI falls in the “overweight” or “obese” range you may be experiencing a variety of emotions. It is important to keep in mind that while a weight classified in the overweight or obesity category has been associated with some health concerns, the risk of health problems decreases as a person makes lifestyle changes to become healthier. Even if your weight doesn’t decrease, there are changes you make to improve your health. It’s also important to remember that having a positive body image is more important than any number on a scale. Focus on the parts of you that you love and that make you special.

How do I know if my weight is classified as overweight or obese?

Health care providers use something called Body Mass Index (BMI) to categorize overweight and obesity. BMI is a tool that shows a ratio (or comparison) of height to weight and can be used to estimate body fat. However, BMI doesn’t always accurately estimate body fat and it shouldn’t be used to determine how healthy a person is. If you are under the age of 19, your BMI is plotted onto a growth chart. Whether your weight falls into the “underweight,” “normal weight,” “overweight” or “obese” category depends on where your BMI falls on the growth chart. While categories have been given these names, the term “normal” does not necessarily reflect what a “normal weight” should be for each individual.

  • BMI percentile <5th: underweight
  • BMI percentile 5th-85th: normal weight
  • BMI percentile 85th-95th: overweight
  • BMI percentile >95th: obese

If you are over the age of 19, your BMI classification is based simply on the number:

  • BMI <18.5 kg/m2: underweight
  • BMI 18.6-24.9 kg/m2: normal weight
  • BMI 25-29.9 kg/m2: overweight
  • BMI >30 kg/m2: obese

BMI is calculated using this equation:

Weight (in pounds) x 703 divided by Height (in inches) squared

If you are under 19 and want to know your BMI percentile, you’ll need to ask your health care provider to look at your growth chart. Remember, BMI is not a perfect tool. Even if your BMI places you into a category other than “normal”, ask your doctor if you need to make any lifestyle changes for your overall health. A health care provider will first assess your weight history, activity level, diet, sleep, mental health, family history and body composition (such as how muscular you are) before they decide if you could benefit from any changes.

What is weight stigma?

Weight stigma, also called weight bias, is prejudice and discrimination based on body weight, often against those who live in larger bodies. Weight stigma commonly results in lack of opportunities in education, employment, and healthcare. There are severe psychological and physical impacts of weight bias such as depression, lack of motivation to engage in physical activity, increased stress, and increased pain.

People might discriminate against someone because they believe that weight is a choice.  This thinking follows common misconceptions that individuals living in larger bodies eat more, eat unhealthy foods, and aren’t active. Some people think that if they just eat less and exercise more they would lose weight. However, this isn’t necessarily true. Diversity among body sizes is similar to any other personal trait such as eye color or hair and higher weight does not equal poor choices or unhealthy behaviors.

Is it unhealthy to have a BMI classification of overweight or obesity?

While it was previously believed that having weight in the range classified as overweight or obese increased risk of some health concerns or diseases, more recent research has illustrated that health behaviors, not weight status, are a better representative of your risk for disease. When we don’t take care of ourselves (both our mind and body) we can see negative health outcomes in the form of issues such as:

  • Type 2 diabetes
  • Asthma
  • Sleep apnea
  • Hypertension
  • High blood pressure
  • Cardiovascular disease
  • Joint pain
  • High cholesterol and/or triglycerides
  • Fatty liver disease
  • Metabolic syndrome

These health concerns don’t always affect someone as a teen, but without healthy behaviors a person may be more likely to have them as an adult. There is increasing awareness that people can be healthy at any size or weight; however, health care providers are encouraged to screen patients for possible future problems that might be able to be prevented with early intervention.

What factors contribute to weight?

Studies have shown that weight is closely tied to genetics (your parents or other family members) as well as individual metabolism (how quickly your body turns food into energy),  environmental factors, health disparities, adverse childhood events, hormones such as ghrelin and leptin which regulate appetite, and diet and exercise. There is nothing that you can do to change your genetics (the genes or body blueprint that you inherit from your parents) or some other factors that affect weight. But if you are interested in making lifestyle changes in order to improve your health such as getting more exercise, eating healthier food, getting more sleep or making healthier drink choices, talk to your health care provider to set goals around what feels comfortable and helpful for you.

My health care provider (HCP) told me to lose weight, what should I do?

If your HCP told you that your health would be improved by losing weight, tell your HCP if you would prefer not to talk about weight and instead ask how you can make changes to benefit your health regardless of weight status. Studies have shown that dieting and other attempts to lose weight are often unsustainable. Dieting can lead to short term weight loss, but often once a person stops the diet their weight returns to the same – or even higher than it was prior to dieting. If you are wanting to make lifestyle changes but aren’t sure where to start, you can ask your HCP for a referral to an exercise program and/or an appointment with a registered dietitian. These are some examples of small changes can make a big difference in your health:

  • Stay Hydrated.  Water and seltzer can be a great way to keep you hydrated throughout the day.
  • Eat breakfast. Starting your day with a nutritious meal will prevent you from getting too hungry during the day and will give you energy to think at school.
  • Pack a snack. Eating snacks that are made up of a protein (dairy, legumes, nuts, cheese, meat) with a fiber (fruit, vegetables, whole grains) can be helpful in fueling the body for longer.
  • Eat more whole grains. Choose whole grain bread, whole grain pasta, brown rice, and high-fiber cereals.
  • Choose lean proteins. Chicken, turkey, fish and vegetarian sources of protein, such as beans and tofu.
  • Eat more servings of fruit and/or vegetables. Aim to include one or both at most meals and for snacks.
  • Pay attention to your hunger and fullness cues. We are often taught to follow external cues around food but it’s actually more important to check in with yourself. Do you feel hungry? Do you feel full? Are you satisfied?
  • Here are some ways to fit exercise into your day:
  • Take the stairs instead of the elevator
  • Walk instead of taking the bus
  • Join a sports team or a dance team
  • Go for a walk with your family or friends
  • Dance to music
  • Join a gym
  • Play with your friends

If you’re feeling overwhelmed by the idea of making changes to your eating habits and/or physical activity, remember: you are not alone. There are hundreds of thousands of teens dealing with this issue and plenty of resources and support. Don’t be afraid to reach out to your health care provider to ask what resources are available to you such as: support groups of peers your age, discounted gym memberships, or meeting individually with a counselor or dietitian to address things like emotional eating, body image, and establishing a healthy relationship with food and your body.