“Wow, you lost so much weight! You look great!”
“Wow, the pandemic really took a toll on you, huh? You’ve gotten big”
“Tell me your dieting secrets… you look so skinny!”
“Listen, I’m only telling you this because I care about your health. You’ve gained a lot of weight.”
These are all comments that I hear all too often told to friends, family, clients and strangers. Maybe you’ve heard it before, but I’ll say it again. It’s not okay.
It makes sense for you to worry about someone’s health if they have gained weight. After all, we’ve been told again and again in the media that being overweight is associated with negative health outcomes. However, more and more research is coming out showing that you can be healthy at any size. Now, this doesn’t mean that you are healthy at any size. But, you can be – and thus you should not be worrying about anyone’s weight unless you know the story behind it. Even so, the comment probably won’t be helpful.
To demonstrate the concept of “health at every size,” a 2016 study aimed to examine cardiometabolic health based on BMI categories (normal weight, overweight, obese). Participants (40,000 of them) were individuals aged 18+ in the nationally representative 2005-2012 National Health and Nutrition Examination Survey. Using their blood pressure, triglyceride, cholesterol, glucose, insulin resistance and C-reactive protein data, the authors reviewed their cardiometabolic health.. What they found was that nearly half of overweight individuals, 29% of obese individuals and even 16% of obesity type 2/3 individuals were metabolically healthy. And, over 30% of normal weight individuals were cardiometabolically unhealthy. This shows that you cannot judge a person’s health by their weight!
Another study reviewed the association between healthy lifestyle habits
and mortality rate, depending on BMI. Habits included eating >5 portions of fruits and vegetables per day, exercising >12 times a month, low to moderate consumption of alcohol and being a non-smoker. Using a sample size of 11,761 participants, they found that with the adoption of more habits, mortality was reduced in all BMI categories. And, with all four habits, there was no difference in mortality across BMI categories. This means that regardless of weight, healthy habits will make you live longer (and someone at a heavier weight will live as long – or longer than- someone at a lower weight).
The studies that correlate weight with health problems are just that- correlations. Correlations are not the same as causality. These studies cannot show cause and effect because there are so many confounding factors. For example, if we look at yellow teeth and lung cancer, we can say that there’s a correlation between the two, but not causation. If we looked at confounding factors, we’d know that it’s the smoking that causes yellow teeth and lung cancer.
In the health and weight example, what are the confounding factors? What caused the higher weight that was associated with the health problem? Was it diet and exercise? Was it determined by social determinants of health? Was it caused by discrimination regarding weight? Was it the health problem itself that can cause weight gain?
Stressful times & the pandemic
Now, it’s true that weight gain may reflect some less healthy behaviours, like becoming more sedentary, or eating less nutrient dense foods more often than usual. But we have to realize that first of all, it’s normal for this to happen in periods of stress. Second of all, the weight gain is likely also associated to that stress.
Take the pandemic for example. Some people have had to quarantine (sometimes, multiple times) for 10-14 days in isolation (hello, 500 steps a day). Gyms have been closed for a big part of the past two years, and sports have been cancelled. There have been multiple curfews. There’s a lot more time at home, and there has been a lot more boredom. Most importantly, we have been feeling isolated. These changes leave less room for healthy behaviours and certainly leave more room for stress, which is likely the biggest player in weight gain.
During stress the body goes into a “flight or fight” response, releasing stress hormones like cortisol. This hormone works to mobilize energy stores so that the energy demand can be met (your body thinks you’re about to run from a bear) and thus deal with the stressor. During stressful times, our bodies are pumping out cortisol almost constantly. Meaning, our cells are constantly being starved of energy and are thus energy-hungry. So, our body keeps sending our brains hunger signals… which can lead to overeating. To add to that, cortisol has been shown to increase cravings for high-calorie foods specifically. A more detailed list of cortisol’s effects can be found in this article by Todays Dietitian.
Won’t a comment on weight be motivating?
In most cases, it’ll just make someone feel bad and more self-conscious. If they’ve gained or lost a significant amount of weight, trust me, they know.
“There is a misconception that sometimes a little bit of stigma is necessary to motivate people to lose weight,” says Rebecca Pearl, PhD, assistant professor of psychology in psychiatry at the University of Pennsylvania’s Perelman School of Medicine. “But time and time again, research shows that this is just not the case.” For example, Pearl conducted a study that found that overweight women who believe negative messages about their bodies are at greater risk for heart disease, diabetes and metabolic syndrome than those who maintain a more positive body image.
Another study on the same subject showed that greater weight bias internalization predicted lower core self-evaluation (an essential evaluation “of one's worthiness, effectiveness, and capability as a person), which in turn predicted greater depression and anxiety, lower global health, and greater health care utilization.
You’re likely saying that they look better at a lower weight.
If you’re saying “wow, you look so good! You lost weight, right?”, it translates to them that they didn’t look as good when they were at a higher weight – and you’re putting pressure on them to stay at this new weight. Or, if you’re saying “wow, you’ve really let things go, huh?” to comment on a person’s weight gain, the negative connotation tells them that they don’t look so good. And people internalize that, man!
You don’t know where the weight gain or weight loss has come from.
It may be from an eating disorder, depression, anxiety, a break up, an illness, etc. If you’re complimenting them for weight loss, you may be complimenting depression. If you’re commenting on their weight gain, you may make them feel even worse about what’s really going on.
In conclusion, don’t comment on people’s weight. You never know the effects that your comment may have, so it’s best to keep it to yourself. Find something else to compliment them on, or something else to give them advice on (if they want it, that is)!