When we look at someone, we often make assumptions about their health based on their size. Many people automatically equate being thin with being healthy, while others assume that carrying extra weight automatically means poor health. The reality is much more complex.
In North America, there is a significant obesity problem, and many chronic diseases are linked to sedentary lifestyles and diets high in ultra-processed, calorie-dense foods. Excess body fat, particularly when it reaches obesity levels, increases the risk of conditions such as type 2 diabetes, heart disease, and certain cancers.
However, the opposite extreme isn’t healthy either.
Take South Korea as an example, where being very thin is often considered the beauty standard. The pressure to stay lean can be so strong that many people focus more on the number on the scale than on overall health. What is often overlooked is that a person can appear slim while still carrying unhealthy amounts of visceral fat—the dangerous fat stored around the organs. Unlike subcutaneous fat, which sits under the skin, visceral fat is strongly associated with insulin resistance, type 2 diabetes, heart disease, and other metabolic conditions.
Research shows that many Asian populations are genetically predisposed to store visceral fat at lower body weights due to a lower capacity to safely store fat under the skin. This means health risks can develop at lower BMI levels than in other populations, which is why the World Health Organization recommends lower BMI cutoffs for some Asian populations.
At the same time, BMI alone doesn’t tell the whole story. It doesn’t distinguish between muscle and fat, nor does it tell us where fat is stored. Social standards and personal feelings about body image can also cloud our understanding of health. Whether its body positivity being used to justify unhealthy habits or extreme pressure to stay thin at all costs, both approaches can become harmful.
Health is not about being as skinny as possible, and it is not about pretending excess body fat doesn’t matter. Being too thin, lacking muscle mass, undernourished, or carrying excessive visceral fat can all negatively affect health and longevity.
Instead of focusing solely on body weight, we should pay attention to factors such as lean body mass, body fat percentage, fat distribution, strength, fitness levels, blood markers, energy, and overall quality of life. These provide a much clearer picture of health than a number on a scale.
Somewhere along the way, we’ve made health far more complicated than it needs to be. The basics haven’t changed: eat mostly whole foods, stay physically active, maintain muscle mass, get adequate sleep, and cultivate strong social connections. These habits support long-term health regardless of whether the pressure is to be thinner or to ignore excess weight altogether.
Health is not found at either extreme. The goal is not to be as skinny as possible or to justify obesity. The goal is to build a strong, capable body with a healthy amount of muscle and body fat that allows you to live a long, active, and fulfilling life.
• https://pmc.ncbi.nlm.nih.gov/articles/PMC10454074/
• https://pmc.ncbi.nlm.nih.gov/articles/PMC8277596/
Mikkie Nettles-Pollon, Certified Personal Trainer/Holistic & Sports Nutritionist
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