(CNN) — Accepting your body as it is and going off all diets may sound great, but would doing so harm your health?
Ads, pop culture, and even doctors can talk about health and weight as if they’re the same thing: smaller bodies are healthier, and larger bodies shouldn’t be healthy.
But neither health nor bodies are so simple and uniform, and health can vary from person to person, he says. Jeanette Thompson-Wessen, UK nutritionist whose focus is not on weight loss.
A higher body mass index (BMI) is associated with conditions such as diabetes and heart disease, said Philipp Scherer, professor of internal medicine and director of the Touchstone Diabetes Center at the University of Texas Southwestern Medical Center. However, BMI is a controversial way of measuring health, and it’s just one of many factors associated with changes in a person’s well-being, according to Dr. Asher Larmie, a UK general practitioner and activist.
Medical care, the environment, social circumstances and biology make up the majority of factors that determine our health, according to the Healthy People 2020 of the Office of Disease Prevention and Health Promotion.
Still, we often give a lot of weight to a person’s appearance when assessing their health, says Shana Minei Spence, a registered dietitian in New York. And even if we learn to throw off the burden of societal beauty standards, it can be hard to be confident in your body if you consider your size to be unhealthy.
Experts say it may be time to untangle health and weight and focus more on behaviors that promote our health than the number on the scale.
Correlation versus causation
It’s important to understand that studies pointing to dire health outcomes for people with higher body fat may only point to correlation, not causation, Larmie said, adding that while studies may say that people with higher weight tend to have more cases of heart disease, they cannot indicate that weight causes heart problems.
But the importance of those studies shouldn’t be discounted, Scherer said. The correlations are strong, and “from a physiological perspective, we work with correlations in the clinic,” she said.
However, according to Scherer, other factors, such as access to health care, could still be at play.
And for people with larger bodies, it can be hard to find good medical care, said Bri Campos, a Paramus, New Jersey-based body image coach.
It’s not just your customers who are afraid to go to the doctor. Although he educates people about his body image and mental health, Campos is often afraid to go to the doctor for fear he will be embarrassed by his weight, he says.
“I can go for strep throat, I can go for a rash,” Campos said.
“Because of my body size, it’s very unlikely that I’ll be able to go to the doctor and get an actual diagnosis other than ‘I should probably lose weight.'”
Bodies are not business cards
Spence likes to remind his clients: Bodies are not business cards.
We can’t take a look at a person’s body and get an idea of their health, their habits or their biology, he said.
“Do we have access to someone’s medical records? Are we talking to their doctor?” Spence said. “And oftentimes, health is honestly out of our control at times. There are so many chronic diseases that people just develop.”
Although we can see correlations between body size and health conditions on a large scale, once researchers look at individuals, it’s not that clear cut, Scherer said.
“The field at large really accepts that not everyone who has a BMI that high is type 2 diabetic,” he said.
People with smaller bodies can develop heart disease or diabetes, and there are plenty of people with larger bodies who are considered completely metabolically healthy, according to Scherer.
“It’s just a reflection of our genetic heterogeneity and how we deal with excess calories,” he added.
Does dieting make us healthier?
What does it mean to be healthy anyway? Can diet help you get there?
That depends on which parts of health you prioritize.
Health is made up of many factors. Avoiding illness is one, but so is maintaining mental health, maintaining active social habits, getting enough sleep and reducing stress, Spence said.
Restricting calories or eliminating certain foods may not be healthy overall if it negatively impacts mental health or prevents you from enjoying time with friends and family, she added. And sometimes those restrictions can cause you to lose weight without properly nourishing your body.
“Weight loss doesn’t equal happiness, and it doesn’t mean you’ll necessarily be healthy because the way you lose weight can also be detrimental to your health,” Spence explained.
For most people, restrictive diets with the intention of losing weight don’t work. More than 80% of people who lost weight gained it back within five years, according to a 2018 study.
If our phones didn’t work the way they were designed so often, most people wouldn’t be using them anymore, Campos said.
“But the diet culture has done a very good job of fooling us that you can get everything you’ve ever wanted. You’ll get health, you’ll get fit, you’ll get accolades,” he added.
If not losing weight, what do we focus on if we want to be healthy? Focus on health-promoting behaviors like quitting smoking, moving more, sleeping better, stressing less and eating the foods your body tells you it needs, Larmie said.
You may lose weight as a result, but that’s not the goal, they added.
“By not focusing on weight, that means we can really focus on some really healthy behaviors that are much more sustainable,” Thompson-Wessen said.