Dr. Sayyada Mawji:
In today's world of social media and filters, we are constantly surrounded by images of perfectly slim models and influencers, by dieting fads, and by Apps promising to help us lose weight quickly. This is hurting us, our bodies, and our relationship with physical fitness and wellness.
How can we fix that relationship? First, we have to focus on the facts and clarify what really matters when it comes to our health. Spoiler Alert: it isn’t just your weight or body mass index (BMI). Once we put that to rest, it becomes easier to have healthier goals for our bodies that set us up for a long-term, sustainable fitness routine. It’s time to say goodbye to comparing yourself to others and to society’s unrealistic standards that don’t actually represent your health.Let’s define together how weight and BMI are used medically, what other factors matter to determine your body's health, and finally, land on some goals you can have to help you step away from hyper-fixating on your weight.
The Problem With Focusing on Your Weight and your BMI
In recent history, being slim and within a “good” weight range or BMI has been seen as a sign of good health, while being overweight has been immediately linked to unhealthy behaviors and disease. But this isn’t accurate.
What is the body mass index (BMI)?
The BMI is a calculation that uses your weight and height to work out if your weight falls within the “healthy weight” category. It is calculated by dividing an adult’s weight in kilograms by their height in meters squared.
In most adults, the healthy weight BMI range is between 18.5 - 24.9. Anything under 18.5 is classified as underweight and anything above 25 as overweight, with a BMI of more than 30 being within the obese range.
BMI can be helpful in certain contexts. For instance, we tend to use BMI rather than weight on its own, as weight by itself is relative. For example: a six-foot man and five-foot woman may be the same weight, but they’ll look and feel a lot different.
Why BMI isn’t Perfect
It’s important to note that obesity has been linked to serious health conditions like type 2 diabetes, heart disease, stroke, as well as some types of cancer, yet BMI definitions of obesity do not take into account what that weight is made up of - and this is important.
Your weight is made up of many factors including muscle mass, bone density, and further metrics of body composition such as visceral fat and subcutaneous fat. BMI also doesn’t account for gender or ethnic and racial differences.
What does this mean? Well, healthy, muscular athletes can have a BMI that appears to be in the overweight or obese category, while conversely those with little muscle mass and a “normal” weight to height ratio may have other underlying health conditions that aren’t healthy.
In fact, one study found that almost one in three people who had a healthy weight for their height based on their BMI, still had at least one risk factor for heart disease such as raised blood pressure, high levels of sugars, or high cholesterol. This was significantly higher in participants of other ethnic groups. The author concluded “that having a normal BMI does not necessarily protect an individual from cardiometabolic risk.”
Simply put? One can have a normal BMI and be unhealthy while one can have an “overweight” BMI, but be healthy. Furthermore, using BMI as a goal can even be complicated — if you’re just starting an exercise routine, chances are that you will lose fat and gain muscle. You may feel physically different in those first few weeks, though your weight and BMI might not reflect those changes - even if your body composition is healthier.
The BMI is a useful guide but more so at a population level rather than at an individual level. So if weight and BMI aren’t great indicators of health, what else is there?
What about measuring waist circumference, is this a more accurate indicator?
Waist circumference is a measure of fat around your middle and is a good indicator of visceral fat in your body (fat that cannot be seen and is wrapped around the organs). Visceral fat is particularly important as it directly relates to the risk of developing diabetes and has been linked to high cholesterol levels and high blood pressure. Yet even this indicator isn’t perfect.
What other indicators of health are important?
An individual's size and weight are something that we can immediately see. Because of this, we are quick to judge and form stereotypes about their health. Even though weight-related metrics such as BMI and waist circumference can be useful, weight alone is not a good indicator of health.
Therefore, it is important to be aware of other metrics of health that are not visually obvious to us such as blood pressure (ideally between 90/60mmHg and 120/80mmHg), cholesterol levels (aim for low LDL and high HDL), or your blood sugar.
Note: regular exercise can improve ALL of these parameters, keeping you healthy in the long run.
Remember too, that your genetics play a part. If you have a family history of heart disease, high blood pressure, cholesterol, or diabetes, it’s worth ensuring you’ve been checked out by your family physician. Knowing you have a family history can make fitness even more important - you can’t change your genetics but you can strive for a healthy lifestyle.
So exercising isn’t just about weight loss?
Exactly. Regular physical activity has multiple health benefits such as reducing the risk of a heart attack, type 2 diabetes, and some cancers. Fitness can also lower blood pressure, reduce cholesterol levels, improve bone and muscle health, and also impact mental health, making us feel happier and more energetic, leading to better mood and improved sleep.
Bone density is particularly important for women post-menopause as the bone density drops, leading to thinner more fragile bones (osteopenia or osteoporosis). Exercising helps to keep bones strong while also ensuring good muscle and tendon support to help avoid fractures.
It’s important to have a holistic approach
We often rely on certain methods to understand how well we are, but actually, wellness is a lot more complex. It relies upon both physical and mental wellbeing, as well as using some of the measures above to guide our health.
In a world where we’ve become obsessed with tracking our every moment through steps, hours of wakefulness, or calories eaten, it’s worth remembering that wellness is more than numbers.
We need to have a holistic and sustainable approach to our health and wellbeing. It shouldn’t be about one-off diets, extreme exercising, or weight loss to make us feel good just because society tells us that this is what we should look like. This is misleading and not an indication of good health.Instead, understand and listen to your own body, incorporate healthy lifestyle measures that you can maintain such as exercising regularly, eating a balanced diet, having a good work-rest balance, getting good quality sleep, avoiding unhealthy behaviors such as alcohol and smoking, and safeguarding your mental health - this will lead to a much healthier and happier version of yourself!
The New Fitness Goals
Because obesity can be detrimental to your health, losing weight could be a very legitimate goal for yourself. If you do decide along with your doctor that weight loss or moving into another BMI class is important to your health, remember that this is a long-term goal and must be achieved in a sustainable and healthy way. This might look like aiming to lose 2kg per month, and should also be combined with other healthy lifestyle goals.
In the meantime, consider other goals to focus on to help you stay motivated and to track your progress beyond weighing yourself too often or hyper-fixating on your body and your weight.
These are also great goals for anyone that wants to focus on their body’s progress without measuring or weighing themselves. I’ll provide a few sample goals to consider.
- Aim to increase how far you can run at a steady pace without stopping. Tap here for a Hybrid Training Journey that includes runs assigned by the Coach.
- Aim to move from an assisted version of an exercise, such as Knee Pushups to Pushups or even harder versions such as One-Handed Pushups.
- Aim to complete a challenging exercise you never thought you could do, like Pullups. The Coach’s Skill Progression feature is perfect for this and goal number 2.
- Pick a god workout to repeat once a month and take note of how much you improve your PB, or notice if you’re able to move on to more challenging gods. Freeletics’ most popular god is Athena. Take her on and set a reminder to try again later, or let the Coach do the thinking for you, as gods are assigned throughout your Training Journey for this exact purpose.
- Most importantly, how do you feel in yourself? Take note of how your energy levels or sleep patterns change when you workout and when you don’t. As you build a sustainable routine, do you notice positive changes that can help motivate you to continue?
Dr. Sayyada Mawji is a London-based family physician and health & wellbeing expert. She is passionate about increasing health awareness, with a special interest in women's health and mental health, and also works to tackle health misinformation online. Dr. Sayyada regularly contributes to national and international media outlets, is a TEDx speaker, and is a health expert panelist for Women's Health Magazine. Her health advocacy work has been recognized and she was the recipient of the Professional Woman Award 2021. Dr. Sayyada also has a keen passion for international aid work and is an avid traveler. Follow her on Instagram: @doctorsayyada
 Cardiometabolic Abnormalities Among Normal-Weight Persons From Five Racial/Ethnic Groups in the United States A Cross-sectional Analysis of Two Cohort Studies - Unjali P. Gujral, PhD, Eric Vittinghoff, PhD, Morgana Mongraw-Chaffin, PhD, Dhananjay Vaidya, PhD, Namratha R. Kandula, MD, MPH, Matthew Allison, MD, MPH, Jeffrey Carr, MD, Kiang Liu, PhD, K.M. Venkat Narayan, MD, Alka M. Kanaya, MD
 Do we need to think beyond BMI for estimating population-level health risks? Mark A. Green,