224 - The Myth That Thinness = Health

Thrive Beyond Size

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15d ago 36:06

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Michelle opens by naming the belief so many of us absorbed early: smaller bodies are healthier bodies. She walks through where that belief came from (BMI’s rise to medical dominance in the 1970s, the 1990s “obesity epidemic” framing) and why repetition isn’t truth. BMI was built for population averages, not diagnosis; over time it became a proxy for health that crowded out far more meaningful indicators.

From there, she unpacks the evidence in plain language. Large studies that account for key confounders—cardiorespiratory fitness, nutrition patterns, sleep, socioeconomic status, access to healthcare, and exposure to stigma—show that the apparent link between higher weight and poor health outcomes shrinks or disappears. Michelle discusses meta-analyses, how methodological choices shape conclusions, and why “overweight” ranges often sit at the lowest all-cause mortality risk in U-shaped curves. She also highlights research showing that weight cycling (losing and regaining) is independently harmful, while behaviours like not smoking, moderate alcohol intake, regular movement, and abundant fruit/veg intake improve outcomes regardless of weight.

A major throughline is weight stigma: shorter visits, misattributed symptoms, fewer screenings, delayed diagnoses, and avoidance of care. Stigma drives chronic stress, inflammation, and worse outcomes—and it hurts thinner patients, too, when clinicians assume thin = healthy and fail to screen. Michelle shares stories from the ER and a listener’s letter that shifted her practice away from weight-centric care.

The episode closes with a practical reframe: health is multidimensional—physical, mental, social, spiritual—and no single number (BMI, weight, waist) can capture it. A weight-inclusive approach centres what people can do and access today: nourishment, joyful movement, rest, stress care, connection, and equitable healthcare. Benefits accrue even if the scale never budges.

In this episode, you’ll hear:

How BMI became medicalized—and why it’s a poor stand-in for individual health.
Why correlation ≠ causation and how confounders change the story on weight and risk.
Evidence that behaviours and access matter more than body size for long-term outcomes.
The harms of weight stigma in clinics and beyond (and how it affects all sizes).
Why intentional weight loss doesn’t produce durable health benefits for most—and how weight cycling increases risk.
What a weight-inclusive care plan looks like in everyday life.

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