If you’ve been paying attention to health news recently, you may have noticed a subtle but real shift in the way society discusses body weight. It started about 10 years ago with the body positivity movement, the idea that we should love our bodies at any size. But around that time, the American Medical Association also classified obesity as a disease. The medical community was divided, with some believing the classification would help reduce stigma while others argued that it pathologized larger bodies.
These transformational changes picked up speed with the arrival of powerful and wildly popular new medications that have already helped many people shed pounds.
We on the “Chasing Life” podcast team think it’s the perfect time to try to sort through some of these medical and cultural threads. That’s why we’re turning the spotlight on body weight in the coming season. For those listeners who, like me, really love the brain, there will be plenty here for you too, as the brain and body are forever linked.
We’re not going to reveal the secret to losing weight “with one weird trick” or even tell you that you should necessarily shed pounds. In fact, our very first episode explores the real link between weight and health. I spoke to Dr. Fatima Cody Stanford, an obesity medicine specialist at Massachusetts General Hospital and an associate professor at Harvard Medical School, about what our weight does and does not tell us about our health — and what she said might surprise you.
Beyond health care dollars
Despite changing attitudes about larger bodies, excess weight does carry a price.
From a health care standpoint, it costs the country a lot of money. According to a study published in the journal The Lancet in 2020, 27% of total health care expenditures in 2016 — about $730.4 billion — could be attributed to “modifiable risk factors” for preventable health conditions like cardiovascular disease. And high body mass index topped the list of those risk factors. It was responsible for nearly a third of that sum: $238.5 billion.
That was eight years ago, when our total health care expenditure was $2.7 trillion, according to the study. But health expenditures have only gotten larger: They grew by more than a trillion dollars between 2016 and 2022, when they hit $4.5 trillion, according to the National Health Expenditure Accounts. Without throwing even more numbers at you, I think we can safely say we are paying a lot of money for health care ultimately caused by excess weight.
But beyond the health care costs to society, there are real costs for individuals in terms of well-being, both physical and mental – and you can’t really put a price tag on that.
Almost 3 in 4 Americans 20 and older are classified as overweight or obese. But weight stigma is widespread, and our culture is steeped in blame and shame when it comes to weight.
It creates relentless pressure on hundreds of millions of people to slim down, exercise more and conform to certain beauty standards that are hard for many to approximate, let alone achieve on an enduring basis. They’re admonished to “get healthy,” which is often code for “lose weight.”
All the blood, sweat and tears do not even take into account the fact that the system we use to categorize people, body mass index, is flawed in the first place.
When Belgian mathematician, statistician and astronomer Adolphe Quetelet developed the formula (weight in kilograms divided by height in meters squared equals BMI) in the 1830s, he was trying to figure out, statistically speaking, the size of an “average man.” And by that I mean average European male in the 1830s.
