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Healthy At All Sizes is BullSh*t
Breaking Down The Optimal Size and Weight For Health
Most of us here know that the “Healthy At All Sizes” narrative is a complete myth and is extremely harmful as an ideology to be accepted as true.
It’s harmful because being overweight is detrimental to our health and takes years off of our lives. Instead of addressing this as an issue people need to fix to literally save their lives, this gives them a reason to be complacent and die a slow death.
We are also going to touch on what is “too big” in terms of muscle mass, then we will get into what the optimal size for someone to maintain in their life is to ensure we’re maximizing both physique and longevity.
Unhealthy At Certain Sizes
We have a range of weight that is both healthy on the metabolic level and isn’t detrimental on our joints.
How this range works will depend on many factors like gender, age, bone structure, height, and the amount of muscle mass we carry.
The last one is especially important because muscle is very metabolically healthy and active meaning we burn more calories throughout the day in maintenance of the muscle. Muscle mass also implies we lift which means our joints, tendons, and ligaments will also grow stronger through progressive overload.
Muscle mass also improves insulin sensitivity, which is how well our bodies utilize insulin. The better the sensitivity, the healthier we are. This is very indicative of total metabolic health.
I’m not talking about muscle mass here because I’m some meathead that thinks muscle mass is the most important thing in the world - I say this because it GREATLY influences what our healthy size is.
We can weigh very little and actually be unhealthy due to body composition; things like “skinny fat” can actually put our health in a very compromised position even though our BMI might say we’re healthy—weight is largely just a number.
Of course health is going to come down to many more factors than just weight and size. A man can be the perfect size, but if he drinks all the time, eats junk food, and never does cardio, he will largely have the same health risks as the obese person.
But think about it for a second - someone would have to live a completely degenerate lifestyle from a health standpoint to cause the same risks as obesity if they are a healthy size.
Now think of the overweight people who partake in these activities as well, and likely more prevalent (a person who cares about their health and thus is a healthy size is going to be less likely to engage in these behaviors—source: common sense).
Chart: Estimated Body Fat Percentage Sizes
Body fat percentage is a much better metric of a healthy size as a male over 15% is overweight. Sure some resources might say this is healthy or even athletic, but the truth is above 15% we start to run into issues like hormone disruption e.g. an increase in aromatase—an enzyme that converts testosterone into estrogen, and it lives in fat tissue.
When we start to climb even higher in body fat percentage, problems start to multiply. As we start to reach obesity body fat percentages, our risk for chronic diseases including type 2 diabetes, hypertension, several cancers, gallbladder disease, coronary artery disease, and stroke increase greatly.
Risk Factors Of Obesity (Source Harvard School Of Public Health)
Obesity and Diabetes:
Compared with men and women in the normal weight range (BMI lower than 25), men with BMIs of 30 or higher had a sevenfold higher risk of developing type 2 diabetes, and women with BMIs of 30 or higher had a 12-fold higher risk. 1
Obesity and Cardiovascular Death
Women with BMIs of 30 or higher had a 62 percent greater risk of dying early from CAD and also had a 53 percent higher risk of dying early from any type of cardiovascular disease, compared with women who had BMIs in the normal range (18.5 to 24.9). Men with BMIs of 30 or higher had similarly elevated risks. 2
Obesity and Cancer
In an exhaustive review of the data, released in 2007, an expert panel assembled by the World Cancer Research Fund and the American Institute for Cancer Research concluded that there was convincing evidence of an association between obesity and cancers of the esophagus, pancreas, colon and rectum, breast, endometrium, and kidney, and a probable association between obesity and gallbladder cancer. 3
Obesity and Lung Function
Excess weight impairs respiratory function via mechanical and metabolic pathways. The accumulation of abdominal fat, for example, may limit the descent of the diaphragm, and in turn, lung expansion, while the accumulation of visceral fat can reduce the flexibility of the chest wall, sap respiratory muscle strength, and narrow airways in the lungs. 4
Obesity and Mortality
increasing weight increases the risks of dying from cardiovascular disease, cancer, and other causes. In a 14-year study of a million-person cohort, researchers restricted their analyses to initially healthy nonsmokers. The risk of death from all causes, cardiovascular disease, cancer, or other diseases increased as BMI increased above the healthiest range of 23.5 to 24.9 in men and 22.0 to 23.4 in women. 5
Obesity and Muscular
Osteoarthritis of the knee and hip are both positively associated with obesity, and obese patients account for one-third of all joint replacement operations. 6
Obesity and Depression
New evidence confirms that the relationship between obesity and depression may be a two-way street: A meta-analysis of 15 long-term studies that followed 58,000 participants for up to 28 years found that people who were obese at the start of the study had a 55 percent higher risk of developing depression by the end of the follow-up period 7
I have listed literally just a small portion of the risk factors to try to destroy the myth that we can be “healthy as all sizes”. It’s simply detrimental to your health. Period.
Simply put we CANNOT achieve even remotely good health if we are obese and we will be NO WHERE NEAR optimal health even if we are overweight.
We have to look at things like chronic inflammation (obesity causes this), insulin resistance (diabetes), things like visceral fat (linked to cancers), cancers itself, arterial plaque, honestly this list could go on.
There is no benefit to excess body fat except the rare chance that you can live longer if the whole world was to run out of food right now.
Something concerning when you google “unhealthy body fat percentage” is the articles that pop up and that are addressing low body fat percentages. I can promise you, most americans are not dealing with being “too lean”—the issue is the obesity pandemic.
Why Google hides these results, I don’t know, but we can all agree that while being too lean poses issues, this is much more rare than the inverse of having too much fat.
The truth is, as we start to creep into the 20%+ body fat range, we are causing massive stress on our body and eliminating the change for “optimal health” or I’d argue being healthy at all.
Now addressing the inverse, below around 8% body fat, males will run into issues like: Cognitive Issues, low blood pressure, lower testosterone, fatigue, mood problems, digestive issues, etc.
So we do have levels of unhealthy body fat in the direction of not having enough body fat, but again much more rare, yet still an issue for some.
As mentioned above, we can weigh very little and still be considered unhealthy due to our individual body composition.
Too Much Muscle Mass
We can also be “too big” in terms of muscle mass—however, this number is going to be very hard to hit for 99.9999% of people without taking anabolic steroids and other exogenous compounds.
Generally, our “Genetic Limit”—the maximum size that our body can get to naturally— will be healthy to maintain as we age. We will naturally lose some muscle as we grow older and having the mass in the first place can help reduce risk for chronic illness, help us age, and fight gravity better.
What Is The Healthy Size
Pinpointing a number that is healthy for you is largely going to be very individualized and dependent on a multitude of factors; however, we can give a rough spectrum of where optimal health is possible and even likely.
Ideally, a male can weigh all the way up to his Max Genetic Potential in terms of muscle mass and hold around 9-12% body fat while also being in the zone of optimal health, solely from a weight/size metric.
We can use a BMI calculator; however, this is going to list most of us who lift weights and have decent amounts of muscle mass as “overweight” or even “obese”. This is still generally useful if you’re not particularly muscular.
If your BMI is between 18.5 and 24.9, you're considered normal or “healthy”
and if your BMI is between 25 and 29.9, you're considered “overweight”.
A BMI of 30 or more is classified as “obese”.
However, the healthiest BMI actually may be considered “overweight” as the BMI that is associated with lowest risk of death is from 23.7 to 27.
So again, we have to use common sense and think that if someone has a 27 BMI, is pure muscle at around 10% body fat, eats a clean diet, does cardio, and their bloodwork is pristine - it is very safe to assume they are a healthy individual.
Another metric is Hip-To-Waist Ratio (WHR). This is simply a measurement that compares waist size to hip size, which can be a decent predictor of general health from a body composition standpoint.
To calculate their WHR, a person should measure around their waist at the narrowest part, usually just above the belly button. They can then divide this measurement by the width of their hip at its widest part.
The Low Risk Category is below .9 Males; below .8 Females
The Moderate Risk Category is .9-.99 Males; .8-.89 Females
The High Risk Category is 1 or greater Males; over .9 Females
The higher this ratio, the greater the risks associated with obesity and being overweight in general. However, as with BMI this can also be skewed based on factors like genetics.
Realistically, instead of listing absolutely every height and weight a person should be depending on the numerous varying factors, we can make the general assumption:
If you have optimal body fat levels, 9-12%, your BMI does not exceed 30 (maybe 35 in extreme cases, but muscle can also be taxing on the heart if it’s in excess), and a WHR of below .9 you are more than likely at a healthy size for a male.
As we can see there is no “Healthy At All Sizes”, we clearly have numbers and specific weights that are indicative of good health, and sizes which are completely detrimental to our health and wellbeing.
My “exceptions to this” comments DO NOT apply to people who are obese, no matter how you might misconstrue this. In no way, shape, or form is obesity EVER going to be a sign of good health. Quite the contrary, it means our risk of chronic illness, numerous health issues, and early mortality are MUCH higher.
Now, reality check. If this is you and you are overweight or obese, do NOT get down on yourself - make the conscious decision that you will make the change.
There are so many resources on this substack both free and paid that can completely change your life and eliminate your risk factors.
Life is exponentially better when you are healthy and fit, and you deserve it for yourself, to your friends, and to your families.
The New Year is coming and you owe it to yourself. If you’re already healthy or on your way to being healthy, keep on keeping on. Let’s make this New Year our best year.
Have A Merry Christmas (talk to you paid subscribers on Christmas),
This is not Legal, Medical, or Financial advice. Please consult a medical professional before starting any workout program, diet plan, or supplement protocol. These are opinions from a Cartoon Ox.
Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis.BMC Public Health. 2009; 9:88.
McGee DL. Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies.Ann Epidemiol. 2005; 15:8797.
American Institute for Cancer Research, World Cancer Research Fund. Food, nutrition, physical activity and the prevention of cancer. Washington, D.C.:American Institute for Cancer Research; 2007.
McClean KM, Kee F, Young IS, Elborn JS. Obesity and the lung: 1. Epidemiology.Thorax. 2008; 63:64954.
Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW, Jr. Body-mass index and mortality in a prospective cohort of U.S. adults.N Engl J Med. 1999; 341:1097105.
Anandacoomarasamy A, Caterson I, Sambrook P, Fransen M, March L. The impact of obesity on the musculoskeletal system.Int J Obes (Lond). 2008; 32:21122.