I was following a thread on a weight-loss forum and came across a post from a woman who is 5’7" and 320 lbs. This equates to a BMI of over 50 :eek: which is morbidly obese. Here is a comment from her post:
“To be at my “ideal” weight as my doctor calls it, based on my bone structure, which is quite large, is 180. When I was 220 about 12 years ago, before my first son, I was healthy and fit and looked great, not fat, but just right. I like being on the thick side In the 100’s, I just looked too thin.”
First, I find it hard to believe that her doctor says that 180 lbs is an “ideal weight” for a woman only 5’7". Sure enough, I ran the numbers through the ideal weight calculator at fitday.com and it indicates that the range of healthy weight for a woman 5’7": 118 to 159 lbs. That still seems a little off, I don’t know many 5’7" women who would not look fat at 159 lbs.
Anyway, what really stood out to me was her comment/belief that she would look “too thin” “in the 100’s”, which I took to mean anything below 200 lbs. Here’s my question: Is this just self-delusion/denial or is there really a segment of the population who has this very skewed view of fat vs thin? Almost the opposite of anorexics, who can look at their skeletal body in the mirror and honestly believe they look fat?
I had a roommate who was about 5’10" and easily 350-400 pounds. He went to the doctor and the first thing he said when he got back was, “the doctor said I’m healthy! My liver and lungs are fine!”
I’d imagine there are a lot of polite doctors, and lots of selective hearing going on.
This blog post from the New York Times discusses a recent article from the Archives of Internal Medicine saying that some people who are obese are healthy metabolically (blood pressure, cholesterol, glucose levels, etc.) while others who are thin are unhealthy metabolically. So it’s not so simple.
I don’t think there’s a significant difference in those two positions. Anyone who is 5’7" and over 200 lbs is heavy - fat. They are self-delsional and/or in denial if they think they look thin. We have a very generally accepted definition of thin and fat, and there’s no way that such a body shape could be considered thin. Someone who says that is kidding themselves. “I just looked too thin” no doubt means that “I like the way I look heavier.” It doesn’t mean that she thinks she is thin at that weight.
Well there is some ambiguity, whether or not is the case in the OP (I suspect not). Some perfectly fit, healthy people are medically obsese, according to their BMI.
I may know where the 180 pound figure came from, and what the doctor was really saying. I tried signing up at work for an optional long term care insurance policy and was rejected with a letter that said I was too overweight to qualify. I would have to reduce my weight below 180 pounds and hold it there for two years to qualify for the policy.
So 180 pounds is not my optimal weight for 5’6", it’s the maximum weight at which the insurance company would be willing to take a chance on me. Not quite the same thing.
I’m guessing the doctor was promoting 180 as the break point between unhealthy and wildly unhealthy, but trying to put a reassuring spin on it. He probably knows that if he goes for a lower weight, she’ll just give up on it.
Let’s not get sidetracked here. Of course there are a few cases like that, but the overwhelming majority of overweight people are at major risk of significant health problems. Pointing out the occasional case of a “healthy” obese person vs an “unhealthy” thin person does not in any way negate the FACT that being overweight is bad for you.
Back on topic: Is there a syndrome where fat people look in the mirror and honestly see the reflection as “too skinny” or even emaciated, in a reverse of the way 70 lb anorexics think they are fat?
Regarding the OP, there is a whole group of problems called “body dysmorphic disorder” that involves excessive dislike of some feature of the body, real or imagined. It includes weight but also the occasional person who develops a belief his ears are bizarre looking.
I think CC said it best-- this person just prefers the way she looks heavier, and a lower weight is thinner than she wants to be, not that it’s thin in and of itself. Also, people distribute weight differently-- I’ve got a friend who lost 20lbs, and it came off every where but where she wanted (her ass & thighs). She’s got scrawny arms, visible ribs and a Lara Flynn-Boyle collar bone, and the same chubby bottom half. She looks even more pear shaped that before and wants to put the weight back on (though, she has always been within the range of "normal’).
I also think the doctor is being pragmatic-- getting a woman who’s BMI is 50 down to the healthy range is a long shot. Getting her from Obese to Overweight (5’7" and 180 = BMI of 28.2) may be a more realistic goal. One that she can get to and maintain. It’s far healthier to hold steady at 28 that bounce between 24 and 34 for years.
I can hold a BMI of 26-27 with a normal healthy lifestyle. I’ve gotten it under 25, but it’s a constant battle that requires vigilant and obsessive behavior. It’s not worth it, and I’ve had multiple doctors agree.
It’s a well established fact that over 30 is bad, and it’s probably uncommon to be healthy at that size. But I think it’s not too uncommon for people in that mid-upper 20’s to be not thin, but not really “fat” either.
I believe there were some studies about this recently-- I’ll have to dig them up when I get home.
I am a woman who’s 5’8" and when I told my doctor my goal was 160-165, he laughed and said that was a sorely unattainable goal for me. He suggested 180 would be better.
Do you know how old this woman from the other message board is? I know some folks in their 50’s who dropped a lot of weight and frankly they look terrible. Skin is not so resilient at that age - especially after menopause (although one of the people I know who lost a lot of weight is a guy). If a person is losing weight but not able to do a lot of muscle toning because of age, or just because they don’t, they could very well look bad at a healthy BMI.
My understanding of BDD is it’s an unrelenting obsession with a minor or imagined flaw. It doesn’t really think it’s a “preference” thing. I’ve never heard of BDD including people who are happy with their appearance, but that appearance doesn’t fit generally accepted beauty standards. If she had BDD making her think she was too thin no matter what, I think she’d still think she was too thin at 320.
I’d be really uncomfortable reading psychosis into someone liking physical traits of theirs that others happen to find ugly. Take the loaded issue of weight out of the picture-- does some who’s objectively got an ugly face have BDD because she looks in the mirror and thinks “I look pretty today” rather than “Oh, dear god, am I hideous.”
Or, it’s entirely possible that his liver and lungs were fine, as were his basic metobolic numbers (blood pressure, cholesterol, thyroid, etc.). Being fat is not a death sentence for most people, it just increases your risk. I don’t doubt that his doctor wanted him to lose weight, but it doesn’t mean that he wasn’t perfectly healthy at that time.
I’m 5’10" and honestly I would be perfectly comfortable at 200 pounds. 180 is an ideal but 200 isn’t bad at all. I am in proportion at that weight and fit a size 16. I can move around well and fit into standard size seats, etc. At 200, I don’t think I’m thin, but I’m comfortable at that weight. And it’s realistic to stay at that weight rather than lose more and have to struggle to maintain it. 200 would be a lot better than my high of 324 and perfectly satisfactory.
One of the other psychological things about overeating and obesity, for some people only, is wanting to be less attractive to not attract attention. I want to be healthier but I don’t want to be thin and what’s considered sexy. That’s not me.
The lady in the OP has hit on the time honored tactic of redefining one’s goal. If she aligns her desired state to her current state, it sure saves a lot of effort.
She’s 320 and aiming for 200 (pretty much the same as me). Sounds like a lot of effort will be needed.
It depends what you consider “fat”. 159 simply isn’t that heavy, even for a 5’7" woman. I’m two or three inches taller than that, and at 150 my collarbone stuck out and so did my hipbones. That’s too thin for me. 175-200 is perfectly comfortable, and given my proportions, not fat.
There’s also the possibility that 180 seems impossible to get to, to her. That’s almost 200 lbs. While her preferred weight is still a significant weight loss, it sounds less intimidating. There’s a big difference between being in the 200s and being in the 100s, especially if you’re above both.
I’m overweight and know many overweight people, and it’s common to set a goal weight that is still actually overweight. It’s a goal where you’d lose weight and be smaller, but less impossible seeming. I’m just trying to get a bit smaller, not get tiny! I can’t do that; no way! I’d definitely fail! I look better with a bit of meat on my bones anyway!
This is NOT to disparage anyone because I understand it myself. I’m not morbidly obese, but 130 (which should be attainable with a height of 5’4") seems IMPOSSIBLE to me, whereas 150 seems like a challenge but something I could possibly achieve.
So it could be a subconscious way to avoid failure, by convincing yourself that you wouldn’t look your best at that weight anyway.
I have a feeling that some people think you are either “fat” or “thin”. I can’t imagine a 5’7", 159 lb woman being “fat”. I’m 5’1", and weigh 140. My collarbone doesn’t stick out, and neither do my hipbones. I am certainly not thin. But neither am I fat, unless “fat” has come to mean anyone larger than a model. My BMI is 26.4, but BMI has limitations, and my waist is 28 inches.