Weight is a scapegoat for just about everything. But other things affect your health too.
Health is not as simple as how much you weigh. While I'm not discounting that weight can play a role in your wellness, you can't boil down every aspect of your health to the number on the scale. That's a form of fatphobia.
There are factors affect your health more than your weight, many of which are not within your control. According to the Centers for Disease Control and Prevention, there are five determinants of health: a person's genetics, environment, physical habits, medical access and social factors. Mental health is also an important factor. Here's what to know.
Our genetics decide a great number of things for us. It's more than just what we look like -- the genes we inherit influence our health. You can have a genetic predisposition to develop diseases and conditions like high cholesterol, certain cancers, sickle cell disease and diabetes. A predisposition doesn't automatically mean you'll develop the condition, though your chances are higher.
There is also a genetic component to weight, with select genes predisposing someone to be larger or smaller. Certain genes influence metabolism, appetite and body fat distribution.
Environmental factors like where someone lives and works will also influence their health. Many other things are also considered environmental factors, like access to clean water, food, air quality and exposure to harmful toxins. Many people may not have to think about these things. You turn on your sink, and water comes out. However, the World Health Organization estimates roughly 12 million deaths annually are attributed to environmental factors.
Studies have shown that people exposed to harmful air pollutants are 17% more likely to die of heart disease. Indoor wood and kerosene burning or exposure to biomaterials also increase the risk of heart-related death. Those with fewer resources to seek general or specialized treatment are more likely to experience worse health outcomes.
Let's think about physical habits in two parts -- what we eat and our physical activity.
Our diet choices hugely impact our health: We are what we eat. A diet filled with heavily processed foods and saturated fats can negatively impact your health. It increases your risk for heart disease, type 2 diabetes, hypertension and certain cancers.
Most people associate a poor diet with obesity. However, you can be thin and have unhealthy food habits, just like you can be heavy and make excellent nutrition choices. Your weight is influenced by many things in addition to diet, so it doesn't tell the whole story. Your metabolism, or your body's ability to process what you eat, also plays a huge role.
The other side of our physical habits is exercise. Consistent physical exercise is one of the most important things we can do for our health -- it keeps our body strong and reduces our risk for chronic conditions. Exercise is good for you no matter your size, and the negative stereotypes about heavy people being inactive aren't true. Our bodies have different baselines, so it's possible to be fit and still weigh more than someone who doesn't exercise at all.
One of the most important determinants of someone's health is their access to health care. Without the necessary prevention, diagnosis or treatment for their conditions, people are more at risk for fatal health outcomes. Barriers to health care include lack of insurance, transportation and the cost of care. And now, with physician shortages, wait times are longer than ever, and care is delayed even further.
Access to health care cannot only be viewed as being able to physically arrive at the doctor's office. What happens while you're there is the other side of access.
When someone faces discrimination in health care, it decreases the likelihood they'll get the care they need or seek treatment in the future. Studies show that Black people who are discriminated against have an increased risk of high blood pressure. It's a similar story for those who experience weight discrimination in health care -- they're more likely to see a drop in their physical and mental health. Older adults have the highest rates of health care discrimination -- one in four Black or Latinx adults reported being treated unfairly, according to one 2021 study.
It's not enough to be able to access medical treatment. It has to be health care that works for you. That's true access to health care.
Social determinants are an umbrella term for all the nonmedical factors that affect health outcomes. This includes someone's circumstances -- where they were born, grew up, live and work. It also encompasses the conditions that shape our lives and the structural policies informing them -- racism, political systems and policies. It's estimated that social determinants account for up to 50% of health outcomes.
Broadly, social determinants are broken out into five categories:
Social determinants will vary for each population subgroup, allowing for health inequalities that influence the type of care someone gets. These factors have a larger impact on someone's health than their lifestyle choices. Let me say it again: Lifestyle choices and your weight aren't as important as factors like your economic stability, education and where you live.
But how is this possible? Think about it like this: If someone doesn't have reliable transportation to the grocery store, their access to healthy foods plummets, as does their nutrition. This increases the risk of heart disease, diabetes and other chronic conditions. If they don't have the money to pay medical bills, they limit how often they go to the hospital.
The CDC doesn't categorize mental health as an official determinant of health, but it should be. Our physical and mental wellness work together to keep us healthy. They aren't separate parts of us; one directly impacts the other.
Maintaining good mental health can lower your risk for serious health conditions like high blood pressure and heart attacks. Ignoring your mental health makes it harder to manage existing conditions, compromising the care you get for them and making your condition worse. Depression is a common comorbid condition with serious medical conditions. Studies have found that having depression increases the risk of cardiovascular events.
That said, access to mental health care is also compromised for many people. The stigma and cost of therapy keep many people from getting needed help. Online therapy options have brought down costs and expanded mental health resources to areas that didn't previously have them.
Weight is one part of our overall health, but it's far from the most important. Factors like our circumstances, genetics, environment and health care access determine our health. And don't forget mental health.
Someone heavier can be healthier than a thinner person based on these factors and their choices. It's not all about weight.