Hello Class,
We are finally getting down to the last few weeks of the semester. In class we've been discussing how medical knowledge is socially contingent. The power that medical doctors and scientists have to produce facts around health is so normative and ideological that we precieve them as truisms. In our society, we precieve obesity as something that is unhealthy, something to be medicalized, however is this the case? Below is a link to a a book entitled obesity myths. I'd am looking forward for some good, well thought responses.
http://www.obesitymyths.com/myth4.1.htm
36 comments:
"A remarkable finding is that heavy people who are fit have lower risk than thin people who are unfit." I feel that in today's society, when someone is catergorized as being overweight, we automatically think they are inactive, which then leads us to associate them with being unhealthy. Inactivity is what's leading us to illness, not the fact of being overweight. I know I tend to judge those who are more broadly set to be less in shape than myself, however, multiple times I have been proven the weak link. On one of my previous field hockey teams, the one girl on the team who looked the least fit, was the one who kicked all of our butts when it came to any running competitions. And just the other day when I was in a work out class, I was dying while the two girls in front of me (who people would consider to be overweight) were still going strong.
It has always bothered me when I go to my physical that the first thing they do is chart my ht & wt. Literally, before I even walk into the room, I have to get on the scale in the hallway. Then the first thing I see when I enter my private room is that HUGE BMI chart. Why don't they FIRST ask me how I'm feeling or what I'm eating and doing for physical activity? Ever since highschool those charts have always told me that I'm overweight for my height.
I agree with what they are saying when it comes to the fact that being labeled as overweight does not mean that you are not fit. I can think of many people who would be considered overweight but could easily out run many skinner people. It all comes down to activity and what you consume. "Consistently, physical inactivity was a better predictor of all-cause mortality than being overweight or obese." A skinny person could be someone who lays on the couch and eats junk food but just has a high metabolism therefore they do not show the effects of their eating habits. This is why it is wrong of our society to simply judge one based on what they look like because a person appearance often tells you little about their lifestyle.
It is also important to point out that what is considered overweight or underweight for that matter is socially constructed. Because it is socially constructed it could also change tomorrow. This means that one day you could be considered healthy and then the next day they could change the standards and even though you weight the same as you did the day before you could all of a sudden be considered overweight. Just that fact alone shows the flaws with labeling a certain body type.
"Most studies of BMI and other measures of obesity have not adequately accounted for physical fitness, a known modifier of weight status and a potential mediator of the effects of obesity on CAD [Coronary Artery Disease] and adverse CV outcomes … Our data support previous studies showing that functional capacity appears to be more important than BMI for all-cause and CV mortality, especially in women."
-JAMA, 2004
I think this piece really shows how BMI and weight alone cannot be used to determine ones health. It is known that muscle weights more than fat therefore a very muscular person could be labeled as obese according to BMI even though they are very healthy. I also think that it is interesting that this quote is from JAMA, the go to magazine for most physicians, yet essentially all physicians still use BMI as a health indicator.
Overall I think people need to focus less on the number on the scale and more on how they feel, what they eat and their activity.
"If the height/weight charts say you are 5 pounds too heavy, or even 50 pounds or more too heavy, it is of little or no consequence healthwise-as long as you are physically fit. On the other hand, if you are a couch potato, being thin provides absolutely no assurance of good health, and does nothing to increase your chances of living a long life."
-Steven Blair, P.E.D., Cooper Institute for Aerobics Research, 1997
The number on the scale does not determine if you are healthy or not. Taking your height and weight to calculate your BMI does not take into account what you are eating, and what you are doing for physical activity. Someone who sits on the couch and watches tv all day who has a "normal" BMI is less healthy than someone who eats healthy, and exercises the recommended amounts per week but is considered to be "overweight" on the BMI scale. BMI should not be the only indicator of your health status. There should be a way to include diet and exercise to determine if someone is truly healthy or not. The fact is that someone who is considered to be a "normal" weight can be less fit than someone that is considered "overweight." Your health status is determined by your physical activity level and diet not just the number on the scale.
I think that this is definetaly valuable in removing social stigmas with being overweight. The only problem is that obesity is just one factor that leads to "unhealthiness" and inactivity is another but in a lot of cases obesity is due to activity which leads to a host of other problems. So I think it is useful to see that maybe obesity is not neccissarliy the cause of cardiovascular disease and other issues. However showing that inactivity is a major cause of these diseases and is also a major cause of obesity. Then obesity is still indirectly causing diseases. I would like to see numbers of how many obese individuals are getting the proper amount of activity. Im not disagree with the data that was presented I think there was a lot more data probably left out. It is interesting though that soceity looks at obesity as a disease to be cured when really inactivity is more detremental to health.
I agree with many of the claims that were stated on the web page. Just because one is diagnosed as overweight, does not necessarily mean they are not fit. This is the problem with current anthropometric data gathering. BMI or Body Mass Index takes an individuals height and weight and measures them along a strictly defined chart which indicates whether they are underweight, normal weight, over weight, or obese. While BMI can be a useful screening tool it does not accurately measure an individuals fitness. Some one that is considered overweight based on BMI may be in better shape than a thinner person because they most likely have more muscle mass than the thinner, unfit person. Muscle mass weighs more than fat mass and the ratio has a significant effect on how fit a person is. The JAMA article from 2004 states this clearly: "Most studies of BMI and other measures of obesity have not adequately accounted for physical fitness, a known modifier of weight status and a potential mediator of the effects of obesity on CAD [Coronary Artery Disease] and adverse CV outcomes … Our data support previous studies showing that functional capacity appears to be more important than BMI for all-cause and CV mortality, especially in women."
The underlying message here is that exercise is crucial to lead a healthy lifestyle. Being a person that is always classified as being as "overweight" even though I would consider myself in pretty good shape. The charts that determine who is overweight and who are not are outdated in my eyes and should be replaced because they do not include muscle mass in the equation. Although I do have to play devils advocate. Obesity is caused in most causes by inactivity, a poor diet or a combination of the two. I do see the author's point in that people can be overweight but in good physical shape but when people hit into the obesity category this is where quality of life plummets. Mood, self esteem and physical health deteriorate. This article focuses on physical health so I will also. Hypertension, athersclerosis, myocardial infartions, etc. are all commonly linked with obesity. This country is becoming increasingly more obese each day and it is hard to read an article that states that being heavy cannot hurt you. I understand the author's approach but just can't see eye to eye with it
As someone who is planning on potentially working with the obese/overweight population, I need to be able to understand who is fit and unfit. Everyday we see people who are obese and we consider them to be lazy unfit people. However, anyone who takes the time during the day to get the recommended amount of exercise is going to be healthier than someone who does not. The finding presented in this book do not surprise me at all. There are many factors that contribute to people being overeight which include genetics, certain diseases, and medications. For some people it is out of their control to be thin and lean but they can always choose to be healthy and fit.
Its to bad that as a society we automatically jump to the conclusion that someone is unhealthy if htey are overweight. We should focus more on ones health status rather than their weight. However, it is difficult to see health and how one feels so we, as a society, judge based on what we can see.
I think that in this case there are some situations in which an overweight person isn't simply put into the category of unhealthy in our society. It is probably not the first adjective brought to mind and that is unfortunate. That is why I think this study is important. More importantly than the idea that because people are overweight, doesn't make them automatically unfit, is the idea that we as a society would automatically group people we physically view as overweight as all being in the same category of unhealthy. It would be the same as saying all extremely thin people are unhealthy and probably don't eat. The worst part to me is that we subconsciously come to a conclusion, persuaded by a societal influence, on someone else's health without regards to anything but their weight alone.
I find these articles very interesting because they refute the common public thought that healthy people have to be thin. The quotes really make people rethink how they feel or judge overweight people's weight and how it may relate to health. I thought the most important quotes were those that stated that obese people who exercise had a longer life expectancy than those who who had lower body mass but were inactive. This really should be a wake up call for people who think they don't need to work out or exercise just because they are in a "healthy" weight range.
"Unfit, lean men had twice the risk of all-cause mortality as did fit, lean men and also had higher risk of all-cause mortality when compared with fit, obese men. The all-cause mortality rate of fit, obese men was not significantly different from that of fit, lean men … In summary, we found that obesity did not appear to increase mortality risk in fit men. For long-term health benefits we should focus on improving fitness by increasing physical activity rather than relying only on diet for weight control."
-American Journal of Clinical Nutrition, 1999
I have to admit that I might not have believed this research even a short time ago. To think that it was published in 1999, is even more surprising because of the unfaltering and unmistakable emphasis still placed on weight. In today's society to be beautiful and healthy, is to be skinny and toned. Automatically, those with a higher percentage of body fat or those who do not appear to be physically active are looked down upon and are placed into an "unhealthy" category. Instead, I feel as if information such as in the excerpt above, needs to be circulated more widely. Not to provide justification for being overweight, but to dispell the rumor that extra weight will always lead to an early death. We need to shift society's focus from obtaining that "perfect" body at all costs, to valuing what is truly best for their overall health. If that means exercising but still being a little overweight, then so be it. Make the time to get some exercise, and your body may return the favor and grant you more time to enjoy this life.
It is true that our society looks and views overweight people as not fit and not healthy. We have been taught and told through our social groups that obiestity is bad, and obiesity leads to additional health problems. Although this is true, we forget about the thinner people who may "look" healthier than someone who is overweight, but are they really healthier than an overweight person who may work out unlike the thin person? These facts are ignored throughout our society because we have been taught that thin people are healthy. An example of this is within sports teams, when someone sees a player that may be overweight and not the most thin on the team, people tend to judge and say they are not athletic. However most times, those people are the ones that will be the star played on the team. When the most thin player is struggling to keep up. The idea of all overweight people being unhealthy and not fit is a myth and I strongly believe that..... "Don't judge a book by it's cover"
Many people may look overweight or less in shape than others, but in reality a lot of those people are built like that to begin with. They were born with certain genes that they can't change. Many of those people are more in shape than the people who look really fit. Some people look fit but at the same time are very unhealthy. Some people may look in the mirror and think I look great and feel they don't have to work out or eat healthy. People who look the least fit actually may be more healthy than those who look really fit.
"A fit man carrying 50 pounds of body fat had a death rate less than one-half that of an unfit man with only 25 pounds of body fat." I think that as a society we are all so concerned with being healthy which means either for women being thin or men being muscular. I think that we have such a misconception about what really is healthy and this website really showed that. It's one thing to be thin for women and to be very unhealthy or to be unfit for a man but be skinny and be unhealthy. Being healthy needs to be a balance between eating right and exercise and just because you may be naturally thin doesn't mean that you are healthy which in our society viewpoint being thin is healthy. A person can be considered 'overweight' just based on their height and weight ratio which never takes into account their actual BMI which is what is really important. It's hard for being who are fit to hear that they may be overweight and sometimes it can lead them down a road of trying to get thinner because a height and weight chart is telling them that they need to.@
I think as a society we have now linked fitness with weight. Unfortunately, this isn't true as the comments on the website indicate. Exercise is a key in leading a healthy fit life style. This is sometimes forgotten when lose weight fast diets and pills come out on the market. People laugh when I sometimes claim how out of shape I feel. Although I am not overweight, I do not exercise as much as I used to and can feel the change in my health. As a society we need to make a change towards encouraging ourselves to exercise rather than encouraging ourselves to strictly diet and lose weight.
I really agreeed with this article. We hear so much about the 'obesity epidemic' and how we all need to lose weight, but that's not where the focus should be. Yes, an increase in physical acitvity and fitness would correlate to a lower body fat percentage, but it is the fitness that is important, not a little baby fat. We tend to focus as a society on losing weight through diets and in the easiest, laziest ways possible. Every time we go into the doctors for a check up, we are weighed, and our BMI is often checked. Our society needs to remember that someone who is in good shape is going to weigh more because they have healthy muscle mass, which gives them a higher BMI than someone who is less healthy.
So this article is telling us that just because you are overweight doesn't mean you are unfit and that we should be less stereotypical. OK, I see what they're saying. But I do think that when we look at severely skinny people we don't automatically think they are healthy do we?? I mean maybe a few very uneducated people think that looking that way is right, but I don't think people are as simple minded as this article makes them out to be. Most people in our field know enough about weight to know that it isn't all about a BMI chart, or what number comes up on the scale. Don't get me wrong. I know society puts way to much stress on people especially younger woman to be thin. But this is more of a social stress than a medical stress I feel.
Our society is guided by a scientific paradigm where we put way too much trust in the medical world. We believe everything that comes out of the medical world to be true because they are "scientific and objective" but knowledge is socially constructed. We have become such a shallow culture where we believe if someone looks fit they are healthy compared to an overweight induvidual. We wrongly link health and beauty. That "perfect looking" model may seem healthy to us but she could have an eating disorder, take drugs, or have high cholesterol abut we would never know. The thinner person we see as healthier may just be blessed with a fast metabolism so they may eat junkfood because they don't have to worry about gaining weight from it. The heavier person may be eating healthy and routinely going to the gym, but our society sees them as unhealthy because of their weight. It was surprising to see that weight didn't play as big of a factor in contributing to disease as we all think it does. If you exercise and have a higher level of fitness, regardless of BMI, then you have less of a chance of getting sick. This needs to be spread to the public so we stop wrongly judging people's health based on weight.
In our society, we see "healthy" are "beautful" very closely linked. Our image of a healthy person is thin, pretty, perfect hair and teeth, toned, etc. We know that many of these traits can be linked to a healthy, hygenic lifestyle. Brushing your teeth will promote good dental health. Showering regularly will keep your hair and skin looking healthy. This myth that is disproved in these articles is that being thin means being healthy. Because we associate poor health behaviors with obesity, such as inactivity and eating a lot of junk food, and because we have a perfect image of heath instilled in us from the cover of several magazines, we see being over weight as unhealthy and being thin as healthy. Because these associations seem natural in our society, we have never questioned them. It may be important to look into what other myths we accepts as truths in the health field because they seem natural when seen through the scientif paradigm.
I agree with alot of the comments before that in our society we look at those who are overweight and automatically assume they are unfit. We all believe that in order to be healthy one must be thin and pretty but according to this article its not. I'll be honest i do it. I know someone who is overweight and honestly she eats very good and exercises alot more than i do. I'm sure people would think that shes more unfit than I am but I bet she could outrun me anyday.
"Consistently, physical inactivity was a better predictor of all-cause mortality than being overweight or obese."
-Annals of Epidemiology, 2002
One of the times I was at the gym, a trainer told me that there is two different ways to work out. One way is with a slow heart rate which gets rid of the fat and that getting at fast heart rate is more for your heart and body systems. In order to be a healthier person a person must work on their insides before they worry about their outsides.
This article puts forth the research and data into obesity amongst several types of people. It’s interesting because it shows how fitness level and activity rate have a major impact on a person much more so than the actual percentage of body fat on a person.
This is interesting, but at the same time they don't really specify which overweight group they were studying. I am not sold on the findings of this artical for the simple reason most unfit people are also over weight and most physicaly active people are more likely to be of "accepted" weight. This study only uses the term over weight but fit, now does this mean the person is 1 pound over weight or 100 pounds. It is true that if you are inactive yes you are more likely to have medical issues, but I don't buy the idea that it is healthier to be over weight and active then have a good bmi and inactive. COPD is found much more in obese people then those of a "good" weight and sleeping disorders such as sleep apnea is almost always associtated with over weight people. bottom line get off the couch or out behind the tv or computer and move you will be healther and most likely not obese and looking at a much healthier life.
I have always thought how it is funny that the first thing someone jumps to assume when seeing an overweight person is that they are unfit. Many individuals assume that people are overweight because they are sedentary,don't work out and eat too much. However that is not true. I have seen many people who would and could be labeled as overweight accomplish great lengths when it comes to running or strength training. I do not think that it is fair to only go off ht and wt charts to label an individual as unhealthy. Being an exercise minded individual, I think that more fitness testing and education should be done for the individuals that are considered unhealthy. And just because an individual can be classified as unhealthy due to a chart, does not mean that they actually are unhealthy.
The idea that actively obese individuals actually have lower morbidity and mortality rates than normal weigh individuals does not surprise me. It all reverts back to how we take care of ourselves and the way in which we perceive one as healthy influences that. For instance in class we looked at magazine that had a slender women on it as it gave off the image of being healthy and we talked about how individuals take unhealthy measures to "look healthy". Those measures include unhealthy eating and skipping meals. We may see someone who is smaller as being healthier because that is what society has created as the ideal image but in reality those who are obese may be healthier than those who have taken unhealthy steps in meeting the acceptance in society.
It is very interesting how health is depicted these days. This article is important in recognizing not only how society views health, but also the facts behind our conceptions. I think that the way that media depicts health is what everyone recognizes it as, but in reality it could be very different. I think that although BMI could be helpful in doctors tracking height and weight, it should not be how they judge health. Other factors such as number of times they work out a week or simple habits should be observed rather than height and weight.
The first issue with the categories of weight is often it is related back to BMI. If just BMI is looked at without interpruting body fat, then I guarantee that almost all athletes would be considered overweight. According to the BMI calculator Lebron James who is 6'8'' and weights about 250lbs has a BMI of 27.5 which is categorized as overweight. Obviously, no one would consider him to be overweight but still based off of a basic BMI calculation he is. This fact could have scued some of the results from the experiments overviewed in the book, but putting this aside the proposed theory is not that absurd. Being active has many benefits that may or may not include weight. Those who are active will see better cardiovascular, respiratory, and other functions while those who are stagnant regardless of weight will not see these benefits. Commonly as a society we associate being thin with being active and being obese with stagnation because typically an active person will see a reduction in weight because of their activity. This is not always true and just because a person is overweight doesn't mean that they don't see the benefits of living an active life style. Obesity isn't life threatening stagnation is, but obesity and stagnation can be a double threat to health.
"[A] fit man carrying 50 pounds of body fat had a death rate less than one-half that of an unfit man with only 25 pounds of body fat."
-Harvard Health Policy Review, 2003
This is probably one of the most astonishing things I've ever read. I agree with the findings however because I know that I'm a little on the "bigger" side of the spectrum, but I feel like I can run for long periods of time without actually feeling like I'm going to pass out afterward. It's interesting how when we look at people who are labeled obese we immediately assume that they are extremely unfit and unable to carry on any form of exercise. Even on weight loss programs, most of the contestants aren't bad because they are overweight but because of the fact that they are inactive and unfit.
"Thirty-five million Americans went to sleep one night in 1998 at a government-approved weight and woke up "overweight" the next morning, thanks to a change in the government’s definition. That group includes currently "overweight" celebrities like Will Smith and Pierce Brosnan, as well as NBA stars Kobe Bryant and LeBron James. "
Firstly, it seems that the numerical indicator for obesity changed at a time that the idea of a beautiful woman being extremely thin became commonplace and encouraged. This is just one more way that medicine has 'helped' define societal norms. Which is interesting, because so many celebrities (namely males), and famous athletes are considered overweight, even obese. Medicine has skewed our perception of obesity by trying to alter our ideas of health, and the way it should look, and then matching 'science' with it to further their point.
The BMI index has never really been an adequate indicator of a person's health. Muscle mass and body type are not taken into account when creating these statistics and only serve to further stereotype "overweight" people as unhealthy. Someone who is thin but partakes in a sedintary lifestyle and eats foods with little nutritional content is more likely to suffer from health issues than an overweight or even obese person who exercises and eats well. Everyone, including health practitioners, use weight as a crutch in assuming medical problems that may not exist. Anyone who does not assume a "normal" body type is categorized as deviant and bombarded with advertisements for diet pills/programs.
At first I too was part of those who believed that all fat people were unhealthy. Now I know better. I do agree that what matters more than weight is how much physical activity some has during the day. I used to know people that were fatter than me and they could run for longer than I could, just like I could run more than some of the skinnier kids. Again, the thing that matters most is how active a person is.
~Cami
Wow, I'm glad I read this! The misconception that obesity and being unfit are always correlated had infected me, too. I suppose I can see both sides of it, here. There are some obese people who have severe, life-threatening health conditions because of their weight… and because of their weight, it is nearly impossible to stay fit. However, people should not be so quick to assume that being overweight means you are unhealthy, just like people should not be quick to assume that being hyperactive (or unmotivated, for that matter) means you are unhealthy. It's as if there is some perfect, normal, healthy human being out there who all of society is wishing to become.
As a society, we put too much emphasis on outward appearance in term of how healthy a person is. Trim, neat, and put-together people "look" healthy to most of us and messy, bigger people generally fit the bill of what we consider "unhealthy." While some of this stereotyping may be true, obviously some of it is not. There are plenty of people who appear to be fit and healthy that have loads of poor health qualities. These may include alcohol or drug abuse, unhealthy eating habits, smoking, or anything else. Likewise, people that appear to be overweight may lead very healthy lives that include exercise and a healthy diet. Therefore, what's going on inside the body could be completely contradictory to what we perceive based on outward appearance.
The last graph included in the fact sheet is quite surprising. To see that some obese people (who are also fit) are only slightly more at risk for all-type mortality than normal weight and fit people is not what most of us would believe. Also, to see that normal weight people who are unfit are twice as high on the chart than fit obese people was surprising.
Although this is some clear cut information, the fight against obesity continues. This is for some valid reasons. Many people who are obese are very uncomfortable with that status and the perceptions around that word. Some are able to combat obesity in a healthy way (through diet and exercise) and can become a fit person of "normal" weight. Unfortunately, others try to cut fat through unconventional and unhealthy ways and remain unfit.
The myths on this site are preposterous. Ive never heard of these myths. some of them do make sense though. If someone is 40 pounds overweight but physically fit decreases their chance of heart disease than someone who is thin but a couch potato. i think however, many of the myths are stating an underlying message of its ok to be fat just be fit. perhaps in a way to get people to go to the doctor more because it has been shown that overweight people do visit the doctors more often. So the myths do sound very true and for someone who might not have the knowledge could very easily give into these just to find themselves at the doctor. Or maybe this is legitimate. maybe physical activity is the number one place to start inorder to avoid going to the doctor and inevitably saving your wallet. but for those who are over weight but have the stamina of someone who is not, good for them and keep it up.
Maybe it isn't obesity that is killing America, maybe it is our false beliefs about obesity. The quotes from this book all express that it is more important to be fit, than it is to be skinny. This is very inconsistant compared to what we, as Americans believe. Our belief stems from americans socially constructive beliefs and the social norms surronding health. If you picked up a "Health" magazine, or a "Fitness" magazine you would see a very skinny person on the cover and the cover stories would be something to the effect of "Lose weight quick" , or "10 easy steps to losing weight". Most of these focus on dieting, and not neccesarily on actual fitness. The result is that we beleive that it is more healthy to be skinny, and not neccesarily active. These findings hopefully can be motivation to people who have struggled with their weight, because even if they aren't skinny, they can still improve health by being fit. It can also hopefully open the eyes of people who seek to improve their health solely through dieting, because fitness seems to be the more important indicator of health. Hopefully we can shift our view of health away from BMI and weight, and more to actual lifestyles.
This is very interesting. Society including myself always believed that people who are overweight are unfit. I also believed that by just being overweight, it can increase your chances for morbidity. This article talks about how an obese, fit person can have lower chances for heart disease than a normal sized unfit person. That seems crazy because society tells us being obese is unhealthy. I know a few kids who eat terrible and don't really do anything active and are still skinny. Having a high metabolism will not keep you healthy. The problem with society is that public views are hard to change and I don't think societies view on obesity will change anytime soon.
The one thing this article does a poor job of doing though, is defining what fit actually is. I don't understand how you can be fit and obese. I feel like if you are fit and obese you are probably losing weight and will no longer be obese if you stay fit.
If you think of the word obese, people will imagine a person who is well overweight and is considered unhealthy. The truth is that we have been fed this ideology by society and our views on simple health subjects are biased. We lean to the idea that the people who are obese are lazy or inactive. This idea is even further pushed onto society by showing weight loss diets that are so easy to do that an obese individual doesn't really need to exercise to lose weight. The truth that is hidden is that a person is measured by their active lifestyle. "Active obese individuals actually have lower morbidity and mortality than normal weight individuals who are sedentary … the health risks of obesity are largely controlled if a person is physically active and physically fit."
I will agree that I have judged people in the past simply by their appearances, but I have learned through this class and other medical classes that a person can be healthy despite what they appear to be. The term obesity has been medicalized and is seen as medical concern to society and that it must be resolved or at least taken control of. Society today has been manipulated to think only what they listen to an in turn become normative and ideological. It's funny, I don't think I have heard the term "myths" used so much in the medical field until these past few years.
I have always disagreed with what determines if people are overweight/obeses versus fit. Each person is built differently and it is unfair to look at two people who may be the same height and say if one of them is more or less fit than the other just by looking at them. Muscle weighs more than fat and if someone weighs more it may because they are more fit and has a higher muscle mass than the other person and yet based on how our society works, the person who has a higher number on the scale is less fit and out of shape. I cannot argue that obesity has its health concerns, however, it is impossible to decide at which point a person become "fit" and "healthy" for their individual body versus when the become "overweigh," "obese" and "unhealthy."
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