You can be underweight at any size

 

Underweight = being at a weight that is lower than the weight that your body would be if you did not suppress it with restrictive eating or exercise.


So, taken from my definition of what “underweight” means above, it stands to reason that a person can be underweight at any size. Yes, you can be underweight in a larger body just in the same way you can be underweight in a smaller body.

If your natural unsuppressed bodyweight is in the range of a BMI of 22, then you are underweight if you are BMI 19.

If your natural unsuppressed bodyweight is in the range of a BMI of 30, then you are underweight if you are BMI 26.

If you are underweight, you are likely in a state of malnutrition. Or, you are certainly at risk for becoming so.

Egregiously, not many people seem to be able to grasp this concept of what underweight actually means on an individual basis. Terrifyingly, many medical doctors frequently practice size discrimination by instructing people in lager bodies to artificially suppress their bodyweight via restriction (and/or exercise). Yes, this means that medical professionals actively promote ill health when they do not follow a HAES approach to evaluating their patients health.

The assumption that people in smaller bodies are healthy, and people in larger bodies are not is founded on weight bias. This means that many people in larger bodies are dismissed when they go to their doctors with health concerns and told to go away and lose weight — something that may actually increase their risk of ill health rather than decrease it. Likewise, people who are in smaller bodies and underweight are often told that their weight is fine, and are more likely to be given medical treatment to “treat” a symptom that is actually a symptom of malnutrition.

For example, many underweight people in all body sizes are given thyroid medication to treat an out of whack thyroid, when the reason that the thyroid is out of whack is because it is under stress from malnutrition. No medication required! Nutritional rehabilitation required!

You can be underweight at any size. You can have anorexia at any size. You can be in a state of malnutrition at any size.

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What do you think?

    • You have to decide if it is worth it living based on what you think other people think of you, based on fear or if you have greater goals and values than that.

  1. What would you say to a person who keeps changing their set point weight due to yo yo dieting? How would they know what their actual target weight should be? If they ate without restriction and they are now obese due to yo yo dieting and restriction then the doctor would have no choice but to recommend another diet to to get to a healthy BMI?

    • I don’t think that is changing set point. They just go back and forth between overshoot and weight loss and probably think “dieting” is their only option. Reality would probably be they need to develop healthy (not pseudo ED diet “healthy”) habits that as a side effect they may or may not lose weight. People seem to get it backwards in a sense: you shouldn’t lose weight to get healthy so much as get healthy [habits and thinking patterns] to get to a healthy weight for one self.

  2. Pingback: Why BMI is Bullshit - Eating Disorder Recovery for Adults

  3. Dear Tabitha,

    How can one know what one’s unsuppressed (aka natural) body weight is if onset age of anorexia was too young to have known? I got anorexic when I was about 16 and my growth got stunted because of that -I know I was supposed to have been taller than I am and that my body is not naturally thin. Now I am 40 and I still don’t know how much I’m supposed to weigh, if I’m overshooting or not even really at my natural weight and therefore underweight. I got my period back and my hair isn’t falling anymore, but I still have these crazy cravings for sugar and, much to my embarrassment, I binge every other day (night, to be more precise). The days that I binge, I’m eating about 2,500 cals a day and I have a BMI of 19.5 now (the biggest I’ve been like, ever) and still don’t know if I’m doing this recovery thing right.

    Thanks to anybody who might respond to this.

    • I want to start off by saying that binging is not something to be ashamed of– it happens (especially in anorexia recovery(. I am not a licensed professional and I don’t know the specifics of your situation, but it sounds to me like the binges and sugar cravings are your body speaking. It sounds like your body feels it is lacking something and therefore craving sugar and more calories. Are you still restricting any food groups from your diet? Maybe try eating more throughout the day and see if that helps stop your urges to binge. Best regards. Sending positive thoughts your way. Keep going on recovery; it sounds like you have already made so much improvement so BRAVO!