Health at Every Size: A Physiotherapist’s Opinion

Only recently have I become aware of the tending hashtag health at every size and because I, as a Physiotherapist, per definition is in the health industry I had to voice my opinion about it. Health at every size is one of those phrases that sounds positive at first but falls apart as soon as you start thinking about it. You don’t even have to be a health professional to know that no, you’re not healthy at every size. It’s a scientific fact. I think that one of the problems is that people often confuse health and beauty which is beyond visible in the fashion industry. In theory it shouldn’t be a problem that clothes is made for people who are both small, large and everything in between. We all have to wear clothes, right?

My problem is that the fashion industry favours the extreme. It used to be models with a very specific body type that certainly isn’t normal in the sense that majority of women don’t look like that, which used to be fine back in the day where everyone knew that models were living hangers. But that’s not the case anymore and the result has been that if the everyday woman tried looking like these models she became underweight, unhealthy, and in the worst case ended up with an eating disorder trying to reach an ideal her body wasn’t made for. We can’t all be tall and have that specific bone structure. Today we’re facing a different issue. I personally don’t mind curvy or plus-size models but I strongly dislike what the fashion industry are trying to portray them as in the hopes of getting a lot of your money. Have you, for example, noticed that body positivity is a term used, almost exclusively, by bigger people trying to justify being an unhealthy size? And have you also noticed that gaining weight, getting bigger, is celebrated in those communities while losing weight, getting smaller, is punished? If you didn’t then I can tell you that a lot of people have received a ton of hate because they wanted to become more healthy which to me is unfathomable.


I get wanting to feel good about yourself, self-love and all that. Obviously there’s a huge mental health aspect to it as well which I fully acknowledge. In fact, it is my job to do so. I 100 per cent stand by people who say beauty at every size. But Beauty is subjective and so different people find different shapes and sizes beautiful. Beauty is also subjective in the sense that we usually find people more attractive or beautiful if they have a personality that goes well together with our own. My point is that you can be happy, love yourself, be/feel beautiful and still be unhealthy. Are we really living in a world now that values beauty above living a healthy life? It certainly seems to be the case. 

Furthermore, the fashion industry are trying to say that they don’t promote obesity and use “beauty comes in all shapes and sizes” as their argument. The problem is that when people want to look like the model on the cover or social, and she is obese, it poses a huge health problem. It makes them indirectly responsible for the message they portray and it is a double edged sword. Weirdly enough, and yes I am being sarcastic, I’ve never heard the same argument from the fashion industry when they’ve put a severely underweight woman on the cover. As always, the “inclusivity” is only for the bigger sizes.

As I see it the two biggest problems are that 1) people want to look like the people they see on magazine covers and social media and 2) that being bigger as been normalized to an extend where being obese is more acceptable than being underweight even though both conditions can potentially kill you. Try and ask youself: why is it that people who probably suffers from anorexia is being told to get off social media and magazine covers and go get help, when morbidly obese people are not? They pose exactly the same health risks just in opposite ends of the spectrum. The answer is: because it is being normalized.

In the eyes of a health professional both pictures underneath are problematic in the messages they send. 



But where does the phrase health at every size come from? As I understand it it comes from the fat acceptance and body positivity community and is based off of the fact that in healthy sized people a slim body isn’t necessarily a healthy one. The keyword being healthy sized! The fat acceptance and body positivity community have taken that fact and twisted it to: you can NEVER tell by a person’s looks/body if he or she is healthy. BUT YOU CAN! As a health professional I don’t appreciate that they twists the truth to fit their unhealthy agenda. It’s not the only scientific fact that they take and twists but it’s the one suitable for this particular blog post.

What is the truth? The scientific truht is that in a normal, healthy sized body, you can be what we call skinny fat or metabolically obese if you prefer the medical term. That means that your muscle mass is really low and fat percentage (visceral fat which is the dangerous kind) is relatively high which also means that you’re still at risk of getting lifestyle diseases. In those cases it isn’t obvious that a person is unhealthy but let me tell you this: you can most certainly tell if a person is either underweight, overweight or obese! In those cases it’s not rocket science; they are uhealthy. The good thing is that it is fairly easy to rectify and the body is great at rebuilding and repairing itself.

Health risks when you are underweight:

  • malnutrition, vitamin deficiencies, or anemia
  • osteoporosis from too little vitamin D and calcium
  • decreased immune function
  • increased risk for complications from surgery
  • fertility issues caused by irregular menstrual cycles

Health risks when you are overweight/obese:

  • type 2 diabetes
  • high blood pressure
  • high blood cholesterol levels
  • heart disease and strokes
  • certain types of cancer
  • sleep apnea
  • osteoarthritis
  • fatty liver disease
  • kidney disease
  • sexual health problems
  • pregnancy problems, such as high blood sugar during pregnancy, high blood pressure, and increased risk for cesarean delivery
  • fertility issues caused by irregular menstrual cycles


In the end it’s about responsibility. You have a responsibility to take care of yourself both physically and mentally. You have a responsibility to your loved ones who need you to be healthy so that you can live a long and happy life with them. You have a responsibility to be capable, meaning mobile and energetic, enough to play with your kids and to let them know that you take care of not only yourself but them as well by prolonging the time they can spend with you. And if you live in a society with universal healthcare you have a responsibility to society (social responsibility) in that you will stay healthy so that you reduce the risk of illness and thereby not spend money that could have been used for something better like the well-being of your kids, or people with certain illness/-ess who actually don’t have a chance of doing anything to prevent that. Your choice, your responsibility.

I will leave you with a little something I found on YouTube that sent chills down my spine. I will not say another word about it but instead let you decide what you think about the direction our society is headed towards.

Thin-priviledge graph_youtube opinion



Let’s connect!

Health at Every Size: A Physiotherapist's Opinion
What do you think of the influence from the fashion industry and social media?
What is your opinion on the fat acceptance and body positive community?



9 thoughts on “Health at Every Size: A Physiotherapist’s Opinion

  1. Rachel

    This is such a tricky topic. In my opinion, it would be best if we could all just stop commenting on each other’s bodies in general and leave the health aspect between the individual and their doctor. But unfortunately, the beauty industry will never function that way.


    1. My paid job is also as a physiotherapist of 30+years. Yes, I believe all health professionals should encourage, empower and walk alongside people who wish to make good health choices. But I think it is a slippery road to judge people’s health on one obvious external eg weight. There are a myriad of – invisible to the naked eye – health issues & risks that many of us humans have or take- smoking/drinking/dietary/ addiction/stress/ mental health/genetics/ etc – and which may have many more consequences than our body fat. For me, it is not for me to judge, but more there but for the grace of God go I.


      1. I don’t think we should judge either. But we do need to educate because people are dying. That’s why I and others became health professionals in the first place: to help people. Obviously there is the whole mental health aspect etc. to it as well but I chose to focus on the “health at every size” movement because it is damaging and can cause more deaths in the long run.
        Thanks for stopping by.


    2. Unfortunately closing our eyes to the problem won’t make it go away. Many need to become aware to even go to the doctor, and a few even say that their doctor is body shaming them because they say that they need to lose weight if they don’t want to die 14 years before time. Education is key, and obviously there is the whole mental health and real eating disorder aspect to it as well.
      And I agree. People definitely has to realise that the fashion and beauty industry is not on the side of health. They will say whatever it takes to get your money.
      Thanks for stopping by.


  2. I find that this is a good article and you made some great points. But what about people who can’t get access to medical care? When you don’t have help to get healthy it can be hard. I know because I don’t have health insurance, and I don’t have many options for getting medical or mental health care. If I had access to a doctor I would be able to get a lot of preventive care.


    1. I get what you mean, but this was focused solely on the “health at every size” movement. It, of course, is a much bigger issue that is not easy to fix but the first step must be to admit that we have a problem and glorifying people basically eating themselves to death isn’t something we should celebrate. Just like people who see a person with anorexia would not say: just keep going! No, we say: go get help. That should apply to mobidly obese people as well with all the support necessary for them to get better mentally and thereby hopefully also physically.
      And then I think people should stop yelling at obese people in the streets. It does not do anyone any good.
      Thanks for taking your time to read and comment!

      Liked by 1 person

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