Fresh Focus #52: Myth – The Scale

It seems like in the health care setting we always hear “losing weight is healthy” and “gaining weight is unhealthy.” It seems like there is this thought that the best predictor of if someone is healthy is their weight and what number shows up on the scale. But the thing is, there are so many factors that come into play when it comes to the number on the scale.

Welcome back to the Fresh Focus podcast. My name is Megan Rivenburg and I am a dietetic intern at the Bay Pines VA in Florida. If you’ve listened to the first few episodes in this myth busting series, you’ll know that I love breaking down common nutrition myths and helping you separate out what’s truth and what’s not. We’ve talked about carbs, metabolism, and plant-based diets, and today’s episode is going to focus on the ever so infamous scale. What the scale can be useful for, what the scale is not useful for, things that impact the reading on the scale, ways to measure progress other than the scale, and finally, is the scale really the best indicator of our health?
What is it that the scale really measures? Weight. We live in a world that puts a lot of emphasis on weight. Whether it be losing weight, staying at a healthy weight, or what have you. But all weight really is, is our gravitational pull towards the earth. And when you think about it this way, it can seem silly that we put so much emphasis on it as a society. Or even that we think it can tell us how healthy we are. But we will get to that piece later. The main point I am making here is that what the scale tells us is how much gravitational pull we have towards the earth.
And what can affect this gravitational pull? Many, many more things than we commonly think.
For starters, our bodies are made up of mostly water. So any shift in our fluid status will show up on the scale. Whether you are hydrated, dehydrated, ate more sodium than normal and are holding onto some extra fluid, just exercised and sweat out fluid, or just drank or didn’t drink a big glass of water.
Kind of related to fluids we also have human waste. If you go to the bathroom, it weighs something! So whether or not you’ve gone to the bathroom when you weigh yourself is going to show fluctuations on the scale, but neither this nor the fluid changes necessarily means you’ve gained or lost fat.
There are so many other things that may influence the number that shows up on the scale. Time of day and how many meals you’ve eaten so far that day, clothes you are wearing, how you’ve been sleeping, for women of childbearing age- the time of month, etc. And since all of these things can impact the number, we have to remember if we chose to weigh ourselves that we shouldn’t let fluctuations frustrate us. They can be so normal!
Now, what is this measurement useful for and what is it not useful for? Let’s start with what it’s helpful for! The first is tracking weight loss or gain trends over time. This can be helpful when your registered dietitian is looking at your weight charts. We see ourselves everyday, so sometimes it can be hard to notice if we’ve lost or gained weight over time. When your registered dietitian is looking at your chart, he or she may see a trend that you were not aware of before, like a gradual, significant, unintentional weight loss. If this is the case, your registered dietitian can help you look at your diet and see if there’s anywhere you can add to your meals and snacks, or refer you out to another healthcare professional to make sure that everything is okay.
Another thing weight as a measurement is helpful for, is people who have issues with fluid balance. Your provider may have you weigh yourself daily if this is an issue for you to monitor how things are going.
And when is the scale not useful? Well, the scale can’t tell the difference between muscle and fat (or anything else that makes up your body composition for that matter). So if you’ve been going to the gym and feel really good and maybe your clothes are even fitting better, but you aren’t seeing the scale change, or maybe the scale’s even going up, your body composition is probably changing, but this can’t be reflected on the scale.
The scale also can’t show what’s going on internally when it comes to your health. Maybe your BMI is technically overweight or obese, but you eat healthy, drink lots of water, exercise, and your labs are GREAT. Size is not necessarily an indicator of health. There are tons of people out there who are technically in the overweight or obese category but are extremely healthy, and also lots of people out there who may be in a healthy weight category, but don’t participate in healthy behaviors.
If you do choose to weight yourself, here are a few tips. It’s going to be more accurate and consistent if you weigh yourself say, once a week versus every day, so that a trend is more apparent independently of fluctuations. It’s also going to be helpful to choose the same day and same time of day each week to do this, in order to have a little bit of control over some of the factors that play into fluctuation. For example, choosing to weigh yourself on Wednesday mornings after you wake up and use the bathroom. Remember to listen to your healthcare provider if you are given specific instructions for weighing yourself, since some health conditions require a little bit more careful monitoring of weight.
There are many people who set a goal of weight loss because they want to be healthier, or feel better. And if feeling good or getting healthier is one of your goals, I want to end here by offering some alternative ways to measure progress. You can track your moods or your sleep quality. Are you feeling good? Are you having regular and healthy bowel movements? Do you have more energy? What are your providers saying about your labs when they come back? How are your stress levels? Are you able to walk a mile when you used to not be able to? Are you able to concentrate on work or in conversations better than you used to?
These are all questions to ask yourself if you find yourself getting frustrated with the scale. Remember, it can be a helpful tool, but it can’t tell you the full picture at all when it comes to your health. And it can never tell you anything about your worth as a human being!
Thank you for listening, talk to you all next time!