Why the number on the scale doesn’t tell you the full picture about your health

Jennifer E. Engen

Many people regularly weigh themselves to stay on track in maintaining a healthy body weight. There is no denying that keeping a healthy body weight is beneficial for internal health and helps mitigate the risk of developing metabolic diseases and weight-related comorbidities. But what exactly is a healthy body weight?

The number on the scale depends on a combination of factors, including age, sex, height, activity levels, metabolism and illness or injury. Even if we studied two women of identical heights, ages and fitness levels, there would never be a one-size-fits-all number when it comes to their ideal weight.

Research consistently shows that if you’re working toward weight loss or weigh yourself for accountability, tracking your weight trend over time is helpful. That said, the scale should be viewed as one of many tools that can help you reach your goals. If you routinely weigh yourself, think of that number as a single snapshot of many factors that fluctuate day to day. If tracking weight is helpful for you, make sure to weigh yourself at the same time every day — ideally in the morning, after using the bathroom and before eating and drinking — for consistency and accuracy.

Unfortunately, for many people, weighing themselves sets the tone for the rest of the day. In my practice, I have seen a lot of patients pursue a specific weight that they associate with a certain physical appearance or even with happiness. We run into serious trouble when we connect the number on the scale to well-being and self-worth. If we have tunnel vision and only focus on that number, we miss out on the many other factors that affect physical and mental health and set ourselves up to chase a body that may or may not realistically help us achieve improved health and fitness.

Weight is an imperfect measurement and only gives us a fraction of information about how healthy we are. Looking at weight as a trend from a zoomed-out lens is more relevant, but that still does not give us the full view.

Your weight at any given moment consists of every morsel you have eaten and every drop you have drunk in recent hours, as well as every cell, tissue and fluid that makes up your anatomy. These factors fluctuate daily. For example, water retention or dehydration can significantly influence the number we see on the scale. You may retain more water the day after a salty meal. If you’re an athlete carbohydrate loading before a competition, you are likely storing water along with those extra carbs. Women can store several extra pounds of water at certain points in their menstrual cycle. This is not a bad thing — this is the way the body works! On the flip side, when we are sick, we often become dehydrated, resulting in a lower number on the scale.

These fluctuations should be normalized, and we should react to them neutrally, not let the number influence how we eat, exercise, or view ourselves for the rest of the day. Your “normal” or consistent weight should be a range to account for these shifts, rather than one single number.

There is a lot the number on the scale doesn’t say, including our body composition. How much of your body weight is muscle versus fat? Some scales spit out numbers for these measurements along with total body water, but few are accurate.

Often, when someone says they want to lose weight or “become more toned,” that means they actually want to lose body fat and gain lean muscle, which sometimes gets lost in translation. Muscle mass is crucial for mobility, strength and function, particularly as we age. Muscle is also a very metabolic tissue that can increase your daily metabolic rate or how many calories you expend as energy each day. If you are working toward body composition change, I recommend measuring your muscle versus fat mass, remeasuring over time to track change. Many gyms have special machines to measure body composition, a common one being the InBody system. You can also take measurements (the waist is an especially important one) with a good old-fashioned measuring tape and reassess every few months.

It can be frustrating if you’ve amped up your workouts and tightened your nutrition habits, but the number on the scale isn’t going down. Don’t be discouraged, as this does not tell us anything about your progress. See how your clothes fit instead. Assess your energy and confidence levels. It’s all about how you feel!

It’s also important to recognize the influence of genetics on body weight. Certain genes influence our metabolism and body composition, including the way we carry weight, how fast or slow we build muscle and how our weight is distributed. Even if you and your best friend are similar heights, your healthy weight range is likely different. And just because someone has a smaller body does not mean that they are healthier than someone with a larger body. Our weight does not tell us what is happening inside at any given moment.

Appropriate indications of internal health include blood pressure and lab work, such as cholesterol, triglyceride and hemoglobin A1c levels. Someone may start a new exercise program that can positively influence these biomarkers but not necessarily see a change in weight. If we’re ultra-focused on that number, we block out benefits that we can’t see or measure in real time, like how your heart is becoming more efficient at pumping blood or how your cells are becoming more efficient at using oxygen.

Consistently implementing new and improved lifestyle habits is challenging, and becoming preoccupied with weight or losing X number of pounds has the potential to cloud the end goal of better health. Set your goals differently by focusing on doing a certain amount or type of weekly workouts, cooking more at home, or bringing your lunch to work; rather than setting a goal weight or weekly weight-loss goal.

Weight can be a useful data point to look at over time, but that number cannot assess your internal health, mental health, nutrition and exercise habits, sleep, sense of community and overall happiness. You are so much more than your weight could ever measure. Remember that.

Emma Willingham is a registered dietitian who practices in an outpatient hospital clinic and through her private practice, Fuel with Emma. You can find her on social media at @fuelwithemma.


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