If you’re wanting to “get healthy”, chances are one of your goals to lose weight. You might’ve even been told by a health professional that you need to lose weight or lower your Body Mass Index (BMI – a ratio of your height to weight, usually scaled against age), which for all intents and purposes is saying the same thing. Yet for a lot of people losing weight – especially a significant amount of weight – can be extremely difficult. More than that, putting in the effort – changing your diet, exercising more, drinking more water, taking supplements, etc. – but not seeing the scale move the way you want can be very discouraging, even make you feel worse about yourself. That in turn can lead to more unhealthy behaviors, such as extreme dieting/exercise, or conversely, returning to bad lifestyle habits.
This might be hard to hear, maybe harder to accept, but here it is: your weight is not the best indicator of your health.
I know that’s going to upset some people, however it doesn’t change the facts: your weight doesn’t tell you anything beyond how much your mass – all the matter that makes up you – is affected by gravity. It doesn’t tell you what proportion of your mass is fat, or how your heart or other organs are functioning, what your cholesterol level is, how hydrated you are, or how you’re feeling today (though that number might affect how you’re feeling, but you shouldn’t let it).
That’s not to say it’s a useless measure: we do know that there are health risks related to being under- or over-weight, though again either condition requires a closer examination of what is actually happening inside you. What I’m saying is that we tend to place too much importance on that number on the scale, when there are much better indicators of our actual health.
If you’re trying to improve your health, I’d like to suggest five alternatives to weighing yourself that could prove useful to helping you see whether you are achieving your goals. This is not an exhaustive list and I’m sure there are many others that might be more specific to you; these suggestions are made as things that you can easily and readily do.
Measure Your Waist Circumference
What you need: a tape measure.
For some time now clinical research has been demonstrating that waist circumference is a stronger indicator of a person’s physical fitness and risk of impaired health than BMI. There have been numerous studies which show that waist circumference, or waist-to-hip ratio (ie: the size of your waist relative to the size of your hips) are better indicators of a range of health risks, for example, risk of heart attack, early death, and other obesity-related health risks.
The reasoning behind this comes from two main observations: first, that increased abdominal fat correlates high with health risks; and second, that BMI alone does not allow for where or how much body fat a person has – for example, bodybuilders can often be classified as obese despite having low body fat levels, whereas particularly tall individuals may be classified as normal despite having increased abdominal fat (indicated by waist-to-hip ratio).
So while you might be losing weight and thereby reducing your BMI, or even if you’re gaining weight (as you might if you’re increasing your muscle mass) and increasing your BMI, if you’re not reducing your waistline, you might not be reducing your risk factors for other health problems.
How do I measure my waist? Simple: find the top of your pelvis and run a tape measure around yourself. For many people this will be roughly at the level of your belly button. Make sure the tape measure is flat against your skin but not squeezing you.
If you want to try and measure your waist-to-hip ratio, measure your waist, then measure your hips by finding the bony part of the outside of your thigh (hint: this will roughly be where your pants pockets are) and use the tape measure as you did for your waist. Divide your waist measurement by your hip measurement (waist/hip). Generally your answer should be less than 1. The World Health Organization (WHO) classifies obesity as a wait-to-hip ratio of more than 0.85 for women and 0.90 for men.
Take Your Resting Heart Rate and/or Blood Pressure
What you need: a watch/stopwatch, smartwatch/smartphone/other device that records heart rate, a blood pressure cuff (sphygnomanometer).
One of the biggest health concerns of carrying excess fat is the affect it has on your heart, not just directly but also in the amount of work it makes our heart do. The tricky thing with your heart is that by the time symptoms that something is wrong start to appear, things have already gotten pretty bad.
When checking your resting heart rate or your blood pressure it’s always best to check when you’re in a state of rest. Generally speaking, this would involve being in a seated position, both feat flat on the floor, and calmly resting for between 5 to 15 minutes before checking. This should help give you consistent readings that you can compare over time.
Your resting heart rate is a good indicator of heart function and fitness. Resting heart rate varies depending on age, however a range of 60-100 beats per minute (bpm) is considered normal. Some people may be outside this range but still be healthy (eg: endurance athletes often have a resting heart rate of 40bpm or less) – you should always go by your doctor’s recommendation for what is right for you.
How do I measure my resting heart rate? If you’ve got a smart watch, smart phone or other device that can measure your heart rate, you’re already covered! If not, the easiest way is to check your pulse and count how many beats occur within a given time frame.
You can find your pulse by using two fingers (not your thumb, it has its own pulse) and placing them over the radial artery on the outside of your wrist, or the carotid artery in your neck (see the picture below). Press gently and you should feel the pulse beating under your fingertips. It can be tricky to locate so you might have to move your fingers around a bit. If you can’t find it yourself, try having someone else find it on you.
From there it’s as simple as counting the beats. You can either count for the full minute, or a smaller amount of time to get an estimate. For example: 10 beats in 10 seconds would be (10 x 6) 60bpm, while 20 beats in 15 seconds would be (20 x 4) 80bpm.
Your blood pressure is a critical indicator of whether your body is getting proper blood flow. Too low and the blood flow is insufficient, causing tiredness, dizziness and even nausea and fainting. Too high can lead to serious complications such as heart failure and stroke. Lots of things can affect your blood pressure, including your heart rate, and the health risks associated with too high (hypertension) or too low (hypotension) blood pressure increase the longer it’s left unchecked.
A blood pressure reading is made of up two numbers, often referred to as the “top and bottom” numbers because of how they’re displayed – you might be familiar with the standard 120/80 blood pressure. The “top” number should generally be somewhere between 90 and 130, while the “bottom” number should generally be somewhere between 60 and 80. Small variances usually aren’t cause for alarm, however it is always best to check with your doctor as to what an acceptable range for you should be.
How do I take my blood pressure? I would always recommend having someone who is trained to take your blood pressure do it for you. This does not necessarily mean is has to be your doctor; many pharmacies, allied health services, some gyms, and even pop-up health services have the staff and equipment to be able to check your blood pressure. If you are going to measure yourself, I recommend using a good quality automatic blood pressure cuff (not a wrist cuff as these are often inaccurate) and follow the directions included with it.
It’s known that weight loss can lower both your resting heart rate and blood pressure, however they can also respond well to exercise, diet, stress reduction and mindfulness practices such as meditation, yoga, and Tai Chi or Qigong.
Check Your Clothes Size
What you need: some clothes.
One of the biggest and most positive indicators that my body was changing shape was when I went to buy myself some new clothes and discovered that I was able to comfortably wear things that were several sizes lower than what I would ordinarily put myself in. If you want confirmation that all that healthy eating and exercise is having a positive affect on your body then in the absence of other ways to measure your results, your clothes and how they fit can give you a good indication how how things are changing.
There are a couple of things to bear in mind though.
First, we’re talking about comfortable fit: it’s not about whether you can squeeze yourself into something despite how it affects your ability to move or breathe. It’s about you being comfortable both in how it feels and how you feel it looks. You know when something is too tight, to restrictive, or just doesn’t feel right. It’s important to be honest with yourself.
Second, understand that there is no universal sizing system: meaning, a size “large” by one manufacturer could be anything from a “medium” to an “extra-large” (or even more extreme) by someone else, depending on who makes it, where it’s made, what materials it’s made from, and what the intended market is. The fashion and retail worlds are as aware and frustrated with this as consumers are, however the fact remains that just because you’re one size in one thing doesn’t mean you’ll be the same size in another.
How do I tell if my clothes size has changed? The easiest way is to compare apples to apples, or more specifically, compare the brand and style of one piece of clothing – let’s say, jeans – with the same brand and style so the only thing that should be different is the size. This would be the most accurate way to tell. Another way that also works as a motivator for some people is to have an item of clothing that you know doesn’t quite fit you, and over time recheck to see if the fit is improving. This was another good indicator to me, when I was able to start wearing several t-shirts I had bought but never worn cause they were just too small (funnily enough, I didn’t realise how big some of my other clothes were on me until I started being able to wear things I couldn’t before).
Notice Your Activity Tolerance
What you need: an activity you enjoy, and a way to measure what’s changing.
Activity tolerance is a phrase that health and exercise professionals use to describe and/or measure your ability to do things. It’s a broad definition, and could include anything from how far you can jog to how long you’re able to spend doing your gardening or housework to how breathless you become walking up a flight of stairs. The bottom line is: as your health and fitness changes, so your ability to tolerate certain activities should also change. Essentially you should be able to do things faster, for longer, and/or easier than you could before.
Because it’s so broad, it’s hard to give a specific example that is suitable for, or relevant to, everyone. The key is to choose something that you like or want to be able to do (or do better), and determine what would indicate an improvement in your ability to do it.
How do I measure my activity tolerance? What you measure will be highly dependent on the activity. Two common and relatively easy measurements are time (how long you can do something) and quantity (how much you can do, how far you can go). For example, if you enjoy walking as a form of exercise, then you could see a change in your activity tolerance reflected in how far you can walk before feeling tired, or how long it takes you to complete a certain distance. In both instances, improvements over time to your strength and endurance will help you walk further and/or complete the same distance in less time.
Another more clinical yet readily available measure of activity tolerance is the Rating of Perceived Exertion (RPE) Scale. The RPE is used to determine how much effort it takes for you to complete a given activity. The difficulty or demand of the activity is irrelevant; it’s about how difficult you perceive it to be. The lower on the scale, better your tolerance for that activity. This again can change over time with improvements to your health and fitness, and has been shown to be a reliable measure of activity tolerance.
Reflect on How You Feel
What you need: some time for self reflection, a diary.
When it comes to be healthy or improving our health, one thing we often overlook is how we feel. Some might argue that how we feel in and about ourselves is the best indicator and most important measure of our health of all. After all, isn’t our desire to improve our health based on wanting to feel better, be happier, and enjoy life more?
Our feelings – our emotional state – and our physical health are reciprocally linked. This is most evident when we get sick: our body is fighting off some bug, and consequently we don’t feel very good. Even in the absence of a specific illness or injury, when we don’t feel good, we often know (whether we acknowledge it or not) that our health is not at its best. Conversely, we also know that our feelings can affect our physical health. When we feel bad, this can have a negative impact or our health; for example, when we feel down or depressed, our immune system is impaired, which in turn makes it easier for us to get sick. However, when we feel good within ourselves, our immune system is stronger and more effective at fighting off infections. This link between physical and mental/emotional states is becoming better understood, and gradually moving from a biophysical to a biopsychosocial model of care.
When it seems like nothing else is changing, reflecting on your mental and emotional state can be a good indicator of whether your health is actually improving. It can take time for the numbers to change in the direction you want them to, whether on the scale, or the tape measure, or the label on your pants. What can change more quickly though is how you feel. The link between exercise and mood – and the subsequent changes to physical and mental health – has been well established, however other things, like changes to your diet and lifestyle, can also bring about changes to your mental and emotional health, and consequently have positive affects on your health. If you are putting in the effort and feeling better within yourself, change is happening, whether you see it or not.
How do I measure how I feel? It’s ideal if we can start any sort of program to improve our health by determining a baseline of where we are mentally and emotionally in addition to physically. Given that very few of us have probably considered this at the start of our health journey, you probably need to take some time to really reflect on how you feel right now, and how you’ve been feeling in the past. If it’s clear there’s a difference, try to identify what caused the change. For example, if you started exercising 6 weeks ago and the scale hasn’t changed but you feel happier, more confident, more engaged in life, it’s likely your health is improving. For some people, keeping a diary of some sort and reflecting on your feelings from time to time can be a good way of demonstrating how things have changed/improved over time, and can be a good encouragement when motivation is lacking or changes seem to have ‘peaked’.
These are just a few suggestions of many alternatives to measuring weight loss that you can use to determine if your health is improving. By all means still check your weight from time to time, but don’t let the scale be your only judge.
Do you use an alternative way of measuring your health and well-being? Feel free to share in the comments!
