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Jessica is our 2016 Olympic Hopeful and Sarah is our 2012 Olympian in Weightlifting. We're setting out to be "Pretty Strong" and we encourage you to do the same.


Monday, June 25, 2012

Does size= health?

Some thinner women are associate with eating disorders and some larger women are associated with over eating. There are assumptions on their eating habits, their exercise habits, and personality traits.

How much truth does your size actually hold? I say none. You must look underneath the exterior to find out the truth about their health. Look into their anatomy. 

I think these factors are the most important in determining the physical health of a person:

Body fat distribution
Blood Work
Bone and joint health

I am going to use myself as an example to demonstrate health despite size.

Here are my stats:
125 kgs/275 lbs
Size 20/22

In a book I have about sports and exercise science, the definition of obesity is, "A pathological condition in which a person's body weight is is 20-25% above their skeletal and physical requirements for a male and 30-35% for a female." It says nothing about body fat, and it says nothing about your clothing size.

For my sport, MY physical and skeletal requirements are based on my weight class and levers. Because I am 5'10 and have a larger frame and long levers, I am best suited for the 75+ weight class and need my body weight to lift large amounts of weight. Am I considered, "obese?" Am I "unhealthy?" It depends on who you ask.

Body Mass Index
I weigh about 275 lbs. I'm assuming if my weight were actually on the chart, I'd be considered "obese." I think this chart is relatively bogus. Athletes, especially power athletes like myself are going to have a large amount of muscle mass, making them weigh more for their height than the average person. I can understand using this chart for the average or sedentary person but it is not applicable to all people. Why is there only one chart? Shouldn't there be one for each gender at least?

In 2010, I had a Dr. tell me what my BMI was and it was 39.1 at 266 lbs

Body Fat Distribution

At 5'10 and 275 lbs, now my body fat percentage is 34.8 That means 95.7 lbs of my body is fat but 179 of it is lean muscle. Take away all of my fat and leave only lean tissue which is organs, bones, and muscle, and I weight 179 lbs. Even at that weight, my BMI is considered over weight.

Where body fat is located is a major indicator of health in my opinion. Is it located subcutaneously (under the skin) or viscerally (around the organs)? Which sounds like a greater problem to your health and life?

My body fat is located under the skin. Not in or around my organs. Thank goodness!

Blood work

When I initially got detailed blood work I was surprised at how bad some of it was. The initial blood work was done toward the end of June and then the beginning of October. Based on the way I "look" you could assume that my blood results were a given because I am "unhealthy." June's results would show what you expect in a big person.  


Total Cholesterol 250 High/Normal 100-199
Triglycerides 171 High/Normal 0-149
LDL Cholesterol 169 High/Normal 0-99
HDL Cholesterol 28.3 Low/Normal >= 30.5
TSH (thyroid stimulating hormone) 99.79 High/Normal 0.45-4.50
Triiodothyronine, free serum  1.2 Low/Normal 2.0-4.4
T4, direct 0.35 Low/ Normal 0.82-1.77


Total Cholesterol 138/Normal 100-199
Triglycerides 118/Normal 0-149
LDL Cholesterol 75/Normal 0-99
HDL Cholesterol 28.3 Low/Normal >= 30.5
TSH (thyroid stimulating hormone) 0.008/Normal 0.45-4.50
Triiodothyronine, free serum  9.6 High/Normal 2.0-4.4
T4, direct 1.67/Normal 0.82-1.77

I started taking Armour Thyroid which is a natural thyroid hormone and within that short period of time, all of my blood work corrected itself. I also adjusted my diet somewhat. I am so thankful to be healthy on the inside! My previous blood work wasn't a result from bad eating habits or lack of exercise, it was because my Thyroid wasn't working properly. TSH is Thyroid Stimulating Hormone. That tells your thyroid to start working. That was because my actual thyroid hormones like T4 and triiodothyronine were low. It's surprising how much your Thyroid actually controls.

I think it's also noteworthy to state that I do not have DIABEETUS.

Bone and Joint Health
The last indicators of health I'd like to discuss are the bones and joints. Your bones and joints, as well as your body fat distribution and blood work can say a lot about the health of a person.

Because I do resistance exercises for a living, my bone mineral density is awesome. My score is 1.364 and my age matched score is 2.8. The highest score possible on this particular chart is 1.383 and the highest age matched score is 3. So I am in the highest percentiles for that. I've never had a broken bone and I don't have anything musculoskeletal issues outside of my wrist deformity (which I will discuss in a future post)

In conclusion

So the moral of the story is that looks can be deceiving. What a person looks like is not a good indicator of their health. Some people may see me and think that I could have health problems. Little do they know I spend anywhere from 6-24 hrs in the gym in a week, totally healthy on the inside and out, and am an Olympian.

That scan of the skeleton and fat is actually me. I want to be as honest and transparent as possible. I guess I did that quite literally this time.

I wish I could elaborate more on the counter argument of thinner people and their health but, using myself is the best I could do.

I still have work to do to make me a healthier person and a better athlete. I will always have that work to do.

I recommend seeing your doctor and seeing what you can do to make yourself healthier and happier. Always see your doctor before starting and exercise or diet regiment.

Stay Strong,


Jules Marsh said...

Great article! It's something I worry about a lot. I suppose I should preface by saying that I'm actually a couple of pounds heavier that you, so not trying to judge. I will say that, diabetes/obesity is the plague of our era. Americans are trending towards shorter sicker lives on the whole. In certain areas of the country, notably the southeast, it's quite dramatic. Body fat percentage is a good indicator of metabolic health and a pretty good predictor of a lot of health problems.

BMI makes me want to scream. The medical profession horribly abuses BMI. BMI is a retrospective, chart review tool. If you're a medical researcher, and you've got a stack of charts from patients, and need to seperate them into obese or not obese, BMI is a wondereful tool. All the charts will have a height and a weight in them, and on a population basis, bmi correlates fairly well with obesity. The problem with BMI is that it assumes you have average (i.e. sedentary) muscle mass. That works ok as an assumption on a population basis, but in individual patients it can be WAY off. If you have an individual patient sitting in front of you, there are much more acurate ways of determining if that person is obese. Something like whole body DEXA is going to be MUCH more acurate in assessing obesity in a strength sport athlete.

I guess i do think that as a super, there's a tradeoff between optimizing your weight for weightlifting vs optimizing you weight for health. If my goal was to be maximally healthy, I'd probably need to be 20-30 pounds lighter. Then I couldn't lift as well. All sports involve some degree of health risk. Down hill skiing, polo, soccer, or even marathoning involve considerable health risk. In my opinion, weightlifting is healthier than those and certainly MUCH healthier than being a couch potato.

I think the thyroid thing is interesting too. Me and another weightlifting friend had quite a bit of trouble with our thyroids last year. Maybe its just coincidence? Maybe something related to all the heavy training?

Donna said...

Yes! Not sure why this is so hard for people to wrap their head around, but I completely agree. Thanks for posting!

Rhiannon said...

I have a lot of admiration for you and I hope that you go far this summer. I don't know if you know anything about Health At Every Size, but if you don't you should check it out. It talks a lot about how weight and BMI has very little correlation with health and how everyone can be healthy no matter what size they are. The book and original research study is by Linda Bacon. I really hope this helps you when you start feeling down about your physique. As a woman who lifts (though not as much as you!) I have found ti to be helpful.

Mel said...

How funny! Jules is a friend of mine. :) Glad to see her opinion on the matter.

I noticed you had a DEXA scan as one of your first images; I think that was a smart way to go, considering the precision of DEXA scan vs. other methods like a dunk tank or electrical resistance.

This is my first read of your blog, so I haven't delved very deeply, but I am just curious what foods you choose to eat? I am generally 80/20 Paleo. I just converted to Oly-lifting a few months ago after 4 long injury-filled years at Crossfit. 5'5",165 lb, getting stronger by the day...

Also a funny anecdote for you: at my gym the other night, a lady who is relatively thin asked us all what we weighed. The majority of the people lifting at the time were women. I think the responses kind of shocked her: "165", "189", "160", etc... she is still in the mindframe that beauty is the number of lb you weigh, and I think we gave her something to chew on in the sense that muscle is denser than fat. :)

Allison said...

What a great post. Youinspire me to see myself outside of societies box.

Crystal said...

Keep trucking, Sarah! You should know you are beautiful on the outside, and you need to keep showing that. From what I've read here, you're a strong woman, inside and out. I hope you accomplish all your dreams.

K said...

I just read a profile about Sarah, linked from Andrew Sullivan's blog. I am so excited to read about your journey through health, both emotionally and physically. I wish all the best for you both in London! As a women gaining strength in the gym, I am seeing how it gives me strength out of the gym. Keep it up, sisters! You're beautiful! Don't forget it!

K said...

I just read a profile about Sarah, linked from Andrew Sullivan's blog. I am so excited to read about your journey through health, both emotionally and physically. I wish all the best for you both in London! As a women gaining strength in the gym, I am seeing how it gives me strength out of the gym. Keep it up, sisters! You're beautiful! Don't forget it!

Beth Woolsey: Five Kids Is A Lot Of Kids said...

Just stopping by to say how glad I am to hear your story. Wishing you every blessing as you pursue your goal!

Anonymous said...

Because I've always been thin, no one seemed to think it was a problem that I never exercised and ate junk food all the time. My doctor never urged me to improve my lifestyle. I eventually wised up by myself and started taking steps toward being healthier, but wouldn't it be nice if I had started earlier! This mentality is damaging to everyone, skinny, fat, etc.

By the way, I wonder if you can get your HDL up by eating more olive oil and avocados, that sort of thing.

jurassicpork said...

Hey, good luck in London, Sarah.

Anonymous said...

Thanks for setting such a great example, Sarah!

Alethea said...

LOL at this: "That scan of the skeleton and fat is actually me. I want to be as honest and transparent as possible. I guess I did that quite literally this time."

You are so funny! And very informative as well as concise. I agree with your top three there. I just recently went to the doctor as my hubby and I are planning to have a baby next year. My body fat distribution and chol, etc. are ok, but I have terrible joints. I experience a lot of neck, shoulder, and lower back pain--I'm not excited to find out how being pregnant is going to affect that D:

By BMI I'm considered normal weight but I'm nowhere near as healthy or athletic as you! I can barely make it through 1/4 of my hubby's usual 3-mile hike, and if I try to lift more than 40 lbs of anything ever, I usually trigger sciatic nerve pain and have to sit on ice on and off for a few days. I'm hoping by the time my (still hypothetical) kid is that weight he or she can help me out by doing more clinging than I have to do the carrying.

I wish people would pay more attention to their overall picture of health and not just what the covers of "fitness" magazines tell us we should look like. Thanks for all the great info and good luck this summer. :D

Anonymous said...

Sarah, I'm a teenage girl from London and I came across an article about you today, and I find you totally inspiring. I'm no professional athlete, but it drives me crazy to have people assume that I can't out-swim or outrun them because I'm a bit bigger. You're an incredible role model, and I love that you prove people's assumptions wrong. All the best for the Olympics!

Yolanda said...

Thanks for this article, Sarah. I have a 10 yr old daughter and recently she was weighed in a physical for school. She weighed 98lbs and immediately her doctor wanted to do a round of blood work, telling me she is borderline obese.

Now, here is the problem. My daughter trains in the martial arts. She trains in her dojo about 6 hours a week, as well as at home. She also does strength and cardio training as part of her regiment. She also swims 4 to 6 hours a week as well. She is muscular and does not even look overweight at all. I am careful with her diet because I am obese and want to ensure she has a very clear way on how to eat healthy. Even though they know she is an athlete, it doesn't matter.

Yet, it seems that her doctor has predetermined my child's health based on my appearance. We have done this round of bloodwork and it came back absolutely perfect. However, now my daughter is starting to obsess about her weight and it has all started with this doctor's comments. Needless to say, we are searching for another doctor.

Thank you for your example and your transparancy. This way people can see you can be bigger than whatever society's "standard" is still be healthy.

Anonymous said...

Sarah, you are amazing and inspiring. Some day, I hope to be as TOTALLY AWESOME as you are. Much love.

Jenna said...

This was a very thorough look at your health vs. what the charts say. Thank you for taking the time to write it all out!

Anonymous said...

I never comment on blogs, but you are super awesome. I'm a large women just starting out in weightlifting. My goal is not necessarily to lose weight but to become strong and enjoy what my body can do. You are absolutely an inspiration in that. I'll be cheering you on at the Olympics!

Michelle Klein-Hass said...

Right on!!! This is totally awesome. Strong is the new skinny. Keep on kicking butt, Sarah!