The Scale: Our Understanding Is Out of Balance

Stepping on the scale can weigh heavy on your mind. Have you gained weight? Do you weigh enough? How accurate is the scale?

Your bathroom scale may cause you anxiety and grief and perhaps even lead to a poor self-image. But, according to Randall Moore, MD, Psychiatry, it can also give you misleading information regarding your health.

In a critical study involving 1100 middle-aged women of normal weight, 54 percent had excess body fat (more than 30% body fat), notes Dr. Moore. These women met the federal guidelines for weight, yet when their body composition was analyzed, they were clinically overweight.

A scale can be deceiving. It provides total weight, without taking into account fat-to-muscle ratio. For example, an average-height, 145-pound woman with small bones and very little muscle with 30 percent body fat will be considered to be of normal weight. Similarly, an average-height, 245-pound male athlete with 10 percent body fat would be considered overweight.

Dr. Moore asserts, “It’s not the number on the scale. It’s not your weight that counts. It’s your body composition that matters. How much muscle do you have? How much fat do you have? It’s critical to see that it’s not the number on the scale that’s important.”

“If your weight is normal, you’re middle aged and you’re not exercising, you probably have a bad body composition. You probably have excess fat and not enough muscle. Even though you’re of normal weight, your cardiovascular risk is double to quadruple what it would be if you had a healthy body composition—less fat and more muscle. So even though you may be of normal weight, you still have all these vascular disease risk factors that put you at risk,” cautions Dr. Moore.


Health problems associated with a poor body composition include:

  • High blood pressure
  • High blood cholesterol
  • Diabetes

Body composition is your proportion of fat and lean body tissues (muscles, bones, and organs). You’re at greater risk for significant health problems if you have too much fat—particularly if the fat is inside your abdominal cavity.

There are two simple ways to calculate your body composition:

  • Waist circumference (the distance around your natural waist)
  • Body mass index (BMI; it’s your weight divided by your height, squared)

According to the American Heart Association, a woman’s waist circumference should be under 35, and a man’s under 40 (depending on height). A healthy BMI is between 18.5 and 24.9.

Dr. Moore reminds us: “The number on the scale is not a guarantee of good health. Our culture tells people—especially women—that their value is determined by the number on the scale. Women say, ‘I am worth what my weight is.’ That’s just wrong. It would be really nice if women would get away from the notion of valuing themselves by the number on the scale.”

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The Scale: Our Understanding Is Out of Balance