My guess is these two words get different reactions from different people. It has been my experience over the years that in our culture we assume pretty much everyone wants to be “thin”. And most people equate being “healthy” with being “thin”. Most of us assume if we tell someone they look “healthy” it would be a compliment. Or, we assume telling someone they are lucky they are so “thin” is also a compliment.

What I have learned from my patients is for those with eating disorders, being told you are “healthy” is equivalent to being told you are “fat”. For some of the patients I work with who have trouble gaining weight, being told they are “too thin” is very hurtful, as their body image concerns are often interfering with their lives just as the person who is concerned about being “too fat”.

My goal is to help people see that a goal of “healthy” is the smartest goal. The first step for some is working on their “self-talk” around the word “healthy” and eventually accepting it has nothing to do with your size. For others whose goal is being “thin”, instead changing to a goal of being “healthy” because that may be a goal they can actually achieve (not to mention, a goal of being healthy is also mentally healthier!)

I will always remember a teenage patient of mine who had moved from Africa and had lost a few pounds (still a very normal and healthy weight). Dad brought her in because he was very concerned about this. When I asked about his concerns, he said “I want her to be fat. Doesn’t everybody want to be fat?” He was very serious but I couldn’t help but smile inside. I did have to explain to him that we can’t always control that but I wanted to be sure she was “healthy”. He never came back ; )