Ideal Body Weight: What Does it Mean?

It sounds like a reasonable question: "What is your ideal body weight?" But beware: this is a technical term that is often confused for what it sounds like: an aesthetic ideal.

"Ideal Body Weight" (IBW) is a term used frequently in the eating disorders world. Sadly, there is no industry standard on what it means or how to calculate it. Although weight restoration is the first order of business in anorexia treatment and often in bulimia as well, no one agrees on the method. Many clinicians use BMI charts, growth charts, or the old "100 pounds for 5 feet plus 5 pounds per inch." Some clinicians are now using pelvic ultrasound (for female patients) to determine the return to a healthy body composition. Others use vital signs like heartbeat and temperature. Many clinicians prefer to use mental stability and flexibility as a guide for weight restoration.

Patients and their families get confused, too. Patients are often asked what THEIR ideal body weight is, which is unlikely to be a number compatible with healthy functioning. Parents, not understanding the role of weight restoration in quelling eating disorder thoughts, often find themselves repeating their child's "Ideal Weight" as if it was a meaningful number or one above which they should be fearful.

The Risk of Setting Targets Too Low

Recent evidence has made it clearer that weight targets have been set too low for many patients and the undershooting of weight targets plays a role in recovery rates.

Here is what I've learned that applies to all of us: healthy body weight isn't a choice. It isn't an aesthetic issue, or a matter of will. The weight and size and body composition of a healthy person is determined by their unique genetic and biological needs. If illness or circumstances keep the person above or below the range their body is expecting they often suffer perplexing mental symptoms. Instead of pursuing a weight or weight range, the "ideal" is really to let go of that and focus on finding healthy energy regulation and activity and mental health.

I Don't Have An Ideal Body Weight

I don't have an "ideal" body weight and I don't know what the charts would set my technical "Ideal Body Weight" to be. I don't actually care - though of course years ago I bought into the same stuff so many of us do. I used to think being healthy meant weighing less than whatever I did and that I was in charge of my weight. Now I let my health be my concern and don't use a scale at all.