For years, I gave patients a number. "Your ideal weight is 165 pounds." Then I watched them obsess over the scale, fail to hit the number, and feel like failures. I don't do that anymore.
The concept of "ideal weight" is medicalized nonsense. It implies there's one correct weight for every person of a given height. There isn't. There never was.
The Origin of "Ideal Weight"
The concept comes from insurance company mortality tables from the 1940s. Metropolitan Life Insurance Company published height-weight tables based on their policyholders — mostly white, middle-class Americans. These tables became "ideal weight" in medical practice.
They didn't account for:
- Frame size (small, medium, large bone structure)
- Muscle mass (athletes vs sedentary individuals)
- Age (metabolic needs change over time)
- Ethnicity (different body composition patterns)
- Health status (chronic illness, medications)
And yet, 80 years later, doctors are still giving patients "ideal weight" numbers. It's embarrassing.
What I Do Instead
Now I give patients a range. A healthy weight range. Based on BMI 18.5-24.9, adjusted for frame size, with the explicit caveat that this is a population-level estimate, not an individual prescription.
For a 5'10" male:
- Small frame: 144-163 lbs
- Medium frame: 149-172 lbs
- Large frame: 155-181 lbs
That's a 37-pound range. Not a single number. And even then, I tell patients: "This is a starting point. Your healthy weight might be higher or lower depending on your muscle mass, metabolic health, and how you feel."
The Real Goals
I shifted my practice from weight-focused to health-focused. The questions I ask now:
- Can you walk up two flights of stairs without stopping?
- Do you sleep through the night?
- What's your energy level at 3 PM?
- What's your fasting glucose? Your blood pressure?
- How's your mood? Your libido?
These are the metrics that matter. Not a number on a scale. The ideal weight calculator on this site? I built it because patients asked for it. But I always pair it with the same disclaimer: this is a range, not a target. Your body knows better than a calculator.
— D. Chen
