Keto Sister - The Problem with Being SkinnyWelcome to Keto Sister.  It seems I am doing an impromptu series on the psychology behind eating choices.  As a nutritional coach and administrator in several Facebook nutrition groups, I see regular comments from young women that truly sadden me.  Just this morning, I am calculating macros for a 30 year old woman whose weight loss has stalled.  She is lifting heavy weights five days per week for an hour and eating only 1,300 calories a day.

Sigh.  Gulp.  Face palm.  Breathe.

I have written about this topic, but I have also been this woman in my past.  The goal of many young women today is to get skinny because in many people’s minds, skinny is the new healthy.  We are taught that if we just get skinny enough, we will be healthy, we will be happy, and all our dreams will come true.

Hear this loud and clear:  skinny does not equal healthy, it just equals skinny.

It saddens me that young women in particular continue to get a message from the world that getting skinny is the way to happiness and self love.  Before you make her your idol, you should know a few things about this woman.

  1. Skinny women do not always have a menstrual cycle. It turns out that oligomenorrhea, irregular cycles, and hypothalamic amenorrhea, loss of the menstrual cycle altogether, are common occurrences among very thin women (Algars et al., 2014).  This is because women’s bodies are meant to maintain some amount of body fat.  Body fat alerts the female body that there is energy available to feed a baby, which is the entire biological purpose of a menstrual cycle.  Does this mean that not having a cycle is fine if you do not want to have children?  Of course not.  The regularity of the menses is a signal of general health in a premenopausal woman’s body.  Irregular or loss of a menstrual cycle is a sign of imbalance in the female body, which over time are correlated to increased risks for PCOS and breast cancer (Munster, 2013), osteoporosis (Slater et al., 2017), endometrial hyperplasia and heart disease (Master-Hunter and Heiman, 2006), to name a few.
  2. Skinny women are not always healthy. There is an assumption that skinny is what healthy looks like.  It’s an image held mostly by overweight people, and its not their fault for thinking so.  We are fed a load of garbage by the social marketing campaigns developed by the public health industry (says the woman with a Master of Public Health degree).  What’s the truth?  I weighed 140 pounds when I was vegan and I weigh 140 pounds today.  When I was vegan, I was hungry all the time, I ate 1,200 calories a day, did cardio five days a week, lifted heavy three days a week.  My hair was brittle, my skin was broken out, my moods were unstable and my teeth were splitting.  Needless to say, I was a size 6 and not the picture of health.  Today, I eat an average of 2,300 calories a day, I walk, do yoga and lift heavy things once or twice a week, I sleep like a baby, and my skin is smooth and my teeth are strong and healthy.  I am lean today but not by sacrificing my health.  And eating high fat helps my body heal some of the imbalances that my former skinny days created.
  3. Skinny women are under stress. Stress can wreak havoc in a woman’s body.  Being sick, not sleeping well, undereating or not eating often enough, and overtraining can increase the stress load on the hypothalamic-pituitary-adrenal axis.  Do you know any women who have “adrenal fatigue”?  Chronic fatigue?  Low testosterone or progesterone or DHEA or estrogen? Sleep poorly?  Have no sex drive? Are moody and miserable and a short fuse all of the time?  If so, then you know a stressed woman.  Stress is something we are meant to endure very short term, like the stress of running from a lion or childbirth.  Stress is not meant to be chronic, daily, or self induced.  Chronic stress in the form of cardio exercise (like running on a treadmill, climbing on the elliptical or racing on a bike), constant dieting, obsessing about food and calorie tracking are all stressful.  Stressed women sometimes are skinny but they often have a ring of belly fat caused by elevated levels of cortisol.  Elevated cortisol also causes elevated blood pressure, insulin resistance and elevated blood sugar, all of which are risk factor for diabetes, heart disease and stroke.

It is not fair to assume that a skinny woman is healthy, or happy, or balanced.  They are unrelated issues.  And because they are unrelated, you can be healthy, happy and balanced today despite your size and shape.  Today, you can:

  1. Eat a healthy diet. Read through my posts on the benefits of a ketogenic diet.  Eating low carb and high fat can be very healing for the body.
  2. Do exercises that make you feel good. This applies to your social life but can also apply to your fitness.  How’s that?  You do not have to exercise for fitness, but you can exercise for fun.  I like walking, I love yoga, and I love how I feel after I lift something heavy.  I am a former runner who realized (late) that I did not like how running made my hips and knees feel, so I do not run anymore.  It is possible to find movements that you enjoy, that feel like play and also elevate your heart rate, strengthen your cardiovascular system and build muscle.
  3. Do other things that make you feel good too. Enjoy your life.  Sometimes managing stress with laughter, good company, and getting good sleep can also have a side effect of dropping excess body fat.  Who knew?!

Being lean is not the end goal.  It can be an important part of being healthy, but sacrificing health for the sake of being lean is never worth it.  Idolize health, not an image that you think represents health.  A healthy, happy body in balance will eventually find its way to being lean.  Thanks for reading.


Algars M, Huang L, Von Holle AF, Peat CM, Thornton LM, Lichtenstein P, Bulik CM (2014) Binge eating and menstrual dysfunction. J Psychosom Res 76(1):19–22

Master-Hunter, T and Heiman, DL (2006).  Amenorrhea: Evaluation and Treatment.  American Family Physician, 73 (8), 1374.

Munster PN (2013).  Fertility preservation and breast cancer: a complex problem.  Oncology (6).

Slater J, Brown R, McLay-Cooke, R & Black K (2017).  Low Energy Availability in Exercising Women: Historical Perspectives and Future Directions.  Sports Medicine, 47 (2): 207-220.