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John Whyte, M.D., MPH Headshot

What Our Clothes Say About Our Health

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Have you noticed lately that a lot of men's shirts seem to be called "slim fit"? I bet you even own a few. Somebody has to own them because they're everywhere. And just recently, I've been baffled by this new category of shirts -- EXTRA slim. What the heck does that mean? What makes it extra slim? Is that like extra skinny? As if trying to squeeze into the standard slim-fit clothes was not enough of a struggle, now we have to suck in that gut and wear an extra-slim shirt and pants, in order to be fashionably fit.

And who is wearing all these slim shirts? Last time I checked we had an obesity epidemic. So how is everyone now slim? According to fashion trends, five years ago, 60 percent of clothes were regular fitted and 4 percent were slim fitted. Flip it around to today and 40 percent are regular, 50 percent are slim, and 10 percent are now EXTRA slim. Calvin Klein even introduced a line called Extreme Slim Fit. Wow! Does this mean we are slimmer than we were five years ago? I don't think that's the case because the last time I checked 70 percent of American adults are overweight.

I think slim fit is becoming the latest fashion craze. You see it everywhere. Consider this: I recently had a student intern working with me at the office. He considered himself athletic, healthy, and for the most part, in shape. Well, at least that's what he told us! He did not realize, however, his shirt buttons were ready to fly across the room, ricochet off walls, and peg someone in the eye whenever he crossed his arms. What he ultimately needed to realize was that he should not be shopping in the ultra-slim-fit section at Macy's and that he was not nearly as healthy as he thought.

[Poll] Let's take a quick quiz. Would you consider yourself underweight, healthy weight, overweight, or obese?

Clothes and their relationship to health is not a new phenomenon. Victorian doctors once believed tight trousers caused an outbreak of internal bleeding in New York. Fast forward to the 21st century and we now know that tight clothes can affect the fertility of men. Tight undergarments may affect the cooling of our organs and was hypothesized to have a role in testicular and breast cancer. In a study published just last year, slim-fit pants limited muscle activity and even increased back pain in factory workers in Thailand.

You're probably thinking "what's the big deal about wearing too tight a shirt? I'll just loosen that top button." Well, it's not that simple. The problem that I have with this burgeoning slim fit (and now extra-slim fit) is that it promotes the idea that one is at a healthy weight. After all, how can you be fat and need to lose weight if you fit in slim-fit clothes? We all know that men are notorious for not going to the doctor. We deny health problems typically until we cannot tolerate symptoms or our spouse makes us. I have had more male patients than I can remember insist they were muscular when I told them they were overweight! The reality was they were obese -- not muscle-bound. So now I have to battle this mistaken belief that many male patients now think they are doing pretty well with their weight -- JUST because their clothes are labeled as "slim" and "fit." Even a scale could not convince them otherwise.

And ignoring excess weight has a lot of consequences. Being overweight can increase your risk of premature death. In fact, people who are overweight have a greater risk of dying than people who smoke 10 cigarettes a day. You might be cutting out 10 years from your lifespan by being overweight.

We have an incredible lack of self-awareness when it comes to our own health. As a matter of fact, a recent study shows that over 40 percent misperceive their own body image. And even when you ask patients with diabetes if weight and diabetes is associated, they will say "yes," but then it doesn't apply to them -- even when they are in fact overweight! What about our kids? Some 93.5 percent of parents recognized their children were overweight or obese -- but 30 percent didn't think their child's excess weight was a problem to their child's health! No wonder obesity has doubled in children and quadrupled in teens.

With an increasing number of Americans trying to adopt the skinny style of our slightly slimmer European counterparts, many of us are stretching our ideas of being healthy and thin -- literally. The inability to associate weight with disease is one problem. The inability to associate our own weights with our personal risk of diabetes, heart disease, and stroke is another problem that cannot simply be zipped up and overlooked.

Still think you're a slim fit? Extra slim? I've got a better test for you than the tag on your clothes: Wrap the thumb and middle finger of one hand around the opposite wrist. Do they overlap, just touch or not touch at all? If they barely touch, or do not touch aedisposition for obesity.

Just because you fit (or think you do) into a slim-fit shirt does not mean you are slim, fit or in a healthy weight range. Let us be honest to ourselves -- fitting into slim-fit clothes is not a strong claim to being healthy. If your clothes don't fit as they should, it may be time to re-evaluate your body image and make the appropriate changes -- with both your closet and your diet. Even if you do fit comfortably into your clothes, it is important to remember that your doctor, not Calvin Klein or Macy's, should be the one telling you about your weight and your health.

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