“Have you had her checked for a tapeworm?” My grandmother asked my mother when I was 11 years old. My outspoken and opinionated grandma was in disbelief that a girl like me could eat so much and not gain a pound.

But I was just a normal, healthy kid with a good metabolism. I didn’t have an eating disorder. I was fortunate that I could eat three bowls of ice cream a day and still fit into my skinny jeans. But when I was in early high school, I was diagnosed as anaemic.

“No wonder you’re so skinny,” a friend told me, insinuating that my body shape was indicative of a medical condition.

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When I look back at pictures of me in my teens, I was thin, but I didn’t look unhealthy. Yet even at the height of my thinness in my youth, I still struggled with body issues. My arms were too hairy, I hated my chin. My ankles weren’t dainty enough. Like most women and girls, my body image was far from perfect.

In university, I gained the infamous “freshman fifteen”. Two years later, when I interned and walked well over 10,000 steps a day to work, I lost weight. When I returned to campus, I was inundated with compliments: “You look fantastic!” “You’re so skinny now, I hate you.” “What did you do to lose so much weight?”

I asked myself, was I really that fat before? Did I look so terrible before I lost weight that people felt the need to congratulate me on my new, more societal appropriate appearance?

With 9kg lost, and back to a size 8, I was suddenly in the “club” again; pretty enough for guys to hit on me at parties and back in the population of women who regularly got catcalled when I walked down a busy street.

Four years later, I was 20kg heavier. I worked for a senator in the United States. In the span of three months, my father died, 9/11 happened, and anthrax was mailed to our office.

And so I ate. Food was a great escape from the stress. At my heaviest, I was a size 16.

Not long after I married, my husband and I tried to get pregnant. Months went by with no luck. I visited an gynaecologist. As soon as she walked into the room she took one look at me and said, “I can tell by looking at you that you’re not ovulating regularly. You need to lose weight. If you drop 10kg, you’ll be pregnant before you know it.”

I left the appointment devastated. Was my fatness the first characteristic people noticed about me? If someone described my appearance, was I the “fat young woman with brown hair?”

I immediately started a rigid weight loss program. I dropped my caloric intake and exercised five to six days a week. I started running. Soon I was running over 24km a week.

Within eight months, I lost nearly 27kg. I fit comfortably into a size 4. People were amazed at my stunning transformation. My husband’s friends congratulated him on his “hot” wife. Apparently, in my mind, I was a troll to them before. Again, I couldn’t stop asking myself, was I really that horrible looking before I lost weight?

Nevertheless, weight loss became an exciting challenge for me.

It seemed as more of me disappeared, the more I was admired. At least by men, anyway. Oddly enough, I noticed the more weight that I lost, women became less friendly to me.

Today, fifteen years since then, my weight has been all over the map. I birthed two children and gained 20kg, trained for a marathon, and was back to size 4.

I got pregnant again, gained 18kg, and eventually lost 10.

In 2016, I fell sick with a mystery illness and became bedbound for hours a day. The less I could do, my weight slowly crept up.

It took four years, 10 doctors and nearly $50,000 in medical bills to finally get a diagnosis: Late Stage Lyme Disease. I’m now on a cocktail of prescription drugs with a slew of unpleasant side effects, including loss of appetite.

In the last nine months, I have lost nearly 13kg and can fit into a size 10 pair of jeans.

Again, I am starting to receive compliments. “You’re looking good, you must be feeling better!”

I know people mean well, but no, I’m not feeling better. On a good day, I eat one meal. I struggle with constant nausea, and the medication I’m on causes me to use the toilet several times a day, often at the most inconvenient times. My muscle mass is minimal due to extreme arm and leg weakness. My legs that used to run 20km a day now creak and ache as I walk up a flight of stairs.

Lyme bacteria, once settled in the body, makes its home in the joints, causing arthritis and other ailments. My arms that used to pump 6kg dumbbells can no longer hold my six-year-old, 18kg daughter.

Being thin does not equal good health. Even when I was running 40km a week, training for a marathon, I wasn’t in a healthy place. I was obsessed with being thin — so obsessed that if I missed even one day of running I scolded myself.

I don’t mean to make the assumption that a person should never compliment someone on their weight loss. We should celebrate when anyone reaches a new health milestone, whether it be losing weight, gaining more muscle mass, or overcoming a mental health challenge.

But we must be mindful not to fall into the trap of overly celebrating thinness. We play a dangerous game with people’s self-esteem and livelihood when we unintentionally praise them for their body size.

There are an array of reasons for weight loss. From chemotherapy, to eating disorders, to autoimmune diseases, to depression — people experience weight loss for the worst of reasons, not because they are necessarily trying to get healthier.

I think back to the gynaecologist who assumed that the only reason I couldn’t get pregnant was that I was overweight. Even when I was my smallest, I still struggled with infertility. And as I struggled to get a diagnosis for the odd neurological symptoms I’ve experienced in the last four years, several physicians told me that I would feel better if I just “lost a little weight”.

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I can’t go back in time and react differently to the way I was treated at my thinnest and my heaviest, but I can do everything possible to encourage and empower my daughters, ages 11 and 6, to have a positive body image.

My 11-year-old, a bright and strong-willed redhead with hair like Merida from Brave, brags about the fuzzy red hair on her legs and proudly compares her size 10 shoe to my “puny” size 8 and a half. She is a tall healthy girl, and proud of it. I haven’t once mentioned to her the possibility of her shaving her legs. I know one day she’ll likely bring it up to me, but until then, we’ll continue to relish in her natural beauty.

I’m teaching my daughters and sons that beauty comes in all shapes and sizes; that thinness doesn’t mean healthy, and that fat doesn’t mean ugly. And it’s a hard lesson to teach. No matter what I preach to my children, I know my voice will be drowned out by messages in the mainstream media about beauty and likeability.

In the meantime, I urge you to think twice before you remark or compliment someone on their weight loss. Even as people compliment me today, unaware of my medical condition, I still have that stubborn question creep up on me. Was I unworthy of compliments when I was 13kg heavier?

The answer, of course, is no. Our self-worth isn’t measured by our dress size.

In a society that tells us otherwise, it’s up to us to train up a new generation of empowered young girls and women. The amount of flesh on our skeleton doesn’t change our DNA, it doesn’t change who we are at our core.

In the end, we all have the same needs: love, security, relationship, and validation. And no number on a scale, no inch marker on a measuring tape, will ever change that. Fat, thin, sick, healthy, and in between, we’re all in this together.

This post originally appeared on Medium and has been republished here with full permission.

Feature Image: Getty. The feature image used is a stock image.