For centuries, artistic representations of power, status and beauty often featured individuals whose physical characteristics would today be associated with higher body mass indexes, according to physician and researcher Dr. Hutan Yafi.

The observation reflects a broader debate among scholars and medical experts over how changing perceptions of health and attractiveness have influenced the interpretation of historical artworks.Yafi argues that throughout much of recorded history, larger body size frequently functioned as a visual indicator of wealth, authority and social standing.

In artistic depictions, rulers, religious figures, members of royal households and other influential individuals were commonly portrayed with fuller physiques. Similar characteristics were often associated with idealized representations of women, particularly in portraiture and other forms of figurative art.

According to Yafi, these portrayals reflected prevailing social and economic realities. In many societies, access to abundant food and resources was unevenly distributed, making larger body size a visible marker of prosperity and privilege.

As a result, artistic representations frequently reinforced social hierarchies by associating physical abundance with power, influence and desirability.“Strong men, leaders, royal families, religious people, high people in the society were portrayed with high BMI,” Yafi said. “Beautiful women and models were also portrayed with high BMI.”

The relationship between body size and cultural ideals remained relatively stable for long periods, Yafi said, before undergoing significant changes during the 20th century. He linked that shift to developments in medical research, particularly growing scientific understanding of nutrition and cardiovascular health.

According to Yafi, perceptions began to evolve during the second half of the 20th century as researchers increasingly examined the role of saturated fats and trans fats in metabolic disorders and cardiovascular disease. Public health discussions around diet and weight gained prominence, influencing both medical guidance and broader social attitudes.

As scientific research expanded, body image standards in popular culture and visual media also changed, Yafi said. He argued that thinner body types increasingly became associated with attractiveness and health, while obesity became more likely to be viewed negatively.

“This led to images of thin, often unrealistically thin, men and women being glorified and obesity being stigmatised,” Yafi said. “Suddenly, thin people became beautiful and the women who inspired artists for centuries were no longer considered attractive.”The evolution of beauty standards has attracted attention from researchers examining the intersection of medicine, culture and visual representation.

Some have sought to analyze historical artworks through a modern medical lens, looking for physical features that may suggest underlying health conditions. Such efforts remain controversial because they rely on interpretations of artistic representations rather than direct clinical evidence.

One of the most frequently discussed examples involves the Mona Lisa, the iconic portrait painted by Leonardo da Vinci during the Renaissance. The painting has long been the subject of academic inquiry across disciplines ranging from art history and conservation science to medicine and psychology.

Yafi noted that some scientists have proposed retrospective medical interpretations of the portrait’s subject. Among the hypotheses advanced in academic discussions are suggestions that features visible in the painting could indicate elevated cholesterol levels, issues related to body mass or endocrine disorders such as hypothyroidism.

“Some scientists believe Leonardo da Vinci’s Mona Lisa was very unhealthy and that she had a problem with her BMI, cholesterol and severe hypothyroidism,” Yafi said.At the same time, Yafi acknowledged the limitations inherent in such analyses. Because the subject lived centuries ago and no direct medical examination is possible, any conclusions remain speculative and dependent on visual interpretation.

“We don’t know because we cannot go back and make a diagnosis, we are just analysing her features,” Yafi added.The debate highlights a broader challenge faced by researchers attempting to apply modern medical frameworks to historical figures.

While advances in medical science provide new tools for interpreting visual evidence, artworks were not created as clinical records. Portraits often incorporate symbolism, stylistic conventions and artistic choices that can complicate efforts to draw conclusions about physical health.Art historian Bendor Grosvenor has cautioned against treating artistic depictions as reliable diagnostic evidence.

He argues that portraiture operates within artistic and cultural contexts that extend beyond physical resemblance.“Poor Mona Lisa, she’s always being diagnosed with something she almost certainly never had,” Grosvenor said.His comments reflect concerns shared by many art historians who view retrospective medical diagnoses as inherently uncertain.

According to Grosvenor, visual characteristics in a painting cannot be separated from the artistic intentions of the painter or the conventions of the period in which the work was produced.“If a doctor today diagnosed someone only on the basis of how their face looked, we wouldn’t take them seriously,” he said.Grosvenor emphasized that portraiture often serves purposes beyond recording physical appearance.

Artists may alter proportions, emphasize particular features or incorporate symbolic elements intended to communicate status, personality or cultural values rather than provide an exact representation of the subject.“Art is art, and a portrait – even one by Leonardo – is usually about so much more than likeness, let alone health,” Grosvenor said.

His remarks underscore a longstanding tension between medical interpretation and art historical analysis. While physicians may view visual details as potential indicators of health conditions, historians generally stress the importance of understanding artworks within their original social, cultural and artistic contexts.

The discussion surrounding the Mona Lisa also reflects broader questions about how contemporary societies interpret historical images. Standards of beauty, health and physical appearance have shifted significantly across different eras, often influenced by changing economic conditions, scientific knowledge and cultural values. As a result, characteristics that were once celebrated or considered desirable may later be viewed differently.

Yafi’s observations suggest that modern assumptions about body size and attractiveness cannot always be applied to earlier periods without considering historical context. Artistic depictions of rulers, aristocrats and celebrated women often reflected the ideals of their time rather than contemporary expectations.

Grosvenor, meanwhile, argues that efforts to diagnose historical figures based on portraits risk oversimplifying works of art whose significance extends beyond physical appearance. For historians, paintings remain cultural artifacts shaped by creative decisions, social conventions and symbolic meanings that cannot be reduced to questions of medical status alone.

“This is as likely for the art of the future as the art of the past,” Grosvenor said. “Art is art, and a portrait is usually about much more than health.”