BMI (Body Mass Index) is an outdated, archaic system being used in the medical system that categorizes people into categories based on weight and is an imperfect tool. BMI doesn’t tell you what your skills, health, abilities are. Ilona Maher, a Bronze Olympic Rugby athlete is a perfect example of this. Ilona recently was body shamed in a TikTok comment for having a BMI of 30. Her response was perfect. I love how the Olympics has a great representation of diverse body types that shows athletes performing all types of athletic sports. Sarah Robles is another Olympic athlete that trumps the narrative that you have to be thin to be in shape and as a former runner, I have to give a shoutout to ultramarathoner Mirna Valerio. She has done so much in the body diversity/BIPOC space.
BMI or as I like to refer to it as the BS Measuring Index1, read on to find out why BMI is based on bad science and is BS.
History of BMI
BMI was created by Lambert Adolphe Jacques Quetelet, an astronomer and mathematician, not a medical doctor in 1832. The tool he created was to measure the average weight of a population NOT an individual. He also only studied white European males which does not represent our diverse population.
BMI wasn’t designed for use on individuals or diverse populations.
Adolphe Quetelet, the creator himself, stated that it was not for use on individuals, and it was most certainly not designed to measure health. Quetelet had no interest in measuring health or “obesity”; he was a statistician looking at population models rather than a medical practitioner studying individual human health conditions.
BMI does not take into consideration age, sex, race, ethnicity, social determinants of health, muscle mass, bone mass, body fat… It’s simply height over weight squared. It’s been found to be less accurate for people of color and women. 2
A common critique that you hear about BMI is categorizing athletes as ‘overweight” or “obese.” Since the equation doesn’t take into consideration muscle mass, it technically means that these athletes are considered to have a “disease” as a result of their weight.
BMI pathologizing that one’s body is “a problem”
Where I see the most harm is how BMI discriminates. It is used in determining who can seek help in many eating disorder clinics and who can get certain insurance coverage for healthcare. Certain bodies are told they need fixing aka lose weight. Our society assumes that those in larger bodies don’t eat healthy, are lazy, and don’t exercise. Bodies are diverse, and there are many folks in larger bodies who are exercising regularly and eating a variety of nutrient-dense foods. I’ve worked with clients with eating disorders who are in the “normal weight” category who are actively engaging in eating disorder behaviors (restricting, weighing, compulsively exercising) and their behaviors are not healthy. Currently, we use BMI to measure individual health which places people in certain categories such as “normal weight”, “overweight”, “obese”. These labels create a lot of shame and create a notion that being overweight is bad for you and being a “normal weight” is the overarching goal. Research has found that being overweight has the lowest mortality and those in the “underweight” BMI category have the highest death risk. 3 Labeling can also create worse outcomes, such as individuals in larger bodies avoiding doctors office due to medical trauma they experience. “I’ve lost count of the number of times I’ve gone to an appointment with a really simple issue like a virus … and come away feeling pretty ashamed or frustrated because the doctor chose to only focus on my BMI or weight,” says Chloe Papas, a campaigner and co-organizer of A Plus market — a marketplace for pre-loved plus size clothes in Melbourne. She says this has resulted in her skipping doctor’s appointments in the past to avoid the conversation. “For me, and for many other people in bigger bodies, the BMI can feel almost like a weapon in doctors’ offices or in medical settings,” she says. 4
Shifting from what is the problem with body to how best support my body and asking the questions:
- “What is the problem with how my body is seen and treated?
- What is the problem with using the BMI to categorize a human’s health status?” 5
Kelly is a weight-inclusive dietitian who doesn’t believe in the whole BMI system and believes health is so much more than a number. If you are wanting not to feel like an arbitrary number on a scale and focus on relationship with food and behaviors with food, please reach out and connect and set up an appointment.
References
- Body Kindness Transform Your Health from the Inside Out–and Never Say Diet Again. Rebecca Scritchfield
- Is BMI a Fair Health Metric for Black Women?https://www.healthline.com/nutrition/bmi-for-black-women#bmi-and-black-women
- The ‘Obesity Paradox:’ a parsimonious explanation for relations among obesity, mortality rate, and aging? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3186057
- The really old, racist and non-medical origins of the BMI https://www.abc.net.au/news/2022-01-02/the-problem-with-the-body-mass-index-bmi/100728416
- Unapologetic Eating: Make Peace with Food and Transform Your Life. Alissa Rumsey
