(Erin Gilbert, RDN, CSO, LDN’s Version)
“Can I ask you a question..?” Have you ever looked over your paperwork after a doctor appointment & seen the words “overweight” “obese” or “abnormal” BMI in “RED”? Or maybe your doctor brought up concerns of BMI being too high? This may have left you “stressin’ & obsessin” or feeling shame & worry. “You’re [NOT] on your own, kid!” We know “all too well” when it comes to health (& fitting in, in general), it’s natural to want things to be ‘in range’. But “dear reader”, Body Mass Index (BMI) –one of the most common measures used in healthcare– is the problem, not you.
“Are you ready for it?...”, Created by astronomer & mathematician Adolphe Quetelet in the late 1800s, BMI was never designed to be used as a health indicator (& “I think he knows”). Quetelet said himself the purpose was to study the average weight of populations, not individuals. It wasn’t until the 1940s that insurance companies started to use this measure as a means of categorizing policy holders with limited (if not an outright stretch of) science to stand on. Flash forward to the 1990s “everything has changed” & the ‘healthy weight range’ was arbitrarily lowered seemingly overnight.
“I knew you were trouble…” BMI does not account for diversity & body variance. At its core, this equation was developed by studying white, European men. No women, no people of color. Unless you’re “the man”, BMI completely overlooks the different body shapes, frames & structures of unique populations. For example, BMI tends to overestimate fatness & health risks for Black people while underestimating health risks for those of Asian descent. It also doesn’t account for women, whose bodies by design have a higher fat percentage for reproduction.
“Call it what you want”, but with BMI being a simple height to weight ratio, it doesn’t take into consideration someone’s body composition- their individual makeup of muscle, fat, fluid & skeletal mass. This can often lead to perfectly healthy people (like athletes who may have a higher amount of muscle mass) falling into the “overweight” or “obese” category.
“Long story short”, BMI misses the big picture. This number does not consider health related behaviors– like whether someone eats an adequate, balanced diet; if someone smokes or drinks alcohol, exercises, manages stress, gets enough restful sleep; or if someone has a family history of significant health conditions.
So, “Shake it off!” Too much focus on BMI “could never give you peace” & any healthcare provider that fixates on BMI without considering the whole health picture “needs to calm down!”
Want to learn more about our health at every size approach to nutrition counseling? We’ve “got a blank space” for you to get started with one of our registered dietitians.
For further information, check out:
The Unethical Use of BMI in Contemporary General Practice
How Useful is the Body Mass Index?
Why BMI is a Flawed Health Standard, Especially for People of Color
The MANY Problems with BMI
The Bizarre & Racist History of the BMI