It’s a struggle to find the balance between making positive, beneficial lifestyle changes while avoiding the toxic diet culture. I get it.
As if working towards accepting our already fabulous bodies wasn’t hard enough, we also have to navigate the whole health and wellness industry. I haven’t mastered this yet; far from it, actually. And I have lots of unanswered questions. But the one thing I know for sure is that using the Body Mass Index (BMI) as a stand-alone measure of health isn’t helping any of us.
The BMI was first developed in the 19th century by a Belgian Mathematician, Lambert Adolphe Jacques Quetelet, as a quick and easy population generalization tool. He wanted to help the government divide finances for resources. It was initially known as the “Quetelet index,” and later termed the “Body Mass Index” in 1972 by a researcher named Ancel Keys.
Adolphe himself advised that the BMI would not help measure people’s health. The equation doesn’t account for many important factors, such as body fat percentage or fat distribution. Despite this, the US started using it to define obesity from 1985.
The development process of this tool was tried and tested on—you guessed it—white European men.
The validity of these results immediately comes into question. If this research were a current trial, researchers would broaden their sample to be more inclusive and diverse. Adolphe’s intention wasn’t ever to use the BMI for individuals and so, this was not an issue.
But if the person who developed the BMI believed it wouldn’t accurately determine overall health, why is this still a medical practice today? And why did it start to be used for individual health monitoring in the first place?
The answer is this—we have no idea. It’s utterly bizarre that wellness industries worldwide still continue to use the BMI to monitor health. It is an outdated and inaccurate guessing tool.
In recent times, our knowledge of health has significantly developed. We have more specific tests to monitor factors that can impact our health in much more detail. These include blood sugar levels, cholesterol, and blood pressure, among other things. This advancement in testing has proven that weight doesn’t necessarily directly correlate with health. Yet, the BMI is still a tick-box exercise and a sure-fire way of making someone feel ashamed of their body.
Although it can help measure the severity of malnutrition in people with very little body fat, the tool is discriminatory towards people with bigger bodies. For example, it doesn’t consider that women naturally have more body fat than men. Yet, the calculation is exactly the same for both sexes.
Furthermore, it doesn’t consider that we are likely to have more fat and less muscle as we age. Research throughout the years has even found that a “slightly high” BMI in elderly people can be protective against disease and early death. So is it “slightly high” or just right?
The number on the scale often means very little.
Sure, additional weight can exacerbate some symptoms of pre-existing conditions. Even so, in these circumstances, “extra” weight is by no means the only factor and certainly not the most important one.
You can weigh more and be more active and generally fitter than someone who weighs less. You might wear a size 18 but have lower cholesterol and a healthier diet than someone sporting a size 8. Most studies show that an underweight BMI is more dangerous than an obese one. Yet, we give and receive praise for losing weight. On the other hand, if we weigh “above average,” we face discrimination.
Ultimately, the BMI is a name-and-shame tool to categorize us into worthy and unworthy.
Even health professionals aren’t immune to weight bias. Many people have come forward with their personal stories of seeking help from their GP. They are turned away or ignored. They’re told to lose weight, and sometimes severe conditions like endometriosis, PCOS, and cancers can remain dormant.
We’re all fatphobic to varying degrees and have internalized the harmful message that fat is bad from society.
If we aren’t actively trying to unlearn these thoughts and behaviors, they will overflow into our everyday lives. This applies to professionals too.
You aren’t necessarily unhealthy if you are fat—so losing weight isn’t always the answer.
Perhaps it’s not the weight that leads to health problems in people who have a high BMI. Maybe it’s the professionals who don’t take people in large bodies seriously. Therefore, their concerns and diseases aren’t addressed quickly enough.
We need to stop discriminating against people with bigger bodies and making assumptions about their health based on an old-fashioned, flawed, one-size-fits-all measure.
After all, your body does awesome things for you every day.