the one where: we discuss BMI + Health
We’ve all been there. Hearing the dreaded term “BMI” thrown around and unsure of what to do with the information.
“I’m category Obese I”
“I’m normal weight”
“I’m category Obese III”
But what if the BMI wasn’t designed to be used as a measurement of health? What if the BMI wasn’t designed to give accurate information for different ethnicities?
Let’s dig in.
The Body Mass Index (BMI) is a system created by Belgian mathematician Lambert Adolphe Jacques Quetelet in the early 19th century as an aid for the government to allocate resources. This formula* was created to categorise the varying degrees of obesity for the general population (at that time).
*BMI = weight in lbs (height in inches x height in inches) x 703
- 703 is to convert the index from the original metric version of the formula
Because of the time when this system was created, it is easy to understand that the main population targeted for this system to be relatively accurate is white men… not varying ethnicities or even women. Besides which, this system takes no account to body fat distribution, waist circumference, or even bone density.
For instance, bone is denser than muscle, and twice as dense as fat, so if an individual has good bone structure and quality, and good muscle, they will more than likely be classified as “overweight” or even “obese” in accordance with the BMI.
This puts a massive strain on the population that thinness equals health, ie. “ideal” or “normal” weight.
But, what if you’re “overweight” or even, dare we say, “obese” in accordance with the BMI – what exactly could that mean?
The BMI was not created by a physician, but a mathematician. It was also never created as an indicator of health, but of an indicator of weight. So, if we break that down and simply look at the BMI chart for what it is; a formula that provides a number between 1-100 to tell you what category you fall in based on your weight and height.
If we take away the “underweight-obese” categories, and just looks at the numbers, it really doesn’t tell you much at all.
It cannot tell you if you have good bone density.
It cannot tell you your body fat percentage or distribution.
It cannot tell you if you can walk up the stairs, for instance, without losing your breath.
It cannot tell you if you have an autoimmune or genetic condition or predisposition for illness.
It cannot tell you if you are battling an eating disorder or disordered eating.
It cannot tell you if you are healthy.
It cannot tell you if you are an athlete or sedentary.
The list goes on.
Simply, it can tell you that you fall into a generic category that has no medical backing, based on a mathematical formula.
So, why do we still use this system today?
As a professional in the health and wellness world, it is extremely frustrating to know that doctors, NIH (National Institutes for Health) and the CDC (Centres for Disease Control and Prevention) rely on this extremely outdated and discriminatory system as a measure of disease and “health”. Not to mention, health insurance companies use this system as well, and those that fall into the higher BMI categories often get penalised with higher premiums due to an insignificant number, instead of what their health actually looks like.
Simply put: Health cannot be determined by a number.
I can tell you, from personal experience with clients over my 12 years as a Holistic Nutritionist, that the BMI is absolutely pointless when it comes to measuring health.
When visiting your GP and they discover that your BMI is >30 (aka “obese”), they will have a serious conversation with you regarding your dietary choices and exercise. They will automatically assume that, because of this number, there is a problem with your portion sizes, food choices (Big Mac every day?) and self-control, as well as your lifestyle (no exercise will make you obese). Perhaps they will dig into weight-loss pills, needles, blood tests for diabetes, and potentially weight-loss surgery suggestions.
They will take this number as a problem and seek to find a way to remedy it.
When visiting your GP and they discover that your BMI is <25 (aka “ideal”/ “normal”), they will be satisfied with that number and move on.
They will not ask you if you are currently struggling with an eating disorder or disordered eating. If you are malnourished or experiencing malabsorption due to a problem with intestinal permeability. They will not inquire about your mental health, and if stress or anxiety is an issue for you. They will not ask how often you exercise, what your diet and food choices look like, or if you are a chronic smoker that cannot walk up a flight of stairs without getting winded.
They will accept this number as “normal” and therefore, you are healthy.
This begs the question of, “So, what CAN I do?”
Unfortunately, with the medical community – not many options are available. Use of the BMI is still standard and will continue to be the way forward for the time being. However, you can decide what you are going to do with that number and proceed accordingly.
There are countless Holistic practitioners (myself included) that do not rely on the BMI as a measurement of health but aim to dig deeper into what constitutes health and wellness for an individual based on their specific circumstances, genetics, and lifestyle and not based on a generic (and flawed) system which generalises health under a weight-related category.
Always use your GP for medical advice and information. But take the BMI and methods for “weight loss” with a pinch of salt. Seek professional advice from a health-focused nutritionist or dietician who does not require a specific number to determine your health and will work with you and your specific needs, requirements, and goals to find optimal health for YOU.
If you do find that your body is uncomfortable and you find every day tasks difficult (general movement is hard, ie. Emptying the dishwasher, walking to your car, getting in/out of your bed, cooking, etc.), working with a profession to get to the root of the problem will better serve you in the long run as weight (under or over) is almost always a symptom of a deeper-seeded issue (mentally, emotionally or physically), and not the cause.
Health is NOT one-size-fits-all, so don’t stress the small (BMI) stuff!
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Sources:
https://europepmc.org/article/nbk/nbk541070
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890841/
https://www.sciencedirect.com/science/article/abs/pii/S0749379720302671