The Problem With BMI

The problem with BMI is that the racist and inaccurate measure of body fat prevents people from receiving affordable healthcare and insurance. It’s also the basis of social violence and medical discrimination. The definition of BMI or Body Mass Index is ‘A measure of body fat based on height and weight’. However, based on your results this index places you in health categories that have proven to be inaccurate. More surprisingly, BMI was invited by a mathematician in the 1830s and was never intended to be an indicator of health.

The History of BMI

BMI was invented by Dr. Lambert Adolphe Jacques Quetelet, a Belgian statistician, sociologist, astronomer, and mathematician. His data was collected primarily from white European men. Dr. Lambert was a eugenicist, not a doctor. He called the weight-to-height ratio calculation he invited the Quetelet Index.

In 1972 a physiologist who studied diets named Dr. Ancel Benjamin Keys tested Dr. Lambert’s calculation, once again collecting data from predominantly white European and American men. In his study Keys concluded that Lambert’s weight-to-height ratio was superior to others when measuring body fat. Instead of the Quetelet Index he renamed it Body Mass Index and wrote about his findings.

In 1985, the National Institutes of Health (NIH) started using BMI to measure individual weight and health, contrary to the intentions of Quetelet. It wasn’t until 1986 that the NIH established a policy that encouraged researchers to include women in studies. It was not made a law to include women and minorities until 1993. 

In 1998, the U.S. National Institutes of Health brought U.S. definitions in line with World Health Organization guidelines, lowering the normal/overweight cut-off from a BMI of 27.8 (men) and 27.3 (women) to a BMI of 25. 

The Problems with BMI

According to the CDC “Factors such as age, sex, ethnicity, and muscle mass can influence the relationship between BMI and body fat. Also, BMI does not distinguish between excess fat, muscle, or bone mass, nor does it provide any indication of the distribution of fat among individuals.”

Photo by Roberto Hund

Since BMI was created from research that excluded women and people of color. Studies show these things to be true:

  • At the same BMI, women tend to have more body fat than men.
  • At the same BMI, Black people have less body fat than white people, and Asian people have more body fat than white people.
  • At the same BMI, older people, on average, tend to have more body fat than younger adults.

A 2003 study published in The Journal of the American Medical Association showed that Black women don’t necessarily show a significant rise in mortality risk until a BMI of 37.

A 2020 study suggests that while white New Zealanders with a higher BMI correlated to “harmful” fat surrounding the heart, this did not apply to those of Maori descent. 

BMI’s biggest flaw is that it doesn’t differentiate between fat and muscle. Body weight is a combination of many things, including body fat, muscle mass, bone density, and more. Muscle weighs more than fat. Two people can be the same weight and have the same BMI with different body compositions and weight distribution. One is a white male professional athlete with more muscle the other is a Black woman with more body fat.

Science says that those with a higher BMI have a higher risk for hypertension, diabetes, cancer, cardiovascular diseases, and heightens the risk of premature death. However, some studies show that some individuals with a higher BMI have lower cardiovascular risk and an improved metabolic profile. While some people with a “normal BMI” are metabolically unhealthy and have increased mortality risk.

Photo by Nataliya Vaitkevich

A team of researchers at the University of Virginia, Charlottesville, found better post-surgical short-term survival rates among people with higher BMI. Compared to patients within the “normal or healthy” BMI range. Patients with a BMI of 23.1 or less were more than twice as likely to die within 30 days of surgery than those with a BMI of 35.3 or more.

New research suggests that even people with “normal” BMI may still be considered “obese”. Instead of dividing a person’s weight by their height, this study used a person’s body fat percentage. The results found that many people with “normal” BMI are likely to develop “obesity-related” conditions.

You may also like: Why You Should Ditch Diets

Goodbye BMI

BMI is a non-medical tool with problematic roots that’s being used as the global standard for health. It is an inaccurate indicator of body fat that is weaponized against marginalized people. Health and life insurance companies use BMI as an excuse to increase rates or refuse to cover people with a higher BMI. Despite scientific proof that explains why it’s not that simple. Still, people with higher BMIs are uninsured and denied medical treatment and life-saving surgeries until they lose weight.

Photo by Towfiqu barbhuiya

There are too many problems with BMI to name, but it continues to be profitable for the diet industry. The International Obesity Task Force is “an organization designed to combat obesity around the world.” Despite having ties to the World Health Organization, the International Obesity Task Force relies heavily on funding from the drug industry. The same industry with a diet and weight loss market set to reach a value of $722.8 billion by 2028.

BMI is not a measure of health, it’s a profitable lie that keeps everyone hyper-focused on weight instead of health.

Annette Richmond

Annette Richmond is an award-winning content creator, travel writer, public speaker and advocate. Richmond is an immigrant that splits her time between Mexico and the United States. The creator of the fat positive travel community Fat Girls Traveling is a native Californian. Annette got her start in the fashion industry working in trend forecasting and public relations. Her love for travel inspired her to start Fat Girls Traveling in 2017 which is where she and Amanda met. When she's not creating diverse travel, fashion, and beauty content for The Fat Girls Guide she is hosting Fat Camp retreats and fat positive tours. In her spare time you can find her speaking publicly and writing articles promoting diversity and inclusivity, recording her new podcast, or sipping a margarita on the beach. Richmond hopes to continue to inspire other marginalized people to see the world and be seen.

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