What’s been your experience with the “BMI”? Many of my clients feel frustrated, confused, and judged by it.
On the one hand, they want to be healthy. They want to lose weight and be in a “normal” BMI range so they can feel confident in their health and respected by their doctor.
On the other hand, the attempt to lose weight causes them LOTS of problems: food guilt, binges, weight regain, and constant thoughts about food. Plus, most of the time their labs are in a good range and they feel fine. Aren’t they already healthy? Does having a normal BMI really matter?
Even if you have lost weight, when you are in a bigger body, it still feels like it is not enough for the standards of BMI when it’s still isn’t in the “normal” range. If you relate to these clients, I’m here to offer a new perspective on BMI that I hope helps you to get relief from the guilt this number causes so many of my clients. This post will help you to look beyond the flawed BMI so that you can have more effective conversations with your doctor about health.
Here’s 3 takeaways about BMI I want you to remember at your next doctor’s visit:
1. BMI was never intended to, and does not, measure individual health
I was shocked to learn the TROUBLING timeline of how BMI made it’s way into our doctors visits. If you’re interested to learn more about my brief summarization of the history of the BMI below, I encourage you to read Body Respect by Linda Bacon and Lucy Aphramor, Anti-Diet by Christy Harrison for more sources and background. Here are some key takeaways you should know:
- BMI is based on a small sample of white males of european descent from around 200 years ago. In 1832 an academic named Adolphe Quetelet decided to commit the original mansplain by measuring a bunch of other white, European men so he could define a “normal” body. Ladies and other ethnicities need not apply! Eventually, the BMI gets adapted and baked into life and medical insurance billing models for its ease of use, not it’s ability to measure your health. This, plus public interest in achieving thinness as a status symbol, solidifies BMI into modern medical practice.
- Data show people in the “overweight” BMI category actually live longest. Practicing health enhancing behaviors like: not smoking, staying active, reducing alcohol, and eating fruits and vegetables improves health outcomes at any size, including higher BMI categories.
- “Obesity” is not a disease, it’s an attribute of size. But the AMA made it a disease anyway. In 1998 a decision was made to reduce the cut-off for the “overweight” BMI classification from the number 27 to the number 25. As a result, millions of people become “obese” overnight. In 2013, the American Medical Association declared “obesity” a disease — DESPITE the advising committee recommending against it.
2. BMI does not measure physical fitness
Size alone does not dictate your physical health. Not all people in bigger bodies have the same health status, just like not all people in smaller bodies have the same health status.
Generally speaking, individual lifestyle behaviors, biochemical labs, signs, and symptoms are more reliable data to use when assessing your health. In addition, there are emerging data to show that social determinants have more impact on health than our individual lifestyle behavior.
Prescribing weight loss without regard to the complexity of the whole person in a bigger body is not helpful to your health and may even feel stigmatizing, because it is. There is not one disease that uniquely affects people in bigger bodies. As such, good medicine would treat your medical signs and symptoms in the context of your personal health goals, rather than prescribe diets simply to change your body size.
3. Even if BMI did matter, there is no safe or effective way to lose weight.
Studies show that most who attempt weight loss on ANY diet will regain it all back within five years. This is because the body eventually adapts to caloric restriction by slowing down metabolism and increasing hunger in an attempt to conserve energy. When we diet, the body perceives that we are in famine, even if it is self-inflicted. These adaptations are our ancient programming working to protect us from starvation.
For this reason, the diet you are following does not feel sustainable or livable, it will not work for long.
Based on this information, my clients work on building individual behaviors that improve their health, rather than focus on weight loss. I help you think about health differently so that you can stop choosing weight loss over your mental and physical health after half your life dieting…but how do you get your doctor to stop harping on your BMI?!
I’ve made you a guide you can use to prepare for your next doctor’s visit! Download the How to Talk to Your Doctor About Health at Every Size guide so you can:
– get clear on your goals before the visit
– choose phraseology that helps your doctor stop focusing on weight
– deal with “getting weighed” as a dieting or body image trigger
– leave your visit feeling empowered, instead of defeated because of your BMI