Eating Disorders Corner
“Food is not the enemy. Self-hate is.”
This corner is devoted to addressing eating disorders, disordered eating, and body image. I have specialized in treating people with all of the above since 1999. It is a large part of my work and my heart. This corner is for those of us on the journey of disconnecting our worth from our size or what we eat.
The Fallacy of the BMI
The formula for Body Mass Index (BMI) is kg/m2 (weight in kilograms divided by height in meters squared). This weight/height ratio is used as a general measure of an individual’s health.
People get classified into one of four categories based on their BMI: Underweight, Healthy Weight, Overweight, and Obese. Doctors use it as if it were a real thing and provide treatment based on this formula.
Which would be fine if the BMI actually assessed individual health. It does not. That is a fallacy.
Quick history lesson: the BMI was invented in the 1800’s by a mathematician (not a doctor) who wanted to know what the “average man” looked like (nothing about health here). It was used to describe a population of people (not an individual). His research was based largely on white, European men (therefore only applies to white, European men). At the time, it was called the Quetelet Index. It was never intended to be a measure of individual health.
Over 100 years later, health and life insurance companies began using it to determine a person’s coverage. Doctors began using it to determine a person’s treatment. This assumes that everyone’s health is correlated with the weight and height ratio of white, European men.
In the 1970’s, the Quetelet Index was renamed the Body Mass Index after it was determined to be a good assessment of body fat (based on a study of European and American men). By the way, the BMI can’t tell what percentage of a person’s weight is based on fat, muscle, or bone.
As you may have gathered, there are SO MANY problems with using the BMI as a basis for health treatment or insurance coverage, starting with the fact that it was never intended to be and is NOT a measure of health. A ratio of weight and height does not speak to health. Research backs this up: the BMI has not been found to be a good predictor of metabolic health.
Another glaring problem with the BMI is that it is applied to everyone but does not take body diversity into account. Bodies naturally differ in size and fat percentage based on genetics, ethnicity, gender, and age. A 25-year-old Black woman’s body is not supposed to look like a 50-year-old white man’s body. That doesn’t make one or the other automatically “unhealthy.” What is unhealthy for one person may be healthy for another and vice versa.
Another major problem is that the four categories are not based on scientific data. They are fairly arbitrary. Case in point: in 1998, the BMI was lowered overnight based on the request of a pharmaceutical company that sold weight-loss drugs. Overnight, millions of people suddenly became “overweight” and “obese” and were treated differently by insurance companies and doctors.
Bottom line: There is no weight range that is a marker of health for every body. There is no weight to be “over” that indicates declining health. “Overweight” and “obese” are incorrect and stigmatizing terms.
The BMI is simply NOT a measure of individual health. It never was. What it does is stigmatizes people because their bodies don’t have the weight/height ratio of a group of white European and American men.
If we were interested in health, it would be much more useful to assess weight stigma. Weight stigma causes actual health issues.