The BMI scale was created almost 200 years ago by a mathematician (not a physician!) named Lambert Adolphe Jacques Quetelet who said explicitly that the BMI scale could not and should not be used to indicate the level of fatness or health status of an individual.
BMI is merely a mathematical equation that allows for us to plot the incidence of weight over height squared across the entire human population. Just as you can’t determine someone’s health based on their height compared to peers, you also can’t determine someone’s health based on their relative BMI.
The first and most obvious problem with BMI is that it doesn’t measure the body fat content of an individual. Bone is denser than muscle, which is denser than fat, so a person with strong bones and good muscle tone might have a high BMI. For example, many body builders’ weight classifies them as obese on the BMI scale.
You may be thinking to yourself, but what about the people who are in the obese category who do have a high body fat percentage? We still can’t make any assumptions about health status based on this categorization! Everyone’s weight set point is different, meaning an individual’s healthful weight could fall anywhere on the BMI scale.
There has been evidence that shows that higher BMI is CORRELATED with certain health conditions. This does not mean that BMI is the causative reason for these health conditions. Studies show that certain lifestyle choices can cause health conditions rather than physical fat on the body.
Weight, like height, is a bell-shaped curve, and someone has to hold down the upper standard deviation from the average, just as others hold down the lower standard deviation from average. Again, these weights are averages, not norms. Many women don’t accept that their optimal weight set point is not to the left of the peak on that bell-shaped curve, meaning they all want lower-than-average weight compared to the vast majority of the population due to discrimination.
Unfortunately, many people who fall on the upper range of the BMI scale (even though BMI, like height, is highly heritable) experience discrimination and unequal access to healthcare based on their relative weight compared to peers. They are often told to lose weight as a solution to their health problems, rather than actually being given a medical treatment that their thin counterparts would receive.
Can you imagine if a health care provider told someone on the upper end of the height average to lose height as a solution to their health problems? That wouldn’t happen because we as a society ACCEPT the fact that height is not within our control.
But what if weight was not entirely in our control either? (More on this later).
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