The U.K. Suggests Ditching BMI To Measure Health — The U.S. Should Take Notes
Recently, members of the U.K. Parliament called for BMI to be scrapped as a measure of individual health. BMI (body mass index) is a number widely used to determine a healthy weight range. But as it turns out, BMI may not be the best way to measure how healthy a person is. It’s an inaccurate measurement of health that can trigger eating disorders and potentially discriminates along the lines of race and gender.
You have most likely heard the term BMI. It is a number based on your height and weight and is commonly used to assess whether a patient is in a healthy weight range. It is used across the world as a screening tool to determine things such as possible weight problems, susceptibility to health risks such as diabetes and hypertension, and an indicator of eating disorders.
Adults can measure their BMI by taking their body weight in pounds, dividing that value by the square of their height in inches, and multiplying the result by 703 (703 x weight (lbs) / [height (in)]2).
A BMI of less than 18.5 is considered underweight. A healthy BMI lies between 18.5 and 24.9. And those with a BMI of 25-29.9 are considered overweight; levels of 30 and above are classed as obese. But these numbers are a less than accurate representation of health because they do not account for body fat percentage, body fat distribution, bone density, or racial and gender differences.
So, where does BMI even come from?
“Body Mass Index” was coined as a term by Ancel Keys, Ph.D., in 1972 in a paper titled “Indices of Relative Weight and Obesity.” Dr. Keys analyzed the adiposity-body density and subcutaneous fat thickness of 7,400 men from five European countries. Then he used a weight-to-height index created by Adolphe Quetelet in 1832 to come up with the body mass index as a straightforward way to measure body weight in relation to height.
And just in case your eyes glazed over while reading the last paragraph…The study that resulted in the broad use of BMI was only conducted on White male Europeans. There were no women or people of color involved. So, BMI is being used as a determining factor of health on populations that it hasn’t been scientifically tested on.
Therefore, it comes as no surprise that studies have found that other ethnic groups can have a higher or lower disease risk in categories considered healthy or normal on the BMI chart. A study done by the World Health Organization in 2004 found Asian people with a high risk for type 2 diabetes and cardiovascular disease had lower BMIs. And a study led by Fatima Cody Stanford, MD, MPH, MPA, FAAP, FACP, FTOS, in 2020 found that Black women with high risk for diabetes and hypertension had higher BMIs than the standard BMI chart. And this is just scratching the surface of the problems with BMI.
Most recently, a report from the Women and Equalities Committee of the British Parliament states that BMI should no longer be used to determine whether someone needs help with an eating disorder or not. The report states, “The use of BMI inspires weight stigma, contributes to eating disorders, and disrupts people’s body image and mental health. Public Health England should stop using BMI as a measure of health.” And now committee members are calling for BMI to be replaced by a “weight neutral” approach.
Chairwoman of the committee, Caroline Nokes, stated, “The use of BMI as a measure of healthy weight has become a kind of proxy or justification for weight shaming. This has to stop.” She went on further to say that, “The government must ensure its policies are not contributing to body-image pressures.”
Chika Anekwe, MD, MPH, an obesity medicine physician at Massachusetts General Hospital and an instructor at Harvard Medical School, shared with Insider.com that there are more accurate predictors of health than BMI. These five metabolic risk factors are waist circumference, cholesterol levels, triglyceride levels, blood pressure levels, and blood sugar levels.
Overall, BMI seems to be a very generalistic view of overall health that doesn’t properly account for race, gender, or body composition. Not only that, but BMI can lead many folks down the dark road of eating disorders and disordered eating. If BMI can’t be scrapped and is still used as a determinant of health, at the very least, it should be further studied. The problematic and harmful aspects of BMI must be addressed.
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