BMI is a eugenicist tool created to calculate the weight of *populations,* not individuals. Even its creator said it shouldn’t be used to measure health. It only entered medical practice because American insurance companies wanted an easy tool for screening/denying claims.https://twitter.com/CakeNutrition/status/1401058532976377861 …
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Even if you have an obese patient who is legitimately experiencing health issues, BMI does jack all to identify the underlying cause, which results in fat patients getting told over and over to just loose weight and exercise, to the exclusion of any real diagnosis.
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I recall a story about a fat woman with breathing issues whose doctor looked only at her BMI, ignored her pleas for other tests, and told her to lose weight. She had a tumour. By the time the doctor felt comfortable “ruling out” weight, it had grown inoperable. She died.
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This is not an isolated incident. It is frighteningly common. And thanks to the medical obsession with BMI and the focus on thinness over health, weight loss behaviours that would be instantly pegged as disordered and dangerous in the thin are *actively encouraged* in the fat.
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During a checkup a year or so ago, my GP high-fived me for weight loss after looking at my prior weight, counting weeks under her breath, and seemingly concluding that I’d lost it at a good rate. Had she actually asked me, I could’ve told her: no, that is not what happened.
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I’d lost it all in just under a fortnight where, due to depression and other physical issues, I’d barely eaten or moved. It all came back on as soon as I recovered. But when I went back after genuinely improving my exercise & eating? More muscle, so higher BMI, so no high five.
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Here’s the thing, though: my GP is, in all other respects, lovely - and when I report a problem, she actually listens and schedules the relevant tests instead of assuming it’s because I’m fat. But even *she* still has a blind spot about weight and BMI. It’s trained into doctors.
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Did you know they still monitor your BMI when you’re pregnant? A charming and pointless source of stress! I nearly wept with relief when the GP I saw while pregnant openly acknowledged, “Yeah, this is utter fake bullshit and we shouldn’t be using it, just ignore it.”
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ANYWAY: the moral of the story is, fuck BMI, and fuck any doctor who genuinely believes it has a purpose beyond furthering fatphobia and medical malpractice.
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Focus should be on behaviours over weight. Someone can start walking, weight training, and eating more leafy greens. Six months later their weight might be the same, but their health markers improved. That should be celebrated, but BMI not changing would classify that as failure.
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We also know that 95% of diets fail and that weight cycling is really bad for the body. And yet...that's what society keeps pushing.
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