Friday morning as I was having my coffee, doing my usual multi-tasking, kind of listening to the news from my bedroom, something I heard made me stop what I was doing and run to the TV. “Indiana Teen refuses to calculate BMI”. What? I am a huge anti-fan of BMI. I was dying to hear this story. In case you have not heard, this young eighth grade athlete has received national attention after her Facebook Post about refusing to calculate her BMI in a class at school. She had been shamed in the past when she was told she was “obese” according to her BMI. Although she says she knows she is a bigger girl, it never had bothered her before but after that incident she felt bad and so the next time, she refused. Instead she wrote an essay about why BMI should not be used to determine health, especially in a middle school where girls are already super body conscious and insecure. Check out just one article Indiana Teen Refuses to Calculate BMI to read more. She went to her doctor who did a complete physical with labs and let her know she was fit and healthy. Her message is simple yet powerful: BMI has nothing to do with health.
An eighth grade kid understands perfectly, yet unfortunately, the medical community still does not get it. Besides falsely labeling larger sized people as unhealthy, people who are very ill but have a “healthy BMI” fall through the cracks. I have story after story of eating disorder patients I have worked with in the past who have been starving themselves, purging in all kinds of dangerous ways, yet when they go for their yearly check up, the doctor responds: “You look great! You lost weight!” Which leaves the poor patient who is suffering in a confused and sometimes angry state. Most of the time the health care provider never asks how the weight was lost. It seems assumptions are made that the weight loss was a result of some healthy eating and exercise, but in these situations it is not the case. As long as that number is where it should be, it seems it does not matter.
The reality is that having a healthy body is not a simple task. Eating a perfect diet or having the correct BMI does not result in a healthy body, and does not negate unhealthy behaviors such as smoking or starving yourself or being stressed out. Genetics play a gigantic role (we all joke about the old man who smokes a pack a day and drinks whiskey and lives to 100). How it is that we have come to rely on some number based on a calculation using height and weight to tell us anything about someone’s health is beyond me. I believe part of the reason could be because it saves time. It is so much quicker to get a height and weight measurement and calculate BMI than it is to ask someone about all of the details of their lifestyle. Most health care practitioners don’t have time for this. In the hospital where I worked as an outpatient dietitian, we moved into a “productivity” based practice, so instead of an hour with a new patient, I was now expected to assess and counsel a patient and family in 30 minutes. If they were 10 minutes late, I was in trouble. It was heartbreaking to me. How could I even start to help a family with so little time to even find out about who they were? I left that job because of it, but I imagine that office is not unlike many others. Time is money.
So, it you ask me, you definitely should NOT worry about your BMI. Instead, you should worry if your health care providers give you advice without ever asking you about your lifestyle. Oh boy, does it make my blood boil when I hear stories from both friends and patients alike about the assumptions made based on weight or body size. It is prejudice, plain and simple, and it is wrong.
Forget the numbers, and keep it simple. How do you feel? What things run in your family that you need to be aware of? Look at all aspects of your life, both physical and mental (which is why I left that job, the stress was affecting my health). What you eat does matter but just to a degree. For instance, if you don’t drink enough to stay hydrated, you just won’t feel good and it can hurt you, especially in hot weather. If you live on sweets, you will likely not feel good either. If you don’t consume any calcium your bones may eventually be at risk. If you don’t eat any fruits or veggies, you may experience constipation which is not fun. So yes, nutrition matters, over time. You can eat brown foods for a week with no repercussions. You can eat sugar every day and have no ill effects. It is all in the big picture, with all aspects of your life having an impact on your health. Food, sleep, stress, movement, fun, family, friends, all of it.
So when someone brings up your BMI, tell them you want to talk about your health, not some dumb number that is meaningless.