Wednesday, September 28, 2011

BMI: Better Meaning for It?

Oh....the BMI. Sigh.

Touted as THE measurement of body fat, it is based on a calculation of our weight and height. If you've been living under a rock these past twenty years, do a little Google search and calculate your own BMI. Where do you fall on the curve?

How do I hate the BMI? Let me count the ways:

1) It lumps individuals into categories - uber-skinny, thin, "normal" (whatever that means), overweight and obese

2) It is reductive

3) It shows nothing about a person's overall health

4) It is pervasive - used in every part of our health care system as a measuring stick for "good" and "bad" (i.e. skinny and fat)

In prenatal care, women with high BMIs are immediately slated for special (i.e. high-risk) treatment. If you didn't already know you had to lose a few pounds, watch out, because you'll certainly know now! You may be lucky and score a decent doctor, who is respectful, kind and willing to treat you as a person. But you may be unlucky to get stuck with a doctor who sees you only as BMI 32 (or wherever you land on that retched curve).

I can't understand how a medical community that is so research-focused and relies only on evidence-based information could miss the boat on this one. The BMI is only useful in context; in relation to a woman's overall health. I know plenty of women that fall over the "overweight" or "obese" line, and who are clearly neither. And yet because they walk around with that number tatooed on their face, their prenatal care can be significantly compromised.

There are plenty of studies out there showing that BMI is not successful in determining an individual's overall health. I won't begin referencing them here, but a quick Wikipedia search will put you in the right direction.

Instead, I have come up with several different meanings for the acronym BMI, just for fun. Play along and send me some more!

Bogus Measuring Instrument

Belittling Methodological Idea

Bitchy Medical Interns

Brainwashing Method (made by) Idiots



  1. The problem with the BMI is that it doesn't take into account muscles vs fat. I know someone who is shorter than me who weighs the same, so she has a much higher BMI, but her weight is entirely muscle, and she's much healthier than me.

  2. I think BMI is a useful tool as part of an overall picture of health. It is certainly a better indicator of health than weight. I don't think the problem is with BMIs, but rather when that is the only thing used to measure health. Just like weight, it's one part of the picture.

    I think for most people, it's a reasonable snapshot of where they're at for health. Let's face it, most of us aren't body builders. And the ranges are fairly broad, so most people in the healthy range are actually a good weigh and most people in the obese range are actually obese. A 5' 10" woman would have to be 210 lbs to be obese, and I think it's reasonable to say that most 210 lbs 5' 10" women would not be healthy.

    But again, it's just one component and should be part of a complete evaluation by a health care provider. And as much as it would be the ideal for every woman to be at their healthiest weight when they get pregnant, that certainly isn't the reality and all women deserve to be treated with dignity and respect; no good comes of shaming someone for their weight intentionally or unintentionally.

  3. @anonymous - yes, I think the muscle vs. fat ratio is the biggest argument against it.

    @Maranda - I might cautiously say that a BMI is useful under certain circumstances. But I know from my work in eating disorders and now with pregnant women that it can be very harmful. I think there are better ways to assess our health that are more qualitative than quantitative. I'm always wary about measurements that treat everyone in the same way, rather than focusing on the individual. I know plenty of women with higher BMI's who are very healthy. And yes, agree completely about respect! I think that is my worry - what I'm currently seeing here in Ottawa is a complete lack of respect for pregnant women with higher BMIs. It concerns me.


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