Is the BMI an accurate measure of health?
Short answer… No
Read on to learn a little bit more about the BMI.
What is the BMI?
It’s simply a ratio of height and weight. It does not account for muscle mass, bone density or overall body composition. An athlete with more muscle mass, like The Rock, is considered obese.
Who created it?
It was created by a Belgian mathematician in 1832 to study large groups of people, originally called the Quetelet Index. In 1972 Ancel Keys renamed it to the Body Mass Index. It was never intended for evaluating individuals.
What populations were originally studied?
It mostly studied male white populations, so diverse body sizes of people of other races and women were not taken into account.
How did it change over time?
In 1998, the World Health Organization lowered BMI ranges at the recommendation of the National Institute of Health’s Obesity Task Force. On this task force, 7 of the 9 members were directors of weight-loss clinics or had other investors from the pharmaceutical industry that had weight loss medications on the market. It was to their financial advantage to lower the standards so that more people would fall into the overweight and obese ranges.
Is it an accurate measure of health?
No, it is not an accurate measure of health. It does not take into account a more comprehensive picture of health that would include: blood pressure, blood sugar, cholesterol, insulin resistance and c-reactive protein (inflammation) measurements. It also doesn’t consider genetics, environment or social determinants of health.
How can it harm individuals in a higher BMI range?
There have been many cases where weight is looked at to be the only cause of someone’s symptoms and other causes are dismissed when someone is in a higher BMI range. The other thing that can occur is that people avoid getting regular medical checkups because of the focus on weight loss.
Virgie Tovar tells a story (see link below) about a woman with intense uterine cramps that turned out to be cancer. Her doctor told her to lose weight and wouldn’t look any further than her weight so her tumor continued to grow for years.
Eknoyan G. Adolphe Quetelet (1796-1874)–the average man and indices of obesity. Nephrol Dial Transplant. 2008 Jan;23(1):47-51. doi: 10.1093/ndt/gfm517. Epub 2007 Sep 22. PMID: 17890752.
Ellis-Ordway, Nancy. Thrive at Any Weight: Eating to Nourish Body, Soul, and Self-Esteem. Praeger, 2019.
Bacon, Lesley, and Lucy Aphramor. Body Respect. Ben Bella, 2014.
Solovay, Sondra, and Esther D. Rothblum. Fat Studies Reader. New York University Press, 2009.