This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing! BMI is a ratio of weight and height. It was created by the statistician Quetelet in the 1830’s. The calculation is weight (in pounds,) divided by height (in inches) squared, multiplied by 703. (The final step is done to convert the formula from metric.) There are problems with this formula at every level.
Just a shower thought: do studies ever account for the difficulty fat people had accessing health insurance prior to the ACA? I hear a lot about how fat people often arrive at the doctor with a later progression of a disease because they've avoided the doctor for fear of stigma, but I don't think I've ever seen anyone point out that, until recently, a fat person may have had greater difficulty in affording healthcare.
My OBGYN used BMI to assess my health while pregnant. At 34 weeks, I’d gained enough weight to creep into the ob*se category, so I suddenly got the whole list of warnings of potential labour and delivery complications despite none of the other indicators of these things being present. I was so mad that he tried to scare me about my size: at that point of the pregnancy, the baby is mostly developed and just needs to get bigger, so the birth parent is just going to keep gaining weight. This was nearly ten years ago and I’m still salty about it; it was the first time I’d really experienced someone being fixated on the number on the scale rather any of the symptoms that I was or wasn’t presenting with.
To correct a few things, I was not a member of the 1998 committee that adopted the WHO guidelines. Quetelet did not himself suggest an index, but he did note that weight increased as the square of height. Because of this observation, the index of weight/height squared was named Quetelet's index after him. This relationship is pretty consistent across populations. BMI itself as an index is not the problem. The problem is the BMI categories, how they are named, and how they are used today. BMI itself was more or less just a way to compare the weights of people of different heights, so it was just a form of height-adjusted weight. It got repurposed much later.
Thank you for this post and all your posts!!! Because of this I just did something I've been wanting to do for a while and requested that "Morbid obesity" be removed from my "health issues". To have it removed the online chart askes why it isn't relevant and I used this post (sorry for my plagiarism) to say: "This is based on my BMI, which was created by the statistician Quetelet in the 1830’s. Quetelet wasn’t trying to create a measurement for individual health and almost his entire sample consisted of European cis white men. BMI and this "health issue" of "Morbid obesity" is used to pathologize bodies based on their size, despite the fact that two people with the same BMI can have vastly different health statuses, and two people with vastly different BMIs can have the exact same health status. Furthermore, as my other health indicators suggest there is nothing "morbid" about my health (other than like everyone else we are aging, but I don't see any "morbid ageing" health issues listed). Given that people of all sizes get the same health issues, we don’t need weight, size, or a ratio of weight and height, to be a middleman for health and I reject using it in my chart. I'm happy for my doctor and I to focus on actual indicators of health rather than this poor proxy."
Just a shower thought: do studies ever account for the difficulty fat people had accessing health insurance prior to the ACA? I hear a lot about how fat people often arrive at the doctor with a later progression of a disease because they've avoided the doctor for fear of stigma, but I don't think I've ever seen anyone point out that, until recently, a fat person may have had greater difficulty in affording healthcare.
My OBGYN used BMI to assess my health while pregnant. At 34 weeks, I’d gained enough weight to creep into the ob*se category, so I suddenly got the whole list of warnings of potential labour and delivery complications despite none of the other indicators of these things being present. I was so mad that he tried to scare me about my size: at that point of the pregnancy, the baby is mostly developed and just needs to get bigger, so the birth parent is just going to keep gaining weight. This was nearly ten years ago and I’m still salty about it; it was the first time I’d really experienced someone being fixated on the number on the scale rather any of the symptoms that I was or wasn’t presenting with.
"The calculation is weight (in pounds,) multiplied by height (in inches) squared, times 703."
I think you mean weight in pounds DIVIDED BY height in inches . . . ?
To correct a few things, I was not a member of the 1998 committee that adopted the WHO guidelines. Quetelet did not himself suggest an index, but he did note that weight increased as the square of height. Because of this observation, the index of weight/height squared was named Quetelet's index after him. This relationship is pretty consistent across populations. BMI itself as an index is not the problem. The problem is the BMI categories, how they are named, and how they are used today. BMI itself was more or less just a way to compare the weights of people of different heights, so it was just a form of height-adjusted weight. It got repurposed much later.
Thank you for this post and all your posts!!! Because of this I just did something I've been wanting to do for a while and requested that "Morbid obesity" be removed from my "health issues". To have it removed the online chart askes why it isn't relevant and I used this post (sorry for my plagiarism) to say: "This is based on my BMI, which was created by the statistician Quetelet in the 1830’s. Quetelet wasn’t trying to create a measurement for individual health and almost his entire sample consisted of European cis white men. BMI and this "health issue" of "Morbid obesity" is used to pathologize bodies based on their size, despite the fact that two people with the same BMI can have vastly different health statuses, and two people with vastly different BMIs can have the exact same health status. Furthermore, as my other health indicators suggest there is nothing "morbid" about my health (other than like everyone else we are aging, but I don't see any "morbid ageing" health issues listed). Given that people of all sizes get the same health issues, we don’t need weight, size, or a ratio of weight and height, to be a middleman for health and I reject using it in my chart. I'm happy for my doctor and I to focus on actual indicators of health rather than this poor proxy."