A Little More Health from our Health Care

You’ve probably heard of BMI (Body Mass Index) as a way to determine basic health.

BMI is a mathematical equation of weight and height.

Just in case you were wondering, The National Institute of Health actually specifies on their site that weight is measured in underwear but not shoes.  This makes me wonder if they’ve seen some of my bras – I think some of my underwires could definitely skew my results by a couple of points, but I digress.

The chart of results looks like this:

  • Underweight = <18.5
  • Normal weight = 18.5-24.9
  • Overweight = 25-29.9
  • Obesity = BMI of 30 or greater

Many people have a specific picture of obesity, so I want us to have proper perspective.  In order to qualify as “obese”, a 5’4 woman needs to be just 30 pounds over her “ideal” weight.

If you find yourself in the overweight/obese category, then you will probably not be surprised to learn that weight loss is suggested as a way to improve overall health.

So what’s the problem here?  First, as they admit on the site:

  • It may overestimate body fat in athletes and others who have a muscular build.
  • It may underestimate body fat in older persons and others who have lost muscle.

Those seem pretty obvious.  I’ll use myself as an example:  currently my BMI is 52.00.  This makes me “Category III – Super Obese”.  No seriously, that’s the actual name.  (If we’re going to do this I prefer OMIGODDEATHFAT but whatever).    Based on the description of super obese,  you would think that they’re going to have to take out a wall of my house and pull me out with a forklift.  Rest assured that I’m an athlete and professional dancer, and I get around fine.

What BMI doesn’t take into account is my muscle mass, which is substantial (Today I pressed 800lbs with my legs for example).  It also doesn’t show my metabolic health (my blood pressure, cholesterol, triglycerides, glucose etc. are all perfect).  However, according to the National Institute of Health  I’m practically dead of fat, I’m a drain on the health care system (which I avoid at all costs based on experiences you can read about below), and I’m considered less attractive than my normal weight peers. (Why the National Institute of Health would choose to include that little gem in their description of the consequences of high BMI is beyond me but that’s another subject for another blog post.)

At my lowest I weighed 135, which made me BMI 21.09. Well within the normal range, yet I was suffering from an eating disorder, extremely sick with some major body systems shutting down.  But hey, at least I was “considered more attractive than my overweight and obese peers”.

And that’s my point.  BMI is a horrible measurement to use for health.  Not only is it a disservice to we healthy fats, but it is a huge disservice to those who are thin but in poor health.  It leads people to believe that simply achieving a weight within the goal range makes them healthy. I’ve been hearing the terms “skinny-fat” and “normal weight obese” thrown around for people who have a “normal weight” but are unhealthy.  (This is annoying on a number of levels, but mostly because it again equates fat with unhealthy, and makes the assumption that there is one weight that is “normal” for everyone).  It’s as if we can’t imagine skinny people as unhealthy so we have to call them fat.  What the hell?)  However it does bring the issue of thin, unhealthy people into sharper relief.

The solution?  How about medical facilities stop being so freaking cheap and lazy and monitor people’s actual health?  Instead of performing a math equation and drawing a bunch of baseless conclusions, what if we actually did the simple medical tests available to look at metabolic health and other health markers?

Even if one does have a health issue – weight loss is never the true solution.  Changing behaviors solves health problems.  If weight is lost through these behavior changes, that’s just a side effect.  We know that 95% of dieters gain back their weight (and lose the metabolic health benefits that came along with it) within 1-5 years.  Is there any other medical treatment that is prescribed for 60% of the population that has only a 5% success rate?  I don’t think so.  Yet our medical system refuses adopt a model where healthy behaviors are seen as the goals, rather than weight loss.  They would rather sell us weight loss drugs, or weight loss surgery, or a lifetime of contributing to the 40 Billion dollar a year diet industry.  Shame on them for doing this and shame on us for buying into it.

This isn’t just about fat people, it’s about all people demanding that their doctor assess their actual health instead of making lazy assumptions.  It’s about actual honest-to-goodness HEALTH care, and not just the latest prescription medication, or surgery, or the newest diet.  It’s about time that we all demand a little more health from our health care.

Published in: on February 16, 2010 at 4:46 pm  Comments (3)