“The FitnessGram pacer test is a multistage aerobic capacity
test that progressively gets more difficult as it continues…”
Now considered a meme, the FitnessGram was a staple of many
childhoods. Despite making people laugh now, one part of the FitnessGram was
far from a joking matter: being weighed in front of the entire class. Weight —
more specifically Body Mass Index — has been used for decades to define what it
means to be “healthy.” However, BMI is not a proper indicator of health, and
using it as such can be detrimental to an individual’s physical and mental
health.
Since 1972, doctors, insurance companies and government
officials have placed emphasis on the importance of maintaining a healthy BMI.
However, what many don’t know is that the formula for BMI was created by a
mathematician in 1832 to track overall health trends of a population. When the
formula was revived in the ‘70s, however, more emphasis was placed on the BMI
of individuals and it began influencing prescribed treatments. To this day, an
individual’s BMI is marked down every time they visit the doctor’s office, even
if just for a flu test. It is actually well within a patient’s right to refuse
to be weighed, barring there is no medical need for an updated weight.
The reason BMI cannot be used as a marker of individual health is because it simply takes into account weight and height. It does not look at body composition — such as water, bone, muscle, and fat mass — which puts many athletes into the “overweight” category, implying they are unhealthy. Think of Dwayne “The Rock” Johnson, he is not in the “normal” BMI range, yet is still far from unhealthy. Additionally, the cutoff for an “overweight” BMI is completely arbitrary. In 1998, overweight was considered to be a BMI of 27.8 or above. However, overnight the National Institutes of Health changed this number to 25 to be more in line with global standards.
Because of the misunderstanding of BMI, it has been given
more power than it warrants in the medical field and weight loss is often
overprescribed. It is assumed that if a person is in a larger body their
illness is due to their weight and thus their fault. Multiple studies have
shown that while weight may be correlated with certain illness, it is not a
proven cause of many. This correlation could be due to genetics that impact
weight and resistance to other illnesses, such as Polycystic Ovarian Syndrome,
which often leads to weight gain, but is not caused by weight gain. A study in
the International Journal of Obesity found that even Type II Diabetes, an
illness so commonly attributed to being at a higher weight, is closely linked
with yo-yo dieting and weight cycling, where an individual frequently
fluctuates within 20 pounds. Individuals who engage in yo-yo and crash diets
are more likely to be at a higher weight and be insulin resistant, a key
feature of Type II Diabetes.
Even if losing weight — and thus having a lower BMI — had a
direct correlation to decreased health risks, it has been proven that weight
loss is rarely a successful medical intervention. A ten-year study published in
the American Journal of Public Health studied BMI changes in individuals of all
weight brackets. This study showed that at least 50% of those exhibiting an
initial decrease in BMI experienced an increase in BMI long term equal to or
greater than the weight that was initially lost. However, for many people not
losing weight is not just falling short of a goal, but a moral failing. In a
society that values thinness and equates a low weight with health, failure to
lose weight and even being in a larger body to begin with can feel degrading
and demoralizing. In fact, a review in the American Journal of Public Health
found that being pressured to lose weight and maintain or achieve a “healthy”
BMI often times leads to increased stress and decreased health promoting
behaviors. Ultimately, when BMI is treated as the end all be all of health, it
often does more harm than good.
Although society likes to paint weight loss as a task of
willpower that results in a happier life, this is not the truth. The truth is
that bodies exist and are healthy at a wide array of sizes, and refusing to
acknowledge this results in poor health care and worse mental health. It’s time for the definition of health to
evolve just as so many others have. How individuals feel and what they’re doing
to take care of their body is more important than what their weight to height
ratio. So next time you feel the need to comment on someone’s body or even
criticize your own body for being “overweight,” ask yourself “over what
weight?”