Share
Science is often perceived as independent, away from the biases that exist in other spheres of life. However, this does not always account for differences across age, sex, and ethnicity at times.
One such standard that has sparked debate in current times is the BMI, or Body Mass Index, which makes a quick assessment of an individual’s health by using their health and weight.
Mathematically, the formula for BMI looks like this:
BMI = weight in kg/ (height in metres)2
The World Health Organization (WHO) released a table of recommended body weight for adults based on BMI values. It is used for both men and women, aged 20 or older.
A BMI between 18.5 and 25 is considered normal. A BMI over 25 is considered overweight, and a BMI below 16 is regarded as severe thinness. If your BMI crosses 30, you’ll be considered obese. These are not set in stone. For example, a BMI of 24 in Indians is considered problematic, given our genetics and predisposition to certain illnesses on account of our lifestyle, diet, etc. So, the numbers aren’t sacrosanct.
BMI is widely employed by medical professionals and insurance companies as a first-line evaluation of health. At a glance, BMI might escape scrutiny, but its biggest flaw remains that it functions on the assumption of the "average
BMI was introduced in the early 19th century by Adolphe Quetelet, a Belgian mathematician, to assist the government in allocating resources by calculating the degree of obesity among the masses. These estimations were made in view of a white male population. Based on this, the average weight was set. The setting of an average creates expectations and norms for people who fall outside of the white male circle. Despite the use of averages in evaluations of large populations, it fails to account for individuals.
Such a standard cannot be applied universally, especially in third-world countries where white people are the minority, without a few adjustments because the current normal is dictated by the narrow range of 18.5–25.
Moreover, these statistics overlook body composition, which is body fat versus muscle mass. It ignores the relative proportions of muscle, fat, and bone in the body. Bone is denser than muscle and twice as dense as fat, so an individual with strong bones, low fat, and good muscle tone will still have a high BMI. Consequently, athletes and other health-conscious people are often classified as overweight or even obese.
In a 2016 study of 40,000+ adults conducted in the United States, researchers compared their BMIs with more specific measurements of health, like their cholesterol and glucose levels, markers of inflammation and blood pressure, insulin resistance, and triglycerides. The results revealed that about half of those categorized as overweight and nearly a quarter of those classified as obese were metabolically healthy. On the other hand, 31% of the people with a "normal" BMI were metabolically unhealthy.
Due to BMI’s association with science, its authority is often unquestioned, even by doctors. Many reported cases accuse the doctor of simply assuming that a person with a normal BMI is healthy, which not only leaves potentially harmful diseases undetected but also shields their unhealthy habits like smoking, eating poorly, or avoiding exercise. On the flip side, the automatic response for those who are considered overweight or obese is to lose weight, leading to eating disorders. People with higher BMIs are also charged a higher insurance premium, which keeps them out of the doctor’s chambers. So, those who need medical assistance the most are also the ones who are being neglected.
Reducing individuals to numbers instead of treating them as a whole has a significant impact on the patient’s psyche. Several studies and other research have repeatedly shown that when patients who are struggling with obesity are treated with the same level of consideration as someone dealing with any other disease, it makes them more attentive to medically advised weight loss. Quantified data leaves out the psychological aspect, which is crucial when dealing with such sensitive topics.
Although more accurate alternatives to BMI have been offered in the form of MRI scans and underwater weighing, where patients are submerged in a tank of water to calculate their body fat, density, and volume, they are expensive and labor-intensive. While BMI can give a basic guess at body fat percentage, it cannot be the sole method of determining an individual’s health. There is a need for a more well-rounded approach to medical evaluations.
