Our scientific knowledge in the modern age sets us as the most technologically advanced civilization we know of. We can communicate almost instantly from one side of the globe to the other. You can study complex qualifications like a hybrid ABSN program without leaving your home’s comfort. Yet within the realm of dietary science, there is still much work to be done, as the revelations of this area of study become notoriously unscientific when put into the public eye.
The misgivings of dietary and health science have given rise to numerous erroneous views regarding health and a “proper” diet in society. One of the most famously contested areas of our understanding of health is the Body Mass Index (BMI.) This scale measures a person’s weight and height and determines what stage of overweight they fit. It has been used as a diagnostic tool for decades by doctors, however, the scale has garnered intense criticism as being inaccurate, and outdated.
What’s the truth? Let’s find out.
Basis for BMI
The BMI, as with most things criticized these days, comes from a man with limited knowledge. In 1796 a person called Lambert Adolphe Jacques Quetelet was born. He grew into a well-known mathematician, sociologist, astronomer, and statistician. He was in no way qualified to conduct any medical standardization. Still, it was Quetelet’s dedication to finding the parameters for the so-called “average man” that drove him to do so.
Quetelet was a young, up-and-coming scientist, graduating with a doctorate in his early 20’s. He wanted to leave a mark in a new area of science much like his heroes. However, his efforts and plans to bring astronomy to Belgium fell through due to rebellion. This led to him focusing his efforts on other areas. The Belgian Rebellion had served to cut his dreams short, and he found himself frustrated with the unpredictability of human nature. Therefore, with his combined knowledge of statistics and astronomy, Quetelet sought the means to categorize humanity and statistically reveal the ideal – or as he called it – the “average man.”
The “average man” or l’homme moyen in French, was Quetelet’s efforts in finding the socially perfect human. It was an exercise in combining statistics and anthropology in what Quetelet called “social physics.” It was never meant to be used as a method of categorizing people’s health by weight. The fruit of this labour was the “Quetelet Index,” which has become the BMI scale we know and have a very complicated relationship with today.
Racism, Sexism, and Capitalism
Was Adolphe Quetelet racist? Who knows? However, the fact is that the BMI is not representative of all body types or fat distributions. During his research in the formation of the Quetelet Index, Quetelet conducted his measurements and gained his statistics from mostly white, European males. In other words, the people he had on hand. So far as we know, there was no control group and certainly no racial or sexual variation. Therefore, the BMI is only “accurate” if you’re a white European male. If you’re a female or Person of Colour, you’re unlikely to get an accurate read on the BMI.
You may ask yourself, how did some French guy’s standard for physical perfection end up as the primary health scale for General Practitioners and health professionals worldwide? Well, that’s the other ‘-ism’ we all love to hate, capitalism.
You see in the 1900s, health insurance companies wanted an easier way to determine a person’s potential mortality. Notice how we said “easier” and not “more accurate.” When the insurance companies saw that increased risk of heart disease, liver disease, arthritis, cancer, diabetes, and sleep apnoea all increased according to the increasing weight scales of the BMI, that was effectively all they needed to know. Soon the BMI was adopted as the standard insurance measurement scale, which then led to it becoming GP’s standard fatness measurement scale, which then let it become society’s health measurement scale.
The Accuracy of the BMI
Having thoroughly dressed down the problematic past of the BMI, it’s time to dress down the present; and the stand-out fact that all but a few dogged professionals agree on is that multiple things have rendered the BMI an inaccurate, and potentially harmful tool’.
Ignoring for a moment the fact that the BMI was not designed as a scale intended for diagnosing obesity or weight, the fact that it ignores every cultural physiology except the one the creator was born and raised in and that it was entirely theoretical – the BMI just does not account for most of what makes a person “healthy.”
Most social ideas around “health” are formed around weight, when we see a fat person we deem them to be unhealthy and when we get an overweight or (God forbid) obese reading on the BMI, we feel like we are unhealthy. But health, even from a purely physical standpoint, rests on much more than just a person’s weight. Weight and fat distribution show up on a person’s body in a variety of ways, and people can appear “overweight” without actually being overweight.
At the end of the day, the BMI is an index that should never have seen the light of day in a medical context, but its simplicity and ease of use made it a good tool for people in the early days of nutrition science. Coupled with society’s obsession with weight, the BMI has proven a difficult parasite to shake, one that is actively harming people and contributing to fat-phobic stigma.
