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the problem with BMI

1 · Nov 13, 2020 · Leave a Comment

diving into the topic of why BMI is so problematic and such a poor indicator of health, as well as why many have made the decision to reclaim the word ‘fat’

Continuing to share some of my favorite newsletters from this past year while I’m on maternity leave! If you want to subscribe for more content like this, sign up here!

If you’re somewhat new to the Intuitive Eating / Health at Every Size® world, one of the things that might be most confusing is the way in which we talk about weight.

Why BMI Is Problematic

If you’re somewhat new to the Intuitive Eating / Health at Every Size® world, one of the things that might be most confusing is the way in which we talk about weight (and why we reject much of the common rhetoric around weight).  So today let’s dive headfirst into that!

The commonly accepted terms used most often to classify weight is by BMI categories: ‘underweight,’ ‘normal weight, ‘overweight’ and “obese.’

The problem is, BMI utilizes just 2 factors to come up with these classifications: your height and your weight.  

If you’ve read any of my nutrition posts, then you know that there are SO MANY other things that impact our health.

BMI is problematic for a number of reasons not the least of which being that is allows us to judge someone’s health status based on a number using factors that may have nothing to do with our health.

But even before we got to that point, the roots of BMI have been troubling.  Developed as a statistical exercise (never meant for clinical use as a medical instrument) in the 1830s by an astronomer named Adolphe Quetelet, it sought to test whether the laws of probability could be applied to humans at the population level.  Not only was it never meant for clinical use as a measure of health, but it was developed using a population of exclusively white, Europeans (therefore differences in body shape/size across all other ethnic groups were unaccounted for).

Despite the way in which it was developed and what it was developed for, insurance companies chose to apply it as a qualification measure for insuring individuals in 1899 stating that ‘from our mortality records the overweights are clearly less desirable than either the normal or the underweights.’ (Flegal et al., 2013).  Important to note here is that  most of the data insurance companies were using was based off wealthy white males (current, more inclusive data shows a very different picture as you’ll see).  Insurance companies then began passing this literature off to doctors and other health professionals, thus beginning the start of fatphobia and weight stigma that still persists in society today.

We’ve discussed that your weight does not necessarily determine your health.  For instance, a thin individual that smokes, uses illicit drugs, never moves their body and eats hardly anything throughout the day is not someone we would ever classify as ‘healthy.’  But because their BMI may be ‘normal’ and they fit the outward appearance of ‘health’ in this culture (i.e. ‘thin’), then they’re often considered such at first glance (or even initially in a medical setting).  

Whereas someone in a larger body that doesn’t smoke or use illicit drugs, is active and appropriately nourished will often be classified as ‘unhealthy’ at first glance (or in a healthcare setting) simply because their weight and height may cause them to fall into the ‘overweight’ or ‘obese’ category and their body doesn’t fit the outward appearance of health we’ve come to accept.

In addition, the use of terms like ‘’underweight,’ ‘normal weight,’ ‘overweight’ and ‘obese’ have their own problems.  The terms ‘underweight’ and ‘overweight’ imply that there’s some magical weight number we should be in order to be healthy (there’s not).  ‘Normal weight” again implies that there’s some specific number that will guarantee us health.  Finally, when you break down the etymology of ‘obesity’ it infers that one has ‘eaten until fat.’

The problem here is that these terms begin to medicalize and pathologize weight beyond a certain (arguably, arbitrary) number which is not only unhelpful, but downright harmful to the individual.

Reclaiming the F Word

Given all of this, there has been a growing movement to take back the word ‘fat.’  Does it make you uncomfortable to describe someone in a larger body or describe yourself as simply ‘a fat person’?  If so, you’re not alone.  I certainly remember feeling that way when I was first introduced to the idea of reclaiming the word ‘fat’ given how demonized fat is in our cultural landscape.  In our society that saying someone is ‘fat’ has become synonymous with an insult.

However, the National Association for the Advancement of Fat Acceptance (NAAFA) argues (rightly so) that fatness is simply a form of body diversity that deserves respect, the same as someone’s skin color, hair color, gender, sexual orientation, etc.

Take a second to process how it makes you feel.  When someone tells you that you look ‘thin’ – do you cringe?  Someone saying “you’re so skinny!” is often seen as a great compliment.  So why, then, do we feel so differently about the word ‘fat’ as a descriptor? 

It’s because our culture has drilled the false narrative into us that ‘fat’ = undesirable, lazy, unhealthy and ‘thin’ = desirable, attractive and healthy.  

There is nothing innately ‘wrong,’ ‘bad’ or ‘unhealthy’ about fatness – it’s simply a different way for a physical body to present.

That said, I understand reclaiming the word ‘fat’ is not for everyone.  For some, that word can still evoke a lot of trauma (particularly if one has endured a lot of weight stigma throughout their life).  Whether you are someone who feels comfortable reclaiming it to describe yourself or not, the point is that there are many other, much more respectful descriptors you can employ outside ‘overweight’ and ‘obese.’

Some of these include:

  • Individual living in a larger body
  • Heavier individual 
  • Higher weight individual

If you are referring to someone directly, you can always ask them what term they prefer to utilize.  Above all, it’s important to be respectful of the terms individuals feel most comfortable with.  This will change person to person – everyone’s journey and preference is different.

References: 

  • Bacon, L. & Aphramor, L. (2014). Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand About Weight. Dallas, TX. BenBella Books, p. 8-10.
  • Harrison, C. (2019). Anti-Diet: Reclaim Your Time, Money, Well-Being and Happiness Through Intuitive Eating.  Great Britain.  Yellow Kite, p. 35
  • K.M. Flegal et al., “Association of All-Cause Mortality with Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-Analysis,” JAMA 209, no. 1 (January 2, 2013): 71-32. [PDF]
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disclaimer: the content that I share in this space should be used for informational and educational purposes only. It should not be used as a substitute for medical or mental health advice and does not constitute a client/practitioner relationship.

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i’m cait, a registered dietitian and mom. i believe in a realistic approach to wellness. on this site you'll find easy recipes, nutrition content, motherhood tips and more! read more →

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hear me out. I know we've been taught to celebrat hear me out.  I know we've been taught to celebrate things like weight loss, toned muscles, beauty procedures that help us look younger...but here's why I always caution against putting so much focus on appearance:⠀⠀⠀⠀⠀⠀⠀⠀⠀
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bodies change.  weight fluctuates. skin sags and wrinkles.  hair grays.  these are all part of the natural process (& privilege) of aging.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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we live in a society that promotes this backward idea that our appearance should remain stable despite years passing.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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rather than internalizing the false idea that we need always be reaching backward and working to re-obtain what once was, allow your body to showcase the beautiful signs that you were given yet another day to walk this earth.  another chance to pursue your passion and purpose...both of which are so much more important than how you look.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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to anyone that needs this reminder today: you are not your body.  your worth and well-being is not dependent on your appearance.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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#caitsplatenutrition #caitsplate #antidietculture #nondietapproach #antidietdietitian #intuitiveeatingjourney #youareworthy
tweaked my slow cooker turkey, bean & veggie chili tweaked my slow cooker turkey, bean & veggie chili this past week to make it meatless and it was 🙌🏼⠀⠀⠀⠀⠀⠀⠀⠀⠀
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here’s how I did it:⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1/2 red onion, finely chopped⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1 cup diced bell peppers (I used a mixture)⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 3 cloves garlic, minced⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 2 tablespoons tomato paste⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1 (28-oz.) can diced tomatoes⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1 15-oz. can black beans, rinsed and drained⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1  15-oz. can kidney beans, rinsed and drained⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1 1/2 cups veggie broth⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 3 teaspoons chili powder (+/- as desired)⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1 teaspoon ground cumin⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1 teaspoon dried oregano⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1-2 sweet potatoes, peeled & cut into 2 inch cubes⠀⠀⠀⠀⠀⠀⠀⠀⠀
- Salt & pepper, to taste⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 2-4 tbsp. olive oil⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 2 cups cooked quinoa⠀⠀⠀⠀⠀⠀⠀⠀⠀
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place everything but the quinoa into a slow cooker & place on HIGH for 4 hours.  Stir in cooked quinoa & add additional salt / pepper / spices to taste.  top with your favorite toppings (I love cheese, avocado, yogurt & hot sauce).⠀⠀⠀⠀⠀⠀⠀⠀⠀
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this chili is great right away (even better after a day to marinate in the fridge) and is an easy make-ahead meal you can enjoy all week!⠀⠀⠀⠀⠀⠀⠀⠀⠀
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#caitsplatefood #caitsplate #chilirecipe #vegetarianrecipe #vegetrianmeal #vegetarianmealprep #slowcooker #slowercookermeals #crockpotrecipes
what's a diet culture rule you've never quite unde what's a diet culture rule you've never quite understood?
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for me it was definitely the "don't eat after 6pm" rule 🤔
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hunger and digestion are not run by the clock.  there are so many factors that can go into why we feel hungry from one moment to the next, and that feeling of hunger is always valid and should be honored, regardless of the time of day.
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similarly, there are no 'right' or 'wrong' times to eat a meal.  breakfast, lunch and dinner are not bound to specific windows of time.  each can be eaten whenever you & your body deem it appropriate.
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hope this reaches anyone who might need these reminders today ❤️
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#caitsplatenutrition #caitsplate #antidietdietitian #mindsetmatters #allfoodsfit #edwarriors #rdchat #dietitiansofinstagram #healthateverysize #dietculturedropout #nondietdietitian #antidietculture #antidietrevolution #intuitiveeatingjourney
these greek spinach & feta turkey meatballs make f these greek spinach & feta turkey meatballs make for a super simple weeknight meal.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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I'm partial to serving them over some couscous or quinoa, slathering them in tzatziki sauce then adding some fresh cucumbers, red onions, tomatoes & pita bread.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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but you can really serve them up in whatever way you like best!  done in 35 minutes and makes enough to eat for several meals 🙌🏼⠀⠀⠀⠀⠀⠀⠀⠀⠀
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grab the recipe on @caitsplate (link in bio): https://caitsplate.com/greek-spinach-feta-turkey-meatballs/⠀⠀⠀⠀⠀⠀⠀⠀⠀
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#caitsplatefood #caitsplate #dinnerrecipes #dinnerathome #easydinner #easymeals #thefeedfeed #f52community #huffposttaste #recipeideas
just to add a little perspective around the messag just to add a little perspective around the messaging that’s out there telling us all how to “lose the COVID 15...”⠀⠀⠀⠀⠀⠀⠀⠀⠀
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let's reframe the fear mongering language around weight gain during this pandemic as a sign of privilege.  having enough, at a time where so many have lost so much, should be looked at as nothing but a positive.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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our bodies are meant to shift and change with different seasons of life.  using food as one way to cope with hard emotions is completely common and part of a peaceful relationship with food.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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we are in unprecedented times.  seeking self-comfort and care in whatever way works for you is OKAY.  having gained weight during this pandemic is OKAY and not something you need to be jumping to 'fix' or 'correct.' and most importantly, it's okay to reframe comfort eating to something you can be grateful for, a coping skill you have the privilege and opportunity to enjoy, rather than berating yourself for it.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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sending everyone a great big virtual hug today 🤍⠀⠀⠀⠀⠀⠀⠀⠀⠀
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#caitsplatenutrition #caitsplate #nondietapproach #antidietdietitian #antidietculture #intuitiveeatingjourney #intuitiveeating #nondietdietitian #youareenough #youareworthy
another favorite from the archives!⠀⠀⠀⠀⠀ another favorite from the archives!⠀⠀⠀⠀⠀⠀⠀⠀⠀
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this veggie sushi grain bowl takes all your favorite flavors from a veggie sushi roll and deconstructs it into an easy lunch.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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finished off with an Asian ginger vinaigrette, it will definitely be a meal you make time and time again.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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here’s what you need: ⠀⠀⠀⠀⠀⠀⠀⠀⠀
for the grain bowl:⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 2 cups cooked rice⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1 cup steamed shelled edamame⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 2 cups carrots, peeled & cut into ribbons (you can also shredded or thinly slice them)⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1/2 cup cucumbers, thinly sliced⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1 avocado, sliced⠀⠀⠀⠀⠀⠀⠀⠀⠀
- Optional: black sesame seeds⠀⠀⠀⠀⠀⠀⠀⠀⠀
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for the dressing (recipe from all recipes):⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 3 cloves garlic, minced⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 2 tablespoons fresh ginger root, peeled & minced⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 3/4 cup olive oil⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1/3 cup soy sauce⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 3 tablespoons honey⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1/3 cup rice vinegar⠀⠀⠀⠀⠀⠀⠀⠀⠀
- 1/4 cup water⠀⠀⠀⠀⠀⠀⠀⠀⠀
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full recipe details on @caitsplate (link in profile): https://caitsplate.com/veggie-sushi-grain-bowl/⠀⠀⠀⠀⠀⠀⠀⠀⠀
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#caitsplatefood #caitsplate #vegetarianrecipe #vegetarianeats #vegetarianlunch #huffposttaste #thefeedfeed #f52community #lunchtoday

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