I was told I am Obese according to my BMI…

For those that are unaware, I occasionally do Medical Role Play jobs, which basically means I am a simulated patient for trainee doctors/nurses either during their training or as part of their exams.

It is a very worthwhile job and I honestly feel like I have learnt so much from them, although of course I am no medical professional.

Recently I was on a station for first year students and so, understandably, the scenarios were very basic. My specific station included them calculating my BMI, amongst other things.

Now this was my personal BMI, not a simulated example, I had to be physically weighed and have my height taken over 20 times throughout the day… which I appreciate for a lot of people would have been triggering as hell.

Luckily I have done a lot of work on my own relationship to these metrics, as well as the narrative that my weight somehow affects my worth, and so even though, being completely honest, I am in a place where my body has changed so much that it has contributed to my recent disconnect from myself and I am woking towards some weight loss as part of my reconnection to self, I was able to hear my current weight and calculated BMI, this many times in one day, without it sending me into a spiral or feeding the old thoughts that I have worked hard on turning down over the years.

Yet it did bring some other feelings up for me…

• The feeling of frustration that BMI is still a metric that carries a lot of weight (pardon the pun).

• The feeling of sadness that so many people are still prisoners of the narrative that weight = worth.

• The confusion at why we haven’t yet woken up and smelt the coffee, allowing us to put down things that are now known to have negative consequences rather than being particularly helpful.

I can appreciate that I am not a medical professional and therefore there may still be room for BMI as a way to note trends or needs within a population… however having the experience I have in working with people who struggle intensely with their body image and self-worth, continuing to use BMI as a marker of health feels ridiculous to me.

BMI is your height to weight ratio - and that is all.

It doesn’t tell you your muscle mass, your fat percentage, your bone density, your cardiovascular health, your hormonal balance, any medical conditions you may have, any experiences of trauma, any mental health issues you are dealing with, your water retention, when you last ate, what your relationship to food and body is….

Along with not knowing how kind a person you are, your intelligence, humour, skillset, strengths and weaknesses, passions and hobbies… it literally knows nothing about you except the correlation of your height and weight….

And yet it causes people to believe they are more or less than as a human being.

How ridiculous is that?!

If society had a healthier relationship to body image and didn’t condition us to believe that our weight and aesthetic matter more than most other things, then maybe, just maybe, BMI might not be so harmful a metric. But in my opinion, it is one of the least helpful things to know about a person and it confuses the reality of what is actually going on for said individual.

Most of the students when relaying to me that I fell into the Obese category were either:

A) confused if they had calculated it right as, whilst I am not small, I don’t look like what most people would think Obese looks like, proving that our perceptions of what these words mean or how certain bodies should look is completely warped.

B) nervous to tell me as if it was a horrible thing to hear. Which again is a condition of the fat-phobic society we live in rather than a medical term relating to your weight but not in any way your worth.

I left the day, not feeling embarrassed or ashamed at myself for falling into this category and having it relayed to me 20+ times, but angry and frustrated that this is still something that is being used so regularly.

I also have a client who is training to be a nurse and she relayed to me her experience of shadowing a community nurse who went to a home visit to tell a family that their child is overweight and needs to restrict their food intake in order to be “healthier”. A child being told they need to lose weight by restricting food is just going to lead to other unhealthy behaviours and ways of being rather that being it helpful and healthful. Not all deliveries of this topic will be a harmful, but the way in which my client described this to me… even to the point that the child in question wasn’t even particularly overweight, it was just their BMI that categorised them here… and the way in which the advice for weight-loss was presented by the nurse…. left me feeling even more angry.

You can promote health without equating everything to weight.

You can offer advice without it being overly restrictive, excessive and harmful.

You can help someone make changes without substituting one issue for another.

In my opinion, whilst the medical industry may still need to take BMI on certain occasions, for whatever reason, it shouldn’t be used as a marker of health for the general public. People don’t need to know their BMI to know if they would benefit from making certain changes to their lifestyle or diet. From my experience all BMI does is drive people towards unhealthy habits and mentalities around food, body and self.

And whilst cardiovascular disease (ie Heart disease/stroke) is one of the leading causes of death according to WHO…. and therefor people can argue that living in a larger body puts you at higher risk of developing these kinds of physical issues, Anorexia nervosa has the highest mortality rate of any psychiatric condition and can also cause cardiac problems including heart failure… so contributing to the increase of people living with an eating disorder because you were trying to help by motivating them to lose weight isn’t the answer. And that’s not me being extreme, that is the truth of what the narrative that weight = worth contributes to, the horror that is “skinny-tok”, or the harmful fat-phobic notions embedded into society all cause people into extremes that can result in death… rather than move people towards health.

So please take note of how you communicate to others about weight and body, please work on changing the way in which you speak to yourself about your weight and body, and know that BMI was created by a middle aged white male mathematician who intended it to be used as a statistical tool to study populations and define the "average man," rather than as a medical assessment for individual health - it wasn’t designed for other genders, races or populations - so maybe don’t put too much emphasis on what it means about you, if you can.

If this has brought anything up for you please feel free to get in touch.

Or for further help and support on Eating Disorders you can head to the BEAT website.