The American Medical Association has finally acknowledged the racist roots of the BMI as a measure of healthy weight. Recently, the AMA released a statement saying, “The AMA recognizes issues with using BMI as a measurement due to its historical harm, its use for racist exclusion, and because BMI is based primarily on data collected from previous generations of non-Hispanic white populations. Due to significant limitations associated with the widespread use of BMI in clinical settings, the AMA suggests that it be used in conjunction with other valid measures of risk … “
I do not see this as some racial justice reconciling by the AMA, but it is still way past due. They now admit their tool is racist and should not be used exclusively to determine health status in individuals. They acknowledge how the measurement has inaccurately targeted bodies without first considering cultural differences or sex. But the fact remains that the policy of solely using the BMI to determine health has led to a life of restriction, starvation, poor body image, and weight gain for me and millions of others.
I have suffered because of this racist tool. I was not a fat child, but I was targeted by my doctors and then my parents because my BMI was high, regardless of my health status or other markers. I am a Black girl — my build is large and I have big bones, but the BMI makes no consideration for this. It only measures height and weight, nothing more. Every diet I completed ended with more weight gained than lost. No one tells you diets do not work and that you are more than likely to gain the weight back and then some.
Because my BMI emboldened my doctors to make claims that I was too fat as early as 6 years old, my mom was shamed into making me lose weight. I was put on every diet you can imagine and some I am sure my mother made up. I couldn’t figure out what was so bad about my body. I was just a kid living my life not hurting anyone, but my entire community was out to make me get into a smaller body. No one stopped my mom or corrected her when she would put me on these obscene diets. She thought she was doing the best for me. My doctors sanctioned this behavior of diets for 6 year-olds and she did as she was told.
At no point did the tool my doctor was using to make his recommendations take into consideration my build, race, gender, and other social determinants of health. My doctor did not question this tool as it was the gold standard used by doctors worldwide. If the doctor had done any research, he would have discovered that the research to come up with the BMI measurement was based on European white men and it was not a measure intended for individual health assessment.
This tool that had dictated how I and my family saw my body as a problem was all a lie. I was not unhealthy in my body. I was not a problem to be solved. I was just a kid trying to live her best life.
Well, that took too long. I consider all the damage that has been done and I am angry, yes I mean angry. I absolutely blame the implementation of the BMI for my weight gain throughout my life starting in early childhood.
Consider this: When the doctor would calculate my BMI he would determine that I was too fat for my height and weight (remember no other considerations were given), he would then prescribe a diet. I would inevitably go on this diet and since I was a good obedient dieter, I would lose some weight. My doctor would applaud me and say I needed to lose more since I was not at my goal BMI. I would try some more to lose more weight. I would not be able to and would eventually go back to eating since I had been starving this entire time. (They call it a diet or lifestyle change but really it is restriction to starvation.) I would inevitably gain back all the weight and then more. It was obvious diets inevitably would not work, but I was pressured by doctors and society to continue to try to the detriment of my health.
I repeated this pattern throughout my entire life. Every doctor I saw said I was too fat, that my BMI was too high, and I needed to lose weight. I felt shamed and would want to do better and so I acquiesced and did as I was told.
The result of all my efforts to get to a “healthy BMI” has led me to the body I am in right now. I will not give you numbers, but you should trust that I am in a super fat body. All the dieting and restricting and punishing my body with exercise has led to one thing — weight gain. Diets lead to weight gain so I was fighting a losing battle. There was no way for me to win a battle that almost no one wins. If I had avoided dieting in the first place, I would not have gained the weight back and more. I was permanently ruining my metabolism and moving my set point. Without question, dieting made me fatter and fatter.
So, who is to blame for this? It is nice that the AMA is correcting itself, but it is a little too late. BMI is so ingrained in our psyche and doctors use it as a lazy way to determine health status. I don’t see them moving away from it that easily. So push back when faced with a doctor who is telling you or your child that their BMI is too high. Ask for other markers to determine health and do not settle until they have taken into account the social determinants of health.
It is an uphill battle, but one that our lives depend on. Hang in there. There is nothing wrong with you and your body.
I am Black, lesbian, disabled, mentally ill, fat, a birth mom, mom and grandmom (grand ma Coco to be exact) and Funny. I am a woman who is constantly fighting for my and your liberation.
I have a history of working for those living at the margins mostly in activist and nonprofit spaces. I currently work in the mental health field serving those who have been convicted of felonies and are in mental heath court. I am also a writer. I write about disabilities, chronic illness, mental health, racial trauma, sexual violence and disordered eating. I am also a public community speaker on the same topics. Hit me up if you need my writing or speaking skills.
Please use she or her pronouns when referring to or about me.