Is BMI Accurate for Everyone- Does it Factor in Race and Gender?

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Did you know that researchers estimate that nearly 75 million Americans are “misclassified” as heart-healthy? On the other hand, more than 30 percent of normal-weight Americans are metabolically unhealthy. What do you think? Is the BMI accurate for everyone?

Is the BMI Accurate for Everyone?

The Body Mass Index (BMI) is derived from a simple math formula. It was invented in the 1830s by a Belgium statistician, sociologist, astronomer, and mathematician by the name of Lambert Adolphe Jacques Quetelet. Why has the BMI caused so much discussion lately? Is the BMI accurate for everyone? We have a lot of work to do. Let’s get started.

Is the Body Mass Index Archaic?

In 1972, the Quetelet Index became known as the Body Mass Index. A physiologist, Ancel Keys, stated that the BMI was essential to quantifying health on an individual level. If you think it sounds odd that we still use a device straight out of the 1800s, it probably is. In fact, it is also strange for the following reasons: 

• The BMI is an archaic system not developed by a doctor
• It does not take into consideration different people, races, and sexes
• BMI does not consider people with varying types of body
• BMI does not account for muscle mass

Does BMI Misclassify?

One of the latest criticisms is that the BMI does not and cannot take into account your body composition, including your body’s ratio of lean mass to fat mass. In fact, the director of the Cedars-Sinai Medical Center in Los Angeles is concerned with the validity of the BMI.

BMI Does not Show Body Mass Percentage

“While BMI does not give the doctor a very basic guess at the patient’s body mass percentage, it is in no way the entire picture when it comes to his or her overall health or even amount of body fat.”

Comparing Apple and Oranges

• A fit 35-year-old had lean muscle mass and weighs more
• A 65-year-old the same height weighs less than a younger man
• BMI shows the young man has a high BMI, But he’s healthy

Does this prove that the BMI is gender-based because these 2 examples are men?

Case Study

One academic community found the BMI to be racially biased. In fact, BMI issues are coming to the forefront of modern medicine. The medical critics say, “You cannot use weight as a marker of health.”  In fact, many study groups claim that the BMI is not just inherently racist; it is also gender biased.

BMI Creator Was Not a Racist

Quetelet should not be accused of being a racist because of his creation of the BMI. It is not his objection to discriminate against anyone, per se. Even if there is a correlation between disease and a high BMI, calculations must include other related adversities before considering BMI. It was created to help people.

Does BMI Help or Harm People?

Research shows that weight loss isn’t the effective cure-all it’s been made out to be. In fact, chronic dieting also leads to heart attack and stroke. A Senior Editor of Good Housekeeping states, “This questions whether blanket weight loss initiatives and deep-seated fears of “excess” fat are helping or harming the well-being of individuals and communities at large (Adele Jackson-Gibson. 2022). She is convinced that the BMI discriminates on many levels.

 Is BMI Flawed?

According to the latest research, BMI discriminates against others and judges a person by their body fat. Is there research to prove that the BMI calculations are flawed?

A list of BMI Inaccuracies

• BMI ignores the fact that people of Asian descent have 2 times the risk of developing type 2 diabetes than white people
• The current BMI cutoffs are based on the imagined “ideal” Caucasian and do not consider a person’s gender or ethnicity.
• Unfortunately, these narrow standards have not changed in America and have been applied globally.
• In Central Africa, white people are the minority (same BMI standards as the U.S.)
• China and Japan define “overweight” as a BMI of 24 (0.9 lower than the U.S.’s cutoff)
• Standard cutoffs don’t help the experiences of some families
• Higher incidences of all metabolic disorders and a lower BMI for South Asians
• Not all patients with higher BMI (larger-bodied) are unwell
• Those with higher BMIs have normal lab work and vital signs. The only thing that was out of the normal range was their BMI.
• People in larger bodies get less quality care, and doctors may misdiagnose symptoms.
• Too much focus on weight encourages harmful, emotional eating. 

BMI Inaccurate for Women of Color

Women of color are at a higher health risk for high blood pressure, diabetes, high cholesterol, and other “obesity-related conditions.” In addition, they are also more likely to have a higher propensity for chronic stress, economic inequality, and institutionalized racism due to obesity. In String’s book, she describes the discrimination that women of color in America endured during the 19th century. Do you think the BMI discriminates?

Higher BMI Promote Discrimination

There is way too much emphasis in our culture on thinness and BMI. As a result, patients with high BMIs are denied treatments such as IVF or other surgeries. I know this is a fact because I was not able to get surgery until my weight was under 200 pounds. In addition, patients sometimes experience a misdiagnosis.

Misdiagnosis Discourages Overweight Patients 

Patients are also misdiagnosed. According to Dr. Paula Brochu, Ph.D., of Nova Southeastern University, “But if the person is not fat, they are much more likely to receive scans and treatment for knee pain at the time of complaint.” She says being mistreated and misdiagnosed discourages heavier patients from seeking medical care. They are adversely affected by the overt stigma. This is common, regardless of the sex of the individual. Also, heavier people are not necessarily less healthy than lighter-weight people.

BMI Inaccurate for Heavier Healthy People

Brochu’s study examined people’s cardiometabolic health across the BMI spectrum. They found the following results:

• Nearly half of overweight people and almost one-third of all obese people are metabolically healthy,” according to Brochu.
• Almost 1/3 of ‘normal’ BMIs were unhealthy. Misclassification seems to be a common occurrence.
• Someone who thinks they’re in the clear with a BMI of 30 may be at serious risk.

Is BMI Sexist?

This painful oversight is rooted deep in our history. In Brochu’s book, she describes how “the idea of blaming fatness for Black women’s health problems echoes 19th-century pseudoscience. This medium claims that Black women eventually die off due to their “animal appetites” and “unwieldy size.” BIPOC women are fighting back.

Black Indigenous and People of Color (BIPOC)

Systemic issues still impact the health of women of color. These disadvantages contribute to the development of chronic diseases. For example, BIPOC women: 

• Disproportionately live in food desserts
• Exposed to air pollution
• Contaminated water

At this level of disadvantage, a BMI number stigmatizes and is a disservice. Instead, we need to have effective ways to care for people, without making them feel inferior. The BIPOC members are leveraging resources that is now available to them. They no longer experience crude, inhumane colonialism.

From Cruelty to Celebration

How reliable is the link between higher BMIs and poor health? Amidst the angst, body fat has come to be feared as one of the greatest threats to society. According to the U.S. Department of Health and Human Services Office of Minority Health (OHM), Black women have higher rates of “obesity” and being “overweight” compared to other groups in the U.S. Therefore, they are at higher risk for cholesterol, high blood pressure, heart disease, and stroke. Also, health insurance is faulty.

Unethical Health Insurance

Health insurance companies in the early 1900s linked “excessive” body fat with an increased risk of heart disease (and still do), even though current science says it’s not that simple. This was significant because insurers use this information to determine a person’s coverage.

Insurers then refused to cover the “overweight,” while many doctors saw these “medico-actuarial tables” as a quick tool to decide who they’d take on as a patient (Sabrina Strings, Author). In essence, insurance coverage and BMI are misleading.

Why is BMI Misleading?

However, this estimated number doesn’t take into account your race, gender, or the amount of body mass versus muscle mass. It ignores your lifestyle or other relevant measurements of health such as your cholesterol or blood sugar. This begs the question – why BMI is still used.

Why is BMI Still Used?

The BMI is currently used by mainstream medical professionals. It offers a quick assessment of whether a person is a healthy weight based on an estimation of body fat percentage. BMI offers a simple and reliable way for people to tell whether they are at a healthy weight. Also, it is a decent, affordable, and easy starting point. But are BMI machines accurate?

Are BMI Machines Inaccurate?

In 1972, obesity researcher Ancel Keys claimed his new body mass tool had more accurate tables, using predominantly white European and American men. This study concluded that the Quetelet Index was superior to previous height and weight tables in measuring fat on a person’s body. Thus, the QI was rebranded as the BMI we know today. However, why is the old BMI being used less and less? 

To Be Weighed or Not to Be Weighed

According to this scale, 42.4 percent of American adults aged 20 and older are obese, notes the Centers for Disease Control and Prevention (CDC, 2020). However, if you do not wish to have a BMI scan or do not wish to be weighed on your next doctor appointment, you now have options.

If you would rather not be weighed next time you visit your physician but aren’t sure how to say so, visit more-love.org. Here, you find helpful phrases to use and small cards you can give providers to express your preference. Overweight is not a synonym for “unhealthy.”

Frequently Asked Questions

What is a Good BMI for a Woman?

Yes, there are other measures you could use in addition to BMI, such as waist metrics. While BMI indicates healthy or unhealthy body fat levels, it cannot measure how fat is distributed in the body. Waist metrics can measure how fat is distributed in the body.

What is a Good BMI for a 14-Year-Old?

The BMI-for-age is percentile is by comparing your teen’s weight to that of other teens. For children and teens ages 2 to 19 years, the BMI varies by age and sex. You can also easily calculate it using the CDC’s online tool.

What is a Good BMI for a 70-Year-Old?

Older adults do better if they have a BMI between 25 and 27/ Research shows that adults over 75 who are underweight experience more health issues and shorter life expectancy.

How Accurate are BMI Calculators?

BMI is based on height and weight. However, it does not take into account muscle mass, bone density, overall body composition, and racial and sex differences. So, proceed with caution using the standard BMI measurements.

When Should BMI Be Used?

The calculation of BMI is used for males and non-pregnant females between the ages of 18 and 65. Although BMI is calculated for children exactly the same way as adults, the results are used differently. A standard BMI calculator should not be used for those under the age of 18 or for elderly people.

Information Needed to Start Calculating My BMI?

You need your body weight, height, and a handheld calculator with a square function.

What is the Most Accurate Way to Measure BMI?

Calipers is the cheapest and easiest way to measure body fat in specific areas. Use three spots on your body – chest, abdomen, and thigh area. Pinch skin, pull muscle away from fat, and measure the fold within the calipers. Always test on the same side. Another way is by using the Dual-Energy X-ray absorptiometry (DEXA) scan. It is the most accurate testing available.

How Accurate is the BMI?

For the most part, BMI is entirely accurate. However, the World Health Organization (WHO) uses the same BMI categories and ranges for people of all ethnicities (as it does with gender). Does body frame factor in?

Does Body Frame Size Affect BMI?

Body frame size affects a person’s measured Body Mass Index. People with a very large body frame can record BMI measurements indicating higher body fat levels than those with smaller frames.

References

1. Fearing the Black Body: The Racial Origins of Fat Phobia, Sabrina Strings.
2. Centers for Disease Control and Prevention (CDC) cdc.org
3. Sabrina Strings, Ph.D., Associate professor at University of California, Irvine.
4. Adele Jackson-Gibson, Senior Editor of Good Housekeeping.
5. A Treatise on Man and the Development of his Faculties by Adolphe Quetelet.

Final Thoughts

The BMI is not a one-size-fits-all calculation. Although it can identify a certain level of normal health, the BMI does not consider other qualifying factors such as the person’s economic situation, age, gender, living conditions, lack of resources, and chronic health conditions that contribute to their higher rates of BMI. It will be upgraded in time and serve a more meaningful purpose to individuals, communities, and the greater society.

So, I thank you for sharing this BMI journey with me. I hope you find this information relevant. Please share it with people within your social circle moving forward. Also, feel free to leave your questions and concerns in the comment section below. This is my favorite part of my blog: getting to have a dialogue with you.

Rachele, Founder

(w) mybluegenes.com 

(e) (rachele@mybluegenes.com