The topic of BMI has come up so much recently due to the pandemic and a high BMI leading to increased risk of severe Covid-19. But BMI has long been problematic, particularly in the Black community. The archaic measurement has led to misdiagnosis and unfair treatment, especially in our community.

Just a year ago, my BMI was 21 which is considered healthy yet I had a body fat percentage of 15% which is considered extremely low for women. Between early menopause, the pandarosa, and working towards a sustainable health routine, I increased my body fat percentage to 22% which is still considered in the ‘fitness’ range for women but that nudged me up to a 24 BMI, one point away from being considered overweight.

So why do our doctors still use BMI? Well, let’s start with what it is and how it came about.

What does BMI stand for? How does it work?

BMI stands for Body Mass Index. It is a calculation of your overall weight in kilograms divided by your height in meters. You can find simple to use BMI calculators online. That number is then put up against a BMI chart that defines the BMI categories of underweight, normal weight, overweight, or obese. It is one of the most broadly used body measurement metrics to determine body fat but it is deeply flawed, just like the number on the scale.

How did BMI come into use?

While in 1832 a Belgian man by the name of Adolphe Quetelet developed the same BMI calculation, then known as the Quetelet Index, the need for a weight index came about due to insurance companies noticing an increase in claims from their obese policyholders. Actuaries and statisticians began to develop tables of “ideal” weights, eventually realizing that height also plays a factor. Their work led them back to the same calculation as Quetelet. In 1972 a study of largely White men and women confirmed the calculation and it was renamed the Body Mass Index.

How is BMI used?

BMI is widely and actively used to determine health risks which can in-turn deny you access to specific medical procedures and care because doctors will want you to lower your BMI to qualify. Just like smoking, insurance companies will increase rates or deny insurance if the BMI is in the overweight or obese range. BMI can also cause misdiagnosis of serious health issues due to doctors looking to find easy answers instead of the right answers.

How does race play a role?

As we know when it comes to health, it’s not one size fits all. While the World Health Organization has provided the guidelines for what a healthy BMI range is, they also made an adjustment for Asian populations who had significantly higher risk of Type 2 diabetes at a lower BMI. While they have failed to make any further adjustments by race & ethnicity, studies have shown body fat percentage differs by race and gender at different BMI levels. For example, when compared to white Europeans of the same BMI, Asians have 3 to 5 percent higher total body fat, with South Asians being particularly high. And in the other direction, Black people have shown to have lower body fat and higher lean muscle mass than Whites at the same BMI.

What are the BMI alternatives?

BMI is the most inexpensive method we have to access “healthy weight.” But now knowing all its flaws and that the percent of fat is really what we are trying to understand, you can see why we need to work towards not just adjusting BMI to account for race & gender, but to also make more accurate alternatives more accessible. While there are things like calipers that measure skin folds to calculate your body fat to muscle composition, there are more accurate options.

That’s why at The Fit In, we brought in the Inbody Body Composition Analyzer which breaks down not just your total body fat and lean muscle, but you also get a reading of how it’s a segmented across the body. More importantly, you get an understanding of visceral fat, the fat that lives around your organs. This, when it gets to dangerous levels, can be a key determiner of major health concerns.

Have you ever used a BMI calculator? How do you think your BMI stacks up against what you think your body composition is? Let us know if the comments.