Unless you are a top athlete, your muscle mass will not be sufficient to distort your BMI
That's not true at all. There are many people who work out enough to have athletic levels of muscle. While top athletes train heavily, most of that training is perfecting technique NOT building muscle.
Muscle gain is also highly dependent on gender and genetics. Some men and women gain muscle easily with little effort, others don't.
Generally top athletes (if they weight train at all, many distance runners will weight train very little) will only lift a few times a week, same as your average Joe or Jane weight lifter. It's not safe or recommended to do more than that as it's too much strain on your muscles.
The reason so many top athletes, especially in sports where speed is key, look so muscular and defined is because before competition they also work hard to lower their body fat to at least 20% and under.
People keep bringing up Michael Phelps and gymnasts as examples of top athletes with healthy BMI's. Yes, they do, because they have to have very strict diets and keep low body fat to make them faster or more agile.
If you look at events like hammer throw, javelin, rugby, boxing, weight lifting, fencing etc. where strength and endurance are prized over speed, you will find a lot of athletes listed as overweight to nearing obese. That's because they don't need under 20% body fat. There's no reason for them to be lean. They are better off well fed and a little padded. And that's when they are in peak form. In the off season they will gain even more body fat when they relax their diets but keep their muscle mass.
Rhonda Roussey weighs in at 5 ft 6 130 lbs for competition. She cuts heavily to get to that weight. When she's not fighting she says her happy weight is about 150/160. Which puts her in a just overweight (and I think she's fibbing a little, looking at her she's probably more 170 but that's because she's the same height as me and has a similar body shape and that's what I weigh in at).
At the end of the day, someone coming in at overweight or obese, who works out regularly and intensely is healthier than someone who has a healthy BMI but does nothing but sit on the couch.
BMI is NOT a diagnostic tool, it's a scientific calculation. I'm overweight by a stone and my doctor says keep up the good work you look fantastic and your healthy as a horse. I have nothing to gain whatsoever by getting into a healthy BMI range other than being able to fit into a size 10 I suppose. Which isn't really my priority in life.
In the case of the woman. No, she doesn't look healthy, and she's had a perforated bowel. In her case I think there were more reasons than her BMI, but that's just what someone said. That isn't to say that someone else her size, with no other health problems, whose active, and has a great deal of emotional stability and patience shouldn't be accepted as a foster parent. They should.