Told to lose weight by midwife

[Paradii]

My BMI is 26 so I am classed as overweight.

I train horses for my job so I have a lot of muscle mass, especially in my legs. I have a flat stomach and definitely don't look overweight. I told her this but she insisted that I'm overweight and should aim to eat less calories/ more healthily.

Aibu to think I shouldn't try to lose weight, particularly when pregnant?

Ignore the MW. BMI is a tool that needs to be gotten rid of as it doesn't take into account lifestyle and activity levels, or muscle.

With your activity levels I wouldn't be concerned at all, clearly the MW just looked at the BMI number and ignored everything else.

MWs are terrible for just following procedures and not realising that people are individuals anyway.

I had a BMI of 29 for both pregnancies and it was never commented on. I wasn’t weighed after the booking in appointment either. I did actually ask my midwife about weight gain when I hadn’t put a single pound on at 6 months with dc2 but she wasn’t remotely worried. I put on 6lb in total (12 with dc1) and left the hospital lighter then when I got pregnant. I’d take everything she says about weight with a pinch of salt.

BMI is notoriously unreliable for athletes and other people who are really fit due to strenuous outdoor jobs etc.

Just ignore the midwife on this one.

@Paradii

Lots to consider here. I don't think I'll ask to change midwife; she was very pleasant and we got on well.

This just bothered me because I now feel like I look "fat" and I'm just going to look increasingly fatter, which I know is stupid. I wear size 10 clothes.

I just don't understand why my BMI is so high if it's not muscle. I'm half tempted to post a pic incase I'm seeing myself completely differently to how everyone else does!!

Oh no.. please don't doubt yourself. I had a BMI of 31 when I fell pregnant with DC3 (still pregnant). I am otherwise fit and well, no health conditions and have had no complications at all.

My midwife was unconcerned about my weight and when I asked if it was going to be a problem she brushed it off and just advised that I stay as active as possible and to eat healthily.

BMI is notoriously unreliable for athletes and other people who are really fit due to strenuous outdoor jobs etc.

It really isn't, unless you're talking about weightlifters, shot putters or other sports where competitors go to significant efforts to bulk up.

Think of some of the most superfit female athletes around - Google their height/weight and calculate their BMI:

Serena Williams - BMI 21.9
Ronda Rousey - BMI 21.1
Simone Biles - BMI 23.3
Caster Semenya* - BMI 23

All of these are elite athletes with significantly more muscle mass than the average woman. All are a healthy BMI.

*I'm ignoring the debate around Caster's sex and treating them as a woman for this purpose.

@shrodingersvaccine

The calculation for BMI is (weight/height)/height - it cannot take anything into account except height and weight. It's mathematically impossible, it's not in the formula.

Every example of 'healthy' BMI CSJobseeker gives is someone BMI is not designed for. It is scientifically illogical, whether a bunch of non-white, non-male, non-sedentary 19th century individuals have 'healthy' BMIs or not.

BMI was invented as a statistical tool to measure the degree of obesity of the general population to assist the government in allocating resources. It was based on 'ideal' French and Scottish males, and Quetelet assumed sedentary lifestyles with low muscle/high fat and even explicitly said that it is useless in assessing individuals.

There is no physiological reason to square a person's height (Quetelet had to square the height to get a formula that matched the overall data). And it ignores waist size, which is a clear indicator of obesity level, actually backed by science. And it ignores bone density, gender, hormones, muscle mass and body fat percentage. Multiple studies have repeatedly proven that BMI is nonsensical and yet still health professionals will look at it rather than the person sitting in front of them to decide whether they are obese or not. It's PATENTLY RIDICULOUS AND GIVES ME THE RAGE.

So much this. It's a terrible tool that is completely inappropriate for measuring a persons health. Looking at a number rather than assessing a person as an individual (lifestyle, activity, muscle mass) is not what we should be doing.

Quetelet assumed sedentary lifestyles

The proportion of the population which was what we would call 'sedentary' in Quetelet's time was miniscule. The car (and all other labour saving devices) hadn't been invented yet, and the majority of the population walked literally everywhere they went. They may not have been training in elite sports all day, but the population the tool was used to measure was a long way from being sedentary.

I think BMI is a blunt tool, allowing HCPs a quick way to gauge one aspects of someone's overall health.

Someone with BMI between 18.5 and 25 is less likely than those who lie outside of that (very, very large range) to have various health conditions.

The key words are blunt, quick, less likely.

I'd agree with that. It isn't nonsense, but neither is it a 100% accurate measure of health. But then I don't think it pretends to be?

It is the tool of choice by most health professionals for what is a 'healthy' weight, so it's very misleading as it isn't accurate or an ideal tool for individuals.

@RosesAndHellebores - midwives talking claptrap pale into insignificance when comparing with a HR department.

@CSJobseeker

BMI is notoriously unreliable for athletes and other people who are really fit due to strenuous outdoor jobs etc.

It really isn't, unless you're talking about weightlifters, shot putters or other sports where competitors go to significant efforts to bulk up.

Think of some of the most superfit female athletes around - Google their height/weight and calculate their BMI:

Serena Williams - BMI 21.9
Ronda Rousey - BMI 21.1
Simone Biles - BMI 23.3
Caster Semenya* - BMI 23

All of these are elite athletes with significantly more muscle mass than the average woman. All are a healthy BMI.

*I'm ignoring the debate around Caster's sex and treating them as a woman for this purpose.

Right, but by the logic of BMI, Simone Biles would still be healthy at a BMI of 18.5, which would be 20lbs lighter for her. She doesn’t have a shred of fat on her, if she lost 20lbs she’d be horribly unhealthy. So obviously her muscle mass IS skewing it, just not enough to make her overweight.

@Aussiegirl123456

I would have eaten the midwife

Brilliant! Too true.

I'm a midwife and I'd tell her to be quiet and stop being rude. Nothing triggers for increased folic acid or towards VTE until bmi is over 30 anyway so there isn't even any medical relevance to what she says. Ignore her.

The silly cow. BMI of 26? That's definitely not anything to worry about.

Surely the best way to be certain is to check your body fat index?

She doesn’t have a shred of fat on her, if she lost 20lbs she’d be horribly unhealthy

Not if the only thing she was losing was muscle mass.

@casamilano if you are being defensive because you work for the NHS I must agree with you. The ex NHS HR people I have ever hired have been absolutely dire.

@BoredZelda

She doesn’t have a shred of fat on her, if she lost 20lbs she’d be horribly unhealthy

Not if the only thing she was losing was muscle mass.

Exactly, she could lose or gain weight and still be perfectly healthy. Sorry but anyone who thinks they are fitter and more muscular than Simone Biles and Serena Williams because of their day job as a dog walker is kidding themselves.

There are so many misconceptions on here about fitness and muscle, particularly in relation to women, it's unbelievable. How many times do i see the following exchange. OP - I've gone for two walks this week and I haven't lost weight Reply - You've gained muscle OP!

Doesn't work that way unfortunately.

@Paradii

Lots to consider here. I don't think I'll ask to change midwife; she was very pleasant and we got on well.

This just bothered me because I now feel like I look "fat" and I'm just going to look increasingly fatter, which I know is stupid. I wear size 10 clothes.

I just don't understand why my BMI is so high if it's not muscle. I'm half tempted to post a pic incase I'm seeing myself completely differently to how everyone else does!!

I don't think I'll ask to change midwife; she was very pleasant and we got on well.

Errm having a pleasant midwife is the very least you can expect from the service.

If you're not happy with the professional advice given, changing midwife is a far smarter move than asking MN (generally home of the food/weight obsessed).

MN is far too extreme when it comes to food/diet/weight.

It was just one thing she said at one appointment, it's not as if she kept going on about it at every appointment and tried to force OP to do it. I don't think OP needs to change if everything else is fine.

You see the midwife for quite a while, you can't expect to agree with every word they say. There will always be a few things where you just say "ok I'll consider that" and never think of it again. This phrase is also useful with health visitors.

In that case, why saying that @TreeSmuggler? What’s the aim if the MW is not supposed to expect the OP to actually listen to her and do something about it ‘because she didn’t mention it several times’ ??

That sort of comment can have huge impact in people.
It clearly has disturbed the OP. It’s not wo danger for the patient especially when it’s not associated with proper advice.

How many people on MN still angry/hurt by comments from a MW or a GP who told them they were too big/needed to loose weight and felt hurt about it still years down the line? As a HCP she should know you dint just throw a comment like that.

@Paradii

Lots to consider here. I don't think I'll ask to change midwife; she was very pleasant and we got on well.

This just bothered me because I now feel like I look "fat" and I'm just going to look increasingly fatter, which I know is stupid. I wear size 10 clothes.

I just don't understand why my BMI is so high if it's not muscle. I'm half tempted to post a pic incase I'm seeing myself completely differently to how everyone else does!!

If you are now feeling worried about being fat, she wasn't that pleasant.

Do not post pictures, do not spin out. See a doctor if you are concerned about your weight and get a different midwife.