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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To think that BMI is largely a load of twaddle?

57 replies

dizietsma · 20/03/2009 22:56

I think it's high time the medical establishment came up with a better way to monitor health, BMI is a misleading health index at best.

A while back I was talking to an Endocrinologist because I experienced a lot of hormonal disturbances after taking Depo Provera, and she mentioned that my BMI was high. I pointed out that I thought BMI is a very poor tool for understanding the health of an individual and several studies have elaborated on its inefficiecies. She agreed!

So why are we still using this flawed measurement?

"Illustrated BMI Categories" Set of Pics

OP posts:
cthea · 20/03/2009 23:00

No major decisions are made solely on the BMI. It's just an easy tool to use. And more palatable to be told your BMI is high than that you're overweight (kg/m2).

SENSESofTOUCH · 20/03/2009 23:01

BMI is not accurate, as muscle weighs more than fat, therefore athletes tend to fall into the 'overweight' or 'obese' categories.

I suppose we are still using it because nobody has yet come up with an alternative for measuring body mass, that better reflects health!

Original poster
dizietsma · 20/03/2009 23:05

"No major decisions are made solely on the BMI."

Yeah they are. I was referred to a consultant when I was pregnant purely because my BMI was high. I felt singled out and shamed.

OP posts:
notnowbernard · 20/03/2009 23:07

I think it is a probably an important tool when working with those who are underweight... ie people with a diagnosed eating disorder like anorexia

cthea · 20/03/2009 23:10

Why would you feel singled out? Did she announce it to a roomfull of people? And why shamed? If you need to see a consultant, that's how it is. You can always decline the referral if you feel it's not appropriate and it's all muscle. The consultant would be more than happy not to have wasted his/her time with someone he didn't need to see.

TigersEnglandChick · 20/03/2009 23:12

While I agree that notnowbernard has a point ...
According to BMI at this moment he was clinically obese if you believe BMI

jugglingwoman · 20/03/2009 23:13

When I was anaemic the consultant wrote that I was a 'young woman of Greek descent who has a raised BMI'. Then got round to obvious bit about me not eating meat and having periods. It annoyed me greatly as I was the thinest I'd been for ages and my weight had gone up due to my muscles from swimming. On the other hand, I know I was just being paranoid

SENSESofTOUCH · 20/03/2009 23:16

It is not helpful with eating disorders either...when you are very thin your natural build had more of an influence on your BMI. And the NHS bases the level of support for eating disorder patients on BMI, which means that many really ill people are not recieving treatment because of a number that is apparently too high to warrant treatment, however, that does not reflect the severity of an eating disorder AT ALL. I would say that is a pretty major decision based on BMI!!!

Original poster
dizietsma · 20/03/2009 23:18

I felt singled out because I had an absolutely healthy pregnancy, and latterly, birth. All my pregnancy I was fearmongered about the dangers of women with high BMI's and pregnancy. I feel it placed me at a much higher risk of unecessary interventions because of the bleak expectations of ill health.

Why shamed? Because there were disapproving tuts and tellings off from all health care professionals throughout my pregnancy because I had the audacity to get pregnant when not conforming to their idea of health.

I did not decline my visit, I went. I went and I showed them how wrong their assumptions had been!

OP posts:
doobry · 20/03/2009 23:20

My access to fertility treatment was determined by bmi which seemed fairly major to me. People are denied the right to adopt on the basis of their bmi.

dittany · 20/03/2009 23:20

This reply has been deleted

Message withdrawn at poster's request.

cthea · 20/03/2009 23:24

I think your problem is with how the info was communicated and with attitudes.

Senseooftouch - I don't believe anything is based on BMi to this extent. It must be a multi-disciplinary decision whether someone gets treatment or not, not just a simple BMI calculation. So what's the BMI cut-off then for getting treatment for eating disorders?

cthea · 20/03/2009 23:26

"They could measure body fat percentage instead which would be far more accurate."

Far more accurate for what?

"I think it's the medical profession being overly influenced by the fashion for extreme thinness rather than by any proper scientific understanding. " That's so ridiculous. Do you think they all read Heat rather than the Lancet?

notnowbernard · 20/03/2009 23:28

You are classed as dangerously underweight with a BMI of 16.5 and under

At around this point a woman with this BMI would probably stop menstruating. I think this is when you get given a diagnosis of anorexia nervosa (at the cessation of menstrual cycle)

cthea · 20/03/2009 23:31

Anorexia nervosa is mainly a psychiatric diagnosis, not based on either BMI or menstruations (men can have AN too). BMI is a tool to help you. But you will gather much more info from talking to the patient.

dittany · 20/03/2009 23:34

This reply has been deleted

Message withdrawn at poster's request.

notnowbernard · 20/03/2009 23:35

Yes, it is a mental illness

Obviously BMI alone is not the only diagnostic criteria

But a BMI of below 17 with an absence of a menstrual cycle gives a pretty strong indication that an ED is present (once other organic causes have been excluded)

Quattrocento · 20/03/2009 23:37

I am tall so I LOVE bmi

Was in a meeting with someone who comes out as morbidly obese by BMI criteria

He just looked totally normal to me. But short though.

Original poster
dizietsma · 20/03/2009 23:40

"I think it's the medical profession being overly influenced by the fashion for extreme thinness rather than by any proper scientific understanding."

Gotta agree with that one.

Sorry the link in OP isn't working, I can't seem to fix it, type "illustrated BMI categories" into google and check out the flickr set.

OP posts:
cthea · 20/03/2009 23:40

Dittany - I understand your more accurate than BMI. I should have asked at doing what? What exactly is body fat more accurate than BMI at? Give me a proper explanation. So overweight people live longer than "normal" weight people? Is this what you're saying? Links please. And how was overweight measured? Are you suggesting the categories of BMI normality are shifted? Or to ditch it altogether and use something else instead?

I know doctors are human but to imply they get influenced by fashion rather than science in their professional practice is ridiculous.

cthea · 20/03/2009 23:43

Notnowbernard - there, you see, you qualified that in so many ways, it's not just the BMI. Important decisions are not based only on that alone.

Please note that I'm only defending the blasted BMI because of the anti-science undertones in a couple of posts.

Original poster
dizietsma · 20/03/2009 23:44

"That's so ridiculous. Do you think they all read Heat rather than the Lancet?"

Ha!

  1. I worked in a hospital, and some doctors really do.

  2. Above point about reading other magazines and newspapers is quite correct. Just cos you're a doctor doesn't mean you live in cloistered isolation from media!

OP posts:
laza222 · 20/03/2009 23:46

I HATE the BMI! When I was at university, I had to go to the doctors fairly regularly for the contraceptive injection I was on and my BMI was between 15-17 at the time which is apparently hugely underweight and meant that I MUST have an eating disorder. The amount of times I had to sit there and listen to a doctor or nurse ask me in a patronising tone 'are you sure you don't have an eating disorder'...it made me so upset! It got to the point where I felt under so much pressure and stress to put on weight that I am sure I was losing weight from the stress.

There was one time when me and my partner were in an M&S cafe. We were just having a lunch and each had a wrap or a sandwhich and a muffin. I would have at this point already have snacked on crap all morning as my partner has always been a late riser, particularly as a student and I would wake up hours before him and eat loads of studenty junk such as crisps, left over pizza from the night before, any other crap I could find! I was physically trying to force feed myself to eat this muffin just because I felt I had to be seen to be trying to put on weight and because of a developed paranoia that everyone must think that because I was skinny, I was anorexic, because that was what the doctors were telling me. My partner eventually said 'for fuck sake (insert my name). This is ridiculous. You look in pain eating it. You aren't hungry so don't make yourself eat it, it's silly'.

When I moved back to my birth town I went to see a doctor or nurse for my contraceptive injection. When she came to weigh me I explained to her first that for the previous couple of years my doctors in my uni town had told me that my BMI was 15/16/17 and that it meant I must have a problem and she looked at me and said 'well have you always been naturally skinny'. I said yes and she shrugged and said 'well honestly, don't let it bother you. The BMI isn't that accurate. It was such a relief as I was (am) a pretty anxious person anyway and it had been playing on my mind for so long.

so for that reason I think YANBU as I hate the bloody system.

dittany · 20/03/2009 23:47

This reply has been deleted

Message withdrawn at poster's request.

SENSESofTOUCH · 20/03/2009 23:47

cthea...a BMI of 17.5 or less puts you into the anorexic category. And diagnosis of anorexia is based mainly on physical symptoms...which makes me

That is not to say that a thin person would be diagnosed anorexic with no psychological symptoms, but that somebody with all the psychological symptoms, and the same level of damage to their body, would NOT be diagnosed and therefore offered more options, if they did ot fall into the anorexic BMI range.